Dealing with Inmate Food Allergies
Food allergies can be a real challenge for correctional nurses. It is important to document these allergies during intake screenings and put safeguards in place to avoid allergic reactions behind bars. However, inmates can report food allergies that are really preferences (I’m allergic to bologna sandwiches) or food intolerances (I’m allergic to onions). How can true allergies be sorted out from among the many reported?
I recently interviewed Dr. Jeff Keller, correctional physician from Idaho Falls, ID, about the issue on the Correctional Nursing Today Radio Show. This episode is full of interesting and important information for correctional nurses. I highly recommend you download or livestream the 30 minute program. Here are some important points from my notes of the session.
- There are IgE mediated and non-IgE mediated allergic reactions. The medical concern is with IgE mediated allergies, which involve immune system mast cells that respond violently to contact with the allergen. Check out this animation to remind you of the IgE allergic reaction process.
- Peanuts make up 85% of food allergies. The remaining 15% are from tree nuts and shellfish. Other food allergies such as fin fish or strawberries are rare.
- Almost all food allergy deaths happen to teenagers and those in their early 20’s.
- Allergic reactions include hives, angioedema and asthma/wheezing.
- Ways to test for true allergy include a food confrontation test and skin prick testing. There is also a fairly inexpensive blood test for IgE circulating levels.
- Epinephrine is the main treatment for a life-threatening food allergic reaction.
Managing Food Allergies Behind Bars
If an inmate is determined to have a peanut allergy, a peanut-free diet is needed. However, precautions do not end here. Cellmate assignment and work detail must also be considered. This inmate may not be able to be housed with other inmates who have peanut products in their possession. For example, peanut butter and peanut butter products such as sandwich crackers may be available in the commissary. A peanut-allergic inmate may not be able to be assigned kitchen duty if peanut products are present. Shellfish and tree nuts are fairly easy to deal with as pecan-crusted shrimp are rarely on the menu. However, peanut butter is an inexpensive protein source in frequent use in corrections.
Preparing for an Allergic Reaction
A coordinated response to food allergies is needed in every facility. Dr. Keller recommended a protocol be developed addressing actions custody and medical staff will take to respond to true food allergies. Besides diet, housing and work detail issues, a coordinated emergency response to a reaction is needed. Epi pens are the standard mechanism for emergency treatment of an allergic reaction. Inmates are not able to carry needles on their person so the location and accountability for epi pens should be considered. Housing officers may need to have pens available and know how to use them. Correctional nurses may need to provide information and demonstration of epi-pen use. Officers are also likely to be the first responders in an allergy emergency. They need to know the signs of allergic reaction so that they can act quickly to summon assistance and administer epinephrine.
How has your facility dealt with food allergies? Tell us your experiences using the comments section.
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New Latent TB Regimen from CDC: Good News for Correctional Nurses
The Centers for Disease Control and Prevention (CDC) announced recommendations for a new treatment option for latent tuberculosis infection (LTBI) this past week. These recommendations are welcome news for correctional nurses challenged with managing LTBI treatment for their inmate population. Correctional nurses are in contact with a significant portion of the more than 11 million people in the US who are infected with the TB bacterium (4% of the population). Reports clock the incarcerated TB infection rate in US prisons at least 4 times higher. This rate is escalated further in under-developed countries. Improving behind-bars treatment of LTBI can significantly improve public health, in addition to the immediate benefit of decreasing infection transmission to inmates and corrections staff.
The current medication regimen for LTBI treatment is onerous, especially in secure settings. Treatments can last for 9 months and require daily doses of one or more mediations. The serious nature of tuberculosis makes this treatment most often given by direct observation, requiring the patient to be transported to the medical unit daily and observed taking the medication. The new guidelines still require DOT administration, but now the medication is only needed once weekly for 12 weeks for most patients with LTBI. This is a much more efficient regimen for the correctional setting.
New CDC Recommended Treatment for LTBI
- Isoniazid (INH) and rifapentine (RPT) – a long acting rifamycin-class antibiotic
- Once weekly in direct-observation dosing for 12 weeks
- Monthly clinical appointments for side effects and physical assessment
Patients Inappropriate for this Regimen
- HIV-infected patients receiving antiretroviral treatment
- Pregnant women
- Patient with LTBI and presumed INH or RIF resistant
- Children under 2 years
The CDC is currently collaborating with the Infectious Diseases Society of America and the American Thoracic Society to update their guidelines to include these recommendations. In addition, it is likely that the Federal Bureau of Prisons (FBOP) will include these significant changes in the next update of their January, 2010 Clinical Practice Guidelines.
2012 will be a good year to re-evaluate and revamp your TB clinical processes. How will these new guidelines change your practice as a correctional nurse?
Photo credit: George Kubica/CDC
On Interruptions and Correctional Nursing
A nurse stands at a small window in a small room with shelves around the interior. Lined up at the window, much like a bank teller’s queue, are inmates waiting for their morning pills. An MAR (Medication Administration Record) is in front of the nurse on her side of the window, with pages organized in alphabetical order by patient last name. The nurse must positively identify the patient by photo ID card, organize the medication to be delivered for this patient on this date and time, and collect the pills from various single dose bubble-packs into a paper soufflé cup. She hands the medication to the patient with a paper cup of water. Fortunately for this correctional nurse, the custody officer in charge of the pill line does the oral cavity check to be sure the patient does not ‘cheek’ the medication for sale on the prison black-market. All this happens in less than a minute. This nurse must administer medication to almost 200 inmates in the course of 2 hours.
