End of Life Care
Many states and counties are reeling from the increased expenses to continue providing healthcare to an aging inmate population. As the average age of US inmates increases, chronic disease and cancers escalate.
In an earlier post I talked about the basics of the aging inmate population. News articles pop up almost weekly about state correctional systems struggling with rising health care costs due to elder inmates and chronic disease.
A growing segment of the aging inmate population is those with cancer and other terminal illnesses requiring specialized care. Recently I spoke with Susan Loeb, PhD, RN, a nurse researcher implementing NINR granted funded research on end of life care in the PA Prison System [Correctional Nursing Today Radio Show]. Her research will lead to a toolkit for facilities to implement to develop a hospice program. It has been reported that at least 70 correctional facilities in the US have some type of hospice program with over ½ of them including inmate caregiver programs. Some facilities are partnering with community hospice services to provide needed staff education and specialty resources. Those with inmate caregiver programs have seen a positive impact on the attitudes and culture of both the inmate and custody community. An independent film was created following 3 dying inmates at the Kansas State Penitentiary. Edgar Berans, film producer, sites multiple positive outcomes of the program in a recent radio interview.
Some progressive correctional systems such as Washington State and California have already created assisted-living and long-term care facilities within their prison systems to accommodate these needs. Elderly inmates can fall victim to predatory younger inmates and require equipment such as wheelchairs and canes difficult to incorporate into a standard correctional system. Equipment of this type can be used as weapons if not properly managed.
Elder inmates also require environmental adaptations not usual in the correctional setting. They are unable to climb to top bunks and can become rattled or agitated by noise stress in prison barracks. Disabled inmates are challenged by stair or are unable to stand for long periods in the various lines that are a normal part of prison life.
How is your correctional system handling inmates at the end of life? Weigh in using the comment section of this post.
Transgender Inmates: He Said, She Said
THE SITUATION: You’re working medical screening for new detainees at a large urban jail. Your next case arrives for assessment with make-up and bright female clothing, although you also see male-pattern facial hair and muscle structure. What do you do?
Transgender individuals are over-represented in the inmate population. If you work in corrections, you are likely to come face-to-face with your attitudes and emotions about these individuals. Nursing ethical principles require those of us in the profession to provide nursing care with concern and respect for human dignity, no matter the life choices the individual has made.
Transgenders (also called trans or cross-genders) are individuals with an incongruity between their felt gender and their anatomic gender. The majority are male and can have a DSMIV diagnosis of gender identity disorder (GID). Your inmate-patient may be in the midst of hormonal therapy or have partial or complete sex reassignment surgery (SRS).
Conversation
Your first concern is how to address the person. Do you use the term ‘He’ or ‘She’? Though it may seem trivial, your sensitivity in this area will establish needed repoire. Often you can avoid using gender terms or you can clearly see which term to use. For example, the individual above is likely to desire to be referred to as ‘she’, especially if the clothing involves a dress or skirt. When in doubt, your best option is to ask the individual how they would like to be addressed. Let them be in control of this small issue – control of so much else is gone. Attempt to be as matter-of-fact and non-judgmental as possible in all interactions.
Destination
Unless your system has special facilities for the transgender inmate, such as the new 30-bed transgender Italian prison, administration will need policies in place to determine housing designation. This is a vulnerable population requiring some type of protective housing. The nature of the condition predisposes the inmate to a higher potential of assault or in-custody violence. In addition, those with GID are more likely to be depressed, suicidal or self-injurers. Keep this in mind when assessing these inmates for any health conditions.
Change Management
What if the person is in the midst of hormonal therapy or SRS? What responsibilities are there for maintaining or continuing escalation of therapy? Policies regarding transgender treatment differ among state and county systems. Investigate the policy at your facility before you need to use it. Discuss the situation with your manager and medical director.
In a recent survey of correction system policies about transgender treatment, the majority of responding facilities had policies for the continuation of hormonal therapy, at least at the current level. Abrupt discontinuation of hormonal therapy can lead to physical and psychological side effects and should be avoided. Many facilities will use a ‘freeze-frame’ approach which continues the current therapy but does not escalate or advance the gender-change process.
Autocastration – Medical Emergency
Be aware that disturbed individuals may resort to autocastration or autopenectomy to reduce testosterone levels. The elasticity of the testicular arteries allows them to retract into the perineum making it very difficult to staunch the flow. Emergency transport, critical care and blood transfusion may be necessary.
More Resources on Transgender Treatment
Transgender Guidelines from NCCHC
Is My Patient Faking It?
Unfortunately, correctional nurses must be wary of a variety of motives behind inmate-patients seeking medical or mental health treatment. Malingering is defined as the intentional falsification or exaggeration of symptoms for external motives or secondary gain. There is a high incidence of malingering in jails and prisons. A reported 20% of mental illness in corrections is malingering.
Reasons to Fake Illness
There are many reasons an inmate may fake a mental or medical condition. The first that usually comes to mind is to procure drugs. Separated from preferred mood enhancers such as alcohol or barbiturates, inmates seek other avenues of relief. Seroquel (Suzie-Q) is an example of a current favorite that may be sought through feigning mental illness or psychosis.
However, in the prison system secondary gain can include other, more benign desires such as special creams, lotions, or supplements. One prison system I worked in had a problem with overuse of nutritional supplements (such as Ensure). It was discovered that it brought a high price on the facility black market as bodybuilders thought it would help them bulk up.
Illness can also bring desirable housing locations or work release. Trips to hospital or specialists provide avenues for escape attempts or a chance for a ‘vacation’.
Some inmates may exaggerate symptoms because they think they will not get attention in the system unless they are in severe distress. A true medical condition exists but not as intense as it is being portrayed.
A Nurse’s Best Response
A good principle to follow is to “Trust no one but give everyone the benefit of the doubt”. This is key to maintaining the right level of professional objectivity, writes Melissa Caldwell, PhD, in a recent article for the Society of Correctional Physicians. Here are some tips to help you maintain objectivity in the face of potential malingering:
- Do a complete nursing assessment. Do not disregard any medical complaint as faking. Always respond.
- Thoroughly document all objective and subjective data. Repeated questioning now or later may reveal inconsistencies or validate findings.
- Review prior documentation and history for comparison or evidence of drug-seeking behaviors.
- Portray empathy. You do, in fact, want to get to the bottom of the issue and provide correct treatment.
- Avoid giving clues that will make them a better malingerer.
- Err on the side of safety. Provide a period of observation (such as in the infirmary or holding area).
- Always question yourself. After 3 false ‘chest pain’ complaints – this could be the real one.
Remember, determining malingering is not a nursing function. Assessment, referral or treatment based on protocol are nursing actions. As in the game of baseball – play your position.
Why It‘s Important
Getting to the bottom of potential malingering is important in order to eliminate the waste of valuable resources and time that could be more effectively used elsewhere. Correctional nurses can help eliminate inmate malingering by taking careful histories and assessments, documenting responses for comparisons over time, and collaborating with medical and mental health staff to develop appropriate interventions.
More Resources on Malingering
Lockup Doc http://lockupdoc.com/tag/malingering
All Nurse: http://allnurses.com/correctional-nursing/print256963.html
CorrDoc: http://www.corrdocs.org/framework.phppagetype=newsstory&newsid=12160&bgn=2
Lawofficer.com: http://www.lawofficer.com/news-and-articles/columns/Kulbarsh/malingering.html
Journal of Family Practice: http://www.jfponline.com/Pages.asp?AID=2821#1
Psychopharmacology: http://www.acbhcs.org/Psychopharmacology/2005/June2005.pdf
Responding to Inmate Sexual Assault & Prison Rape
Fear by Tetine
The statistics on prison rape are shocking. According to the 2007 Department of Justice study, 4.5% of all state and federal inmates experienced at least one incident of sexual victimization. That is nearly 1 in 20 inmates. My first reaction to the information was to assume this was inmate on inmate victimization, but this is only part of it. More assault is reported involving facility staff (2.9%) than inmate perpetrators (2.1%).
The Prison Rape Elimination Act (PREA) was passed by the US Congress in 2003 and legislates actions to be taken by corrections personnel to prevent and respond to sexual assaults. PREA also established a Commission to monitor the process of preventing rape in the country’s jails and prisons. How can correctional nurses respond?
What is Considered Prison Rape?
Any unwanted sexual contact between inmates is considered prison rape. This can include fondling of genitalia or even instilling fear of rape. It does not necessarily have to be full penetration and does not require force to be defined as prison rape.
There is an even higher standard for staff on inmate sexual contact. ANY sexual contact between a staff and inmate – even if consensual – is considered prison rape and can be prosecuted. Be clear for yourself and your work-mates – there is NO permissible level of sexual contact with an inmate. Staff members have been prosecuted and sentenced for writing sexually explicit letters to inmates. A recent example of progression into illegal sexual contact is described in this article.
Who is a Likely Rape Candidate?
As you might expect, studies confirm that the likely inmate sexual assault victim is young, a first time offender, and of small build. In fact, juveniles in adult prisons have a 5 times higher chance of being a rape victim. If you have juveniles in your facility, keep this in mind when you are providing care. Be on the look-out for indications of having been assaulted. Some prisons automatically take protective actions for any juveniles who have received adult sentencing. This is also true for transgender, mentally ill, or developmentally disabled inmates. Be alert when assessing and evaluating any of these categories of inmates.
Impacting Healthcare
Every one of our inmate-patients is at risk for sexual assault or rape and may seek medical treatment for it. We need to be alert to the possibility and ready to respond. Here are a few clinical situations to consider
- An inmate arrives in sick call with a vague complaint – she is depressed, nauseous, agitated, or exhibit other traumatic stress responses
- While working in the segregation unit, you see a generally compliant inmate break rules toward the end of his seg stay, seemingly intent on extending his time
- A young inmate begins covering himself with feces. After mental health evaluation it is discovered that he uses this as a protective mechanism against repeated rapes by his cell mate
Action You Can Take
Be familiar with your DOC procedures before you are confronted with a sexual assault situation. That way you will know what mechanisms to put into action. For example, you may need to inform the shift commander. Many places have a sexual assault response team consisting of a mental health provider, law enforcement professional and medical provider.
Document clearly the statements made by the individual. Allow them to vent without moving into investigative mode and asking questions. Asking questions too early may cause a victim to retreat and close down.
Arrange for a sexual assault evaluation, including a rape kit if the report is within 96 hours of the assault. A specially trained individual should perform this function as forensic evidence will be obtained. In some facilities arrangements must be made to send the inmate-patient out to a hospital emergency room for this procedure.
Arrange frequent mental health follow-up for post traumatic stress responses.
Unfortunately, not all healthcare staff, correctional officers or administrative staff consider sexual assault an important issue. You may encounter conflict in your attempts to advocate for the victim. Be reminded, and remind your corrections colleagues, that being aware of the situation and not responding is both unconstitutional (Eighth Amendment) and illegal (PREA). In addition, as nurses, we have a moral obligation to act in a rape situation. Sexual assault is not a part of the punishment. We need to respond compassionately as any prudent nurse would in a community situation.
Have you have an experience with a prison rape situation? Share your story in the comments section.
Ethical Dilemmas in Correctional Nursing
I recently had the opportunity to be interviewed for the KindEthics Radio Program. We had an interesting discussion about ethical dilemmas unique to nurses (and doctors) working in corrections.
Basis of Ethical Care
Two basic principles of ethical care are beneficence (acting only for the benefit of the patient) and nonmalfeasance (do no harm to the patient). In the course of working in a security environment, an ethical dilemma can arise when the goals of custody administration seem to conflict with these principles. A code of ethics specific to correctional healthcare was created by the American Correctional Health Services Association (ACHSA). Lets look at just a few examples of ethical dilemmas that may be encountered.
Body Cavity Searches
Healthcare staff may be asked to perform searches of rectal or genital areas for contraband items such as drugs or weapons. This action would not be of benefit to the patient and has no health purpose. Professionals may have concerns that these searches done by custody might injure or harm the patient. However, there is general agreement that body cavity searches should not be performed by healthcare staff that have a patient-provider relationship with the inmate.
Collecting Forensic Information
Along the same lines, requests can be made to assist with collecting forensic evidence to be used against the inmate, such as blood tests, DNA analysis or psychological evaluations. Providing such services would constitute a conflict of interest for the care providers working in the facility. Resources outside the facility medical unit should be accessed to provide these services.
Executions
Fortunately most states executing the death penalty have moved to the use of outside providers for monitoring and initiating lethal injection. All authorities agree that participation in executions is inappropriate for healthcare staff with a patient-provider relationship to the inmate population.
Hunger Strikes
Ethical conflict can develop regarding treatment choices during hunger strikes. Most certainly, monitoring the health status of a striking inmate would be beneficent and nonmalfesent care. The dilemma begins if healthcare staff are asked to force feed (tube feed) the starving inmate. Practitioners are mixed on a response to this request. Although there is no clear consensus, the ACHSA has adopted a position statement advocating force feeding in some situations. The Federal Bureau of Prisons has a program statement on hunger strikes indicating force-feeding is a medical decision based on emergent life threatening criteria.
Inmate Discipline
Involvement in inmate discipline can also result in an ethical dilemma. For the most part, healthcare staff should not be involved in disciplinary action or disciplinary committees determining actions in the facility in which they work. However, involvement becomes necessary when a staff member has witnessed or is the receiver of wrongful action. It is appropriate to provide factual objective testimony in order to maintain security in the facility and the safety of other inmates and staff members.
Patient Confidentiality
Healthcare providers often get queries from custody staff about the health condition of particular inmates usually related to infectious diseases or mental health. Information can also be spread through knowledge of the type of services provided to specific inmates or special needs issues (bottom bunk, food privileges, etc). In these situations it is important to carefully share needed information which will minimally jeopardize patient confidentiality. The specific need can be shared (bottom bunk) without sharing the diagnosis (epilepsy).
What other ethical dilemmas might be experienced in correctional practice?
Shackling Inmates in Labor? What’s Up with That?
Shackling laboring inmates has been an issue for some time in corrections and is getting press due to coverage in New York. Last week they became the sixth state to ban the use of shackles during labor except is special situations. The ACLU and other prison watch groups have been actively pursuing a change in this corrections practice. It is one of many ethical dilemmas correctional nurses become involved with. Unlike in hospitals, healthcare is secondary to security and safety in the running of the correctional facility. The Department of Corrections and custody officers can have a very different perspective on any given situation from the healthcare providers. A ‘Command and Control’ attitude can be quite challenging to deal with.
Shackles are for Outside the Walls
Some clarification is necessary to the uninitiated. The news articles make it appear that the women are INSIDE the prison giving birth and being shackled. Unless referring to the few prison hospitals around the country, what is really happening is that the women have been transported to the hospital to give birth. They are therefore outside the security perimeter of the prison and there are standard precautions in place to decrease the chance of escape and to reduce the need for a large number of officers to attend them. Those standard precautions include handcuffs and shackles.
Standard Security Procedure
Now those of us who have given birth know that it is highly unlikely that a women in true labor is going to have the wherewithal to evade an officer in the L&D Unit and escape into the community. However, inmates have been known to be very creative in their escape plans. No corrections officer wants to be the one on duty when an escape takes place. Therefore,the custody officer is going to use standard procedures (IE shackles) unless special directives are issued – thus the need for specific policy to be in place regarding the laboring inmate in the community.
Advocating for Change
I’m not really an advocate for legislation for everything so the idea of getting legislation about this in all 50 states seems a bit much to me. However, the Federal Bureau of Prisons and 5 other states so far have specific policy or legislation allowing the laboring inmate to be free of shackles. The visibility of the New York situation may speed the adoption throughout the country – that is a good thing. The Rebecca Project for Human Rights has also taken up the call and been instrumental in facilitating the New York State legislation. A listing of specific state by state information was recently posted by the Crime Reporter.
Can Correctional Nurses Care? – Part II
Caring for and about the inmate population has a variety of challenges to overcome. Besides the dilemma of caring for a criminal, there is the issue of showing care and concern to this population.
‘Warm and Fuzzy’ is Not the Way to Care for Inmates
Many healthcare environments allow, and even encourage, physical expressions of caring such as touching the arm, patting the shoulder, or holding a hand during a painful procedure. These are not appropriate caring behaviours in the corrections setting. These actions in the correctional setting can frequently be sexualized and misinterpreted as making advances. Touching the patient is limited to necessary procedures and treatments.
Firm, Fair and Consistent
Verbal interactions with inmate patients require similar boundaries. Idle chat or asking personal questions which may come naturally in other care settings are inappropriate in corrections. Being firm, fair and consistent in all communication with the patient reduces misinterpretation. A goodly amount of inmates have socially deviant or manipulative behavior patterns. This group of inmates will prey on staff members with insecurities or poor self-esteem. Being ever vigilant to deflect these behaviors can establish the necessary boundaries for good nursing care.
Caring by Protecting from Themselves
Another avenue of caring in correctional nursing is though protecting the inmate from breaking custody rules. Establishing and maintaining barriers in the care environment prevents access to contraband or opportunity for theft. Keeping narcotics, sharps, syringes, and dental equipment under constant observation or locked away prevents the inmate from taking a foolish action that could cause harm to themselves or others.
Caring by Advocating within the Custody Environment
My final thought is that correctional nurses care through advocacy for inmate healthcare needs within the custody environment. I have great respect for my custody colleagues – they provide protection and safety 24/7 in very challenging situations. Sometimes the goals of security and healthcare conflict. Depending on the situation, advocating for a patient’s health need can be percieved as counter to the immediate security needs or the general goals of the facility. Challenging the status quo in these circumstances is an act of caring.
What other ways do you think correctional nurses care for their patients? Leave a comment
Can Correctional Nurses Care? – Part I
The American Nurses Association defines nursing as
…the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations (emphasis added)
Quite a mouthful, and quite a challenge to deliver in a correctional setting. Some may ask if nurses working in corrections can truly ‘care’ for their inmate-patients, considering the circumstances for which they are incarcerated. Thus is the generation of several ethical dilemmas for this nursing specialty.
Providing Care to Criminals
A major challenge for any correctional nurse is to see the inmate-patient as a human being in need of healthcare at this point in their lives without regard for their conviction. Just as in any other healthcare setting, the patient does not recieve care based on the goodness or badness of their life actions or choices. In other settings, the nurse is not aware of past law violations of patients - whether they cheat on their taxes, run red lights, or are cruel to neighbors or pets. Delivery of quality nursing care is a goal to strive for no matter the characteristics of the patient.
In fact, I recommend that nurses working in corrections make a point of not knowing the reason for the patient’s incarceration – it can only cloud your vision for delivering good care. That does not include level of security, by the way. Always be aware of the level of security for the facility or area in which you are practicing. Safety is of first concern and must be attended to at all times.
What do you think? Are you a correctional nurse or could you be one? What would the challenge be in caring for a criminal?
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BlogTalkRadio Podcasts- I Can't Eat That! Food Allergies in Corrections - Dec 22,2011 December 22, 2011Jeffrey Keller, MD, FACEP, discusses the thorny issue of self-reported food allergies in the correctional setting. There are many misconceptions about what constitutes a food allergy. In addition, food preferences can be inappropriately identified as an allergy. How should correctional nurses sort out food allergies? Dr. Keller is the president of Badger Cor […]CorrectionalNrsgTday
- Are Correctional Nurses Outcasts? - Oct 04,2011 October 4, 2011Lorry chats with Kevin Connor, BSN, RN, CCHP, President of the California-Nevada Chapter of the American Correctional Health Services Association about the image of correctional nursing. Keven is Communicable Diseases Coordinator for the San Bernadino Sheriffs Department and works out of the West Valley Detention Center in Ranco Cucamonga, CA. The CA-NV ACHS […]CorrectionalNrsgTday
- Aging, Stressors and Inmate Health - Sep 17,2011 September 17, 2011Lorry talks with Dr. Tina Maschi, assistant professor at the Fordham University Graduate School of Social Service in New York City about her work on behalf of prisoners. She is a 2010 recipient of the competitive Hartford Geriatric Social Work Faculty Scholars Program Award, which is funded by the Hartford Foundation and the Gerontological Society of America […]CorrectionalNrsgTday
- Correctional Nursing in the UK - Aug 29,2011 August 29, 2011A chat with Ann Norman, SEN, RGN, a long time prison nurse now advising the Royal College of Nursing where she assists in the development of policy, support members locally and nationally across the 4 UK countries. In her role she actively supports the interests of prisoners and detainees, prison and police custody nursing staff, individuals who have a learn […]CorrectionalNrsgTday
- Thoughts on Correctional Nursing from the ACA Exhibit Hall - Aug 28,2011 August 28, 2011Lorry roams the Exhibit Hall at the 2011 American Correctional Association Conference in Orlando tracking down correctional nurses. They share advise for nurses new to the specialty.correctional nursing | American Correctional Association | Lorry Schoenly | corrections | nurse interviews […]CorrectionalNrsgTday
- Tales from the Jail: Inside Jail Nursing - Jun 30,2011 June 30, 2011Paul "Trey" Flores, BSN, RN, CCHP shares an insider look at nursing in couny jails and detention facilities. He should know, having worked a variety of these settings from small 400 inmate sites to those with over 3,700 average daily population.Jail Nursing | Correctional Health Care | Correctional Nursing | Trey FLores | Lorry Schoenly […]CorrectionalNrsgTday
- Critical Thinking in Correctional Nursing Practice - May 26,2011 May 26, 2011Lorry interviews Tre’ O’Brien, BSN, RN, CCHP-RN about her work in developing critical thinking skills for correctional nurses. Tre has been a registered nurse for over 23 years with experience in nursing including acute care, outpatient services and management. She has worked in correctional nursing for the past 16 years and currently practices as a clinical […]CorrectionalNrsgTday
- Understanding Inmate Seizure Disorders: Considering Psychogenic Causes - Apr 07,2011 April 7, 2011Guest Gregory Famiglio, MD discusses his experiences with seizure management in the inmate population, especially the challenges of psychogenic seizures and the female population. Dr. Famiglio practices in a female prison in the Pennsylvania Prison System. Seizures | Psychogenic | Corrections | Lorrys Schoenly | Gregory Famiglio […]CorrectionalNrsgTday
- Healthy Inmates 2020 - Mar 25,2011 March 25, 2011In this episode Lorry talks with Susan Tiona, MD, who is heading up a project which applies the Healthy People 2020 effort to the US inmate population. Dr. Tiona is a family practice physician currently practicing in a medium security prison in Colorado. More Healthy Inmate 2020 info can be found at their website: http://www.healthyinmates.org/Healthy Inmate […]CorrectionalNrsgTday
- Psychiatric Emergency Response: Just In Time Intervention - Feb 17,2011 February 17, 2011Kat Major is an RN working a mobile unit that intervenes in psychiatric emergency situations in California. Psychiatric Emergency Response Team (PERT)members ride with law enforcement during off-hours to respond to calls concerning mental health clients. Learn more about this unique service and the corrections connection.correctional health care | lorry scho […]CorrectionalNrsgTday
- I Can't Eat That! Food Allergies in Corrections - Dec 22,2011 December 22, 2011
- Correctional Nursing Today Podcasts
- HIV Treatment in Jails and PrisonsOriginally Aired January 13, 2011: Josiah Rich, MD, MPH, of Miriam Hospital and Borwn University talks about his research in preventing and treating HIV in the inmate population. Dr. Rich is the director and co-founder of the Center for Prison Health and Human Rights at the Miriam Hospital Immunology Center and is recent recipiant of one of 12 NIH grants to […]
- Improving Clinical Communication in CorrectionsOriginally Aired December 16, 2010: Effective communication improves patient safety and assures quality care, yet is a great challenge in the sometimes fragmented correctional healthcare system. Idaho Prison System nurse leaders share their tips for improving clinical communication including using the SBAR model for nurse-physician interactions. […]
- Reducing Legal Risk for Correctional NursesOriginally aired November 20, 2010: Valerie Lane, RN, CLNC, discusses legal risk for correctional nurses. Valerie is a certified legal nurse consultant specializing in correctional cases and has worked many years in the California Corrections System. […]
- Cancer Care Behind BarsOriginally aired October 27, 2010: A chat with Gail Kwarciany, RN, MSN, about her work with inmate cancer patients at UTMB, Galveston. Discussion includes the challenges of cancer care behind bars and the special needs of inmates with cancer. […]
- Infusing End of Life CareOriginally aired August 31, 2010: Susan Loeb, PhD, RN, discusses the National Institute of Nursing Research Grant funded project to include End-of-Life Care in corrections. Dr. Loeb is Associate Professor of Nursing at the Pennsylvania State University and Faculty Affiliate in the Gerontology Cneter and Bioethics Program. She is Principle Investigator for th […]
- Failure to RescueOriginally aired August 19, 2010: Sue Smith, RN, MSN, CCHP-RN, joins Lorry to discuss the issue of failure to rescue. First recognized in acute care facilities, failure to rescue has come to be associated with understaffing, lack of communication, healthcare staff who become overly task oriented and to lack of vigilance. In the correctional setting, inmate-p […]
- Inmate Health Perspective with Author Piper KermanOriginally Aired July 14, 2010: Piper Kerman, author of the memoir "Orange is the New Black" discusses her book and experiences in a federal prison, focusing on the healthcare perspective. […]
- Exploring Juvenile Correctional NursingOriginally aired July 1, 2010: A chat with Ellyn Presley, RN, CCHP, Public Health Nurse at Prince William County Juvenile Detention Center. Ellyn has worked in Juvenile Corrections for almost 20 years and is very active in professional correctional health care activities. […]
- Correctional Nurse TrailblazerOriginally aired June 17, 2010: Lorry chats with Jackie Moore, PhD, RN, CCHP-A, CCHP-RN, about the beginnings of organized correctional healthcare. Whe was there at the start! Dr. Moore has over 3 decades of nursing experience primarily in corrections and started the first correctional healthcare company providing services to facilities in the northeast. She […]
- Double Down on TB in JailsOriginally posted 06-02-2010: Janice B Hill, RN, MPH, is a correctional nurse leader with nearly 3 decades of experience with the Pinellas County Sheriff's Office in Largo, FL. She is an active nurse educator frequently presenting on juvenile standards for the National Commission on Correctional Health Care. She was instrumental in the development of Fl […]
- Preventing Suicides in Jails and PrisonsOriginally posted 05-06-2010: Lorry talks with Anne Hanson, MD, about strides made to reduce suicide in corrections. Dr. Hanson is the director of the University of Maryland's forensic psychiatry fellowship program and chair of the American Academy of Psychiatry and Law's correctional psychiatry committee. She has worked in correctional psychiatry […]
- Talking About Jail NursingOriginally Posted 04-14-2010: Becky Pinney, MSN, RN joins Lorry to provide an insider look at jail nursing. Becky is currently President, Metropolitan Corrections Systems, for Prison HEalth Services with multi-facility responsibilities for PHS sites and regions. In her current position, she is responsible for the oversight and direction to facility-based sta […]
- ANA Correctional Nursing StandardsOriginally posted 03-19-10: Lorry talks with Catherine Knox, MS, RN, CCHP-RN, about the latest revision of the Scope and Standards for Correctional Nursing. Catherine has 22 years of correctional nursing experience in a variety of settings. She was the Statewide Director of Nursing for the Washington Department of Corrections from 2004 until the Fall of 2008 […]
- Is Prison Nursing for Me?Originally Posted 02-18-2011: Margaret M. Collatt, BSN, RN, CCHP-RN/A, joins Lorry to talk about correctional nursing in the prison setting - What it takes to be a Correctional Nurse. Margaret has over 26 years of correctional healthcare experience and was the Health Services Manager at the Oregon State Penitentiary for 8 1/2 hears. She has developed and ins […]
- Dealing with EmergenciesOriginally Posted 02-09-2010: Lorry interviews SUsan Laffan RN, CCHP-RN/A about how to handle emergency medical issues in a correctional facility. Susan has been a registered nurse for 28 years. She has worked in the ED for 28 years and correctional nursing for 18 years. Susan is currently the chairperson of the Academy of Correctional Health Professionals. […]
- History of Correctional NursingOriginally posted 01-21-10: Mary Muse, MS, RN, CCHP-A, joins Lorry to talk about the hisory of the correcitional nursing specialty and its future direction. Mary has over 14 years of correctional health care experience and was the Chief Nursing Officer for the Cook COunty correctional system for a dozen years. She currently works in the Wisconsin State Priso […]
- HIV Treatment in Jails and Prisons
Lorry Schoenly
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News Briefs- They call us 'jail nurses' January 13, 2012
- Pennsylvania county OKs inmate medical costs program January 13, 2012
- Ensuring standards are standard behind bars January 13, 2012
- Academy seeks scholarship applicants January 13, 2012
- Study: Why is alcohol addictive? January 13, 2012
- California convicts arrive in Los Angeles County with costly mental illnesses January 13, 2012
- Do no harm — and keep an eye on costs January 13, 2012
- Xanax abuse and addiction January 13, 2012
- Prometa protocol: Not effective for meth dependence? January 13, 2012
- Brain activity linked to delusion-like experience January 13, 2012
Corrections One- Contraband: Cell phone carrier pigeonThis photo, taken by the Sao Paulo State Prison Affairs Department, shows a live pigeon carrying a makeshift backpack with a cell phone in it.The bird was caught flying into a prison in Sao Paulo, Brazil. In Sao Paulo, gangs frequently use carrier pigeons to smuggle phones behind bars. Tell us: Have you ever seen something like this at your facility?Have you […]
- Top 3 challenges for women in corrections in 2012I have worked in male dominated professions my entire life. I started in a county jail in the 80s where the only women were me, the nursing staff and a former Jail Matron who had managed to work her way up to Assistant Superintendent. When I got there in the 80's, I had little trouble adapting to jail life. The inmates seemed receptive but I faced chall […]
- 4 correctional healthcare game changers from 2011By Lorry SchoenlyAnother year is here and we can look back on plenty of correctional healthcare news from 2011. What top stories from the past year are most memorable to you? Here are my top picks for 2011 game changers along with suggested action to reduce their impact. #1 Legal eagles rule the roost Healthcare is now the most common legal issue raised by i […]
- Top 10 corrections resolutions for 2012By Robert HoodAs 2011 comes to an end, it is time to make plans for 2012. Many people are thinking of resolutions for the New Year. Each year millions of adults resolve to "get in shape" or "lose weight." While the effort to adopt resolutions shows an optimistic sense of good intent personally, the same idea can be applied to your profess […]
- 5 most dangerous contraband items of 2012By Joe BouchardIt is easier to look back than to look forward. No matter if you are Nostradamus or Jean Dixon or even the modern-day psychic Sylvia Browne, making predictions for coming times can be tricky. This is especially true if your ego makes it difficult to commit an error.No Nostradamus am I! Still. I can make two predictions for the year 2012. First […]
- Private corrections: We can do it better and cheaperBy Charles AlbinoIn the first segment of this series, I detailed some of the conditions that led to the formation of private companies to operate correctional facilities in the United States. As we move forward in Part 2, we will hear from the private sector and why they believe they merit a "place at the table" in correctional facility operations. […]
- When officials fall from graceBy Cherrie GrecoWhen well-known officials fall from grace, members of the general public express a variety of emotions and impose vigorous vocal judgment. Feelings of shock, disgust, and disappointed head-shaking are commonly exchanged at the water cooler. Faith in a system once trusted becomes fragile; trust caves in and is replaced by cynicism. In time, th […]
- Success with one is success with manyBy Eugene AthertonI remember a promotional interview for Warden in our correctional system. I suggested that effective leaders encourage successful relationships among staff in order to achieve success. When asked how that could be done, I answered, "One relationship at time." Now, at the time I was not sure of the meaning of the statement. It soun […]
- Top 10 corrections stories of 2011: A look backBy Carol McKinley Stories come and go throughout the year on our website, and there are so many, sometimes we forget them. So CorrectionsOne looked back at the most popular stories of the year and called the people and facilities involved to get an update. Here's a look back at the top stories of 2011. 1. The 23-year-old California woman who police say […]
- California corrections 2011: A year in reviewBy Bob WalshThis has been a momentous year for the profession within the formerly great state of California. Monumental. Nearly overwhelming. Maybe even disastrous. It depends a lot on who you ask and from which side of the issues you are looking.The Books Not Bars crowd is no doubt deliriously happy about the near-total demise of the Division of Juvenile Ju […]