The daunting daily task, performed by hundreds of correctional nurses every day, is complicated by distracting noise and frequent interruption. This medication room in a county jail also doubles as a nurse’s station. The medication nurse is working where other nurses are sharing report and physicians are stopping by to change orders and ask about patient status.
A recent study published in the Archives of Internal Medicine tracked the toll of interruptions on medication errors by viewing nurses administering medications in 2 hospital settings. Each interruption was associated with a 12.7% increase in clinical error. When three interruptions occurred in the administration of a single medication there was a 38.9% rate of error. Nursing experience played no part in the error rate. It was consistent for new nurses and those with years of experience. This is astounding objective data to support efforts to reduce interruptions in the medication administration process.
Here are some ideas for reducing interruptions in medication administration that might be applicable in the correctional setting:
- Establish Quiet Times when medications are being administered in a public area. Ask staff members to commit to evacuate the area while pill line is in effect.
- Place posters indicating Quiet Time is in session as a visual alert. (No, you can’t keep them up all the time!).
- Have the medication nurse where an item of clothing, such as a brightly colored vest or apron, when administering medications. No staff member can approach a nurse when wearing this vest.
- Educate all staff members to the patient safety basis of uninterrupted medication delivery.
- Educate custody staff and patients of the need to decrease nurse interruptions during medication administration processes.
What do you think? Can we reduce interruptions in medication administration in corrections?
Photo Credit: © Dana Heinemann – Fotolia.com
Even Minimal Exercise is Important
Even small amounts of regular physical activity can have big benefits for your patients, according to research recently published in the Lancet. That means correctional nurses should be encouraging physical activity for all inmate-patients, and especially those with chronic conditions such as cardiovascular disease. The astounding news is that even 15 minutes a day of low-level activity 6 days a week can ‘reduce all-cause mortality by 14%, cancer mortality by 10%, and mortality from cardiovascular disease by 20%.” (pg 1202). Holy smoke, that is good news for our patients in confinement or with exercise-limiting disability!
A big factor in starting and increasing physical activity among patients is simple and repeated advice to do so. Correctional nurses are the health care professionals most likely to be in contact with inmates. Be sure you have a game plan that includes regular reminders to exercise. Scope out possible exercise venues in your facility and encourage patients to use them. If permitted, consider creating a simple exercise plan sheet to provide to interested patients. Even those in Ad Seg, Special Housing, or other restricted locations can find a way to do low-level physical activity daily for 15 minutes.
If your facility encourages group activities, you may want to try organizing a group exercise program. If you get something like this going, be sure to videotape it and get it posted on YouTube! Here is a video done by inmates at Cebu Provincial Detention and Rehabilitation Center (CPDRC), a maximum security prison in the Philippines.
Photo Credit: © Anton Vakhlachev – Fotolia.com
4 Myths About Hangings in Jails and Prisons
The prison intercom crackles with the news of an emergency on Pod 7. Arriving with the emergency bag in tow, the nurse finds a crime scene in full swing. An inmate is hanging from a makeshift bed linen noose creatively tied around the upper bunk slats.
The actions taken in the first few minutes after a discovered hanging can be the difference between a hospital transfer and an in-custody death. Hanging is the most common form of successful suicide in corrections.
Correctional nurses are confronted with situations unusual in other care settings. Be sure to prepare yourself by eliminating these common jail and prison nursing myths from your practice.
Myth #1: It won’t happen here – this is a small jail.
Although it might appear that most hangings happen in large urban jails, the Bureau of Justice Statistics (BJS) Special Report on Suicide in State Prisons and Local Jails reports that the country’s smallest jails had suicide rates 5 times higher than the largest jails. Jails holding fewer than 50 inmates accounted for 14% of all jail suicides. With smaller staffs and fewer resources, small jails need to remain vigilant to the potential for hangings. Detailed policies and procedures on prevention and post-hanging interventions should be in place. Emergency procedures for a hanging situation should be periodically practices and involve both custody and medical unit staff.
Myth #2: It won’t happen here – We have great suicide screenings and watch suicidal inmates closely.
Improved suicide prevention and management processes have definitely reduced hanging suicides in the correctional setting over the last two decades. As outlined in a prior column I wrote for CorrectionsOne, incarcerated suicide rates in both jails and prisons have declined sharply; with jail suicides still over 3 times the rate of state prisons. Suicidal inmates are creative and will use any resource available to craft a noose and the leverage to asphyxiate by hanging body weight. Screenings can help weed out obvious potential for self-injury, but require a good mechanism for protecting those who do not pass the screen. A strong communication process with mental health services is needed to complete the protective program. All staff must be vigilant for indications of self-harm. Suicide attempts can take place later in the incarceration period triggered by court hearings, family issues such as divorce proceedings or custody issues, and classification changes such as administrative segregation placement. Do you have a process that allows for re-evaluation following such events.
Myth #3: Hangings are lethal. If found strung up and lifeless, no need to intervene.
The major factors leading to a hanging fatality is height of the drop during hanging and the suspension of the body (full or partial). Most hangings in corrections take place in the housing area (primarily the inmate cell) which leaves little chance for a full body suspension and great height. This results in good chances of survival with early intervention. One study concluded that even if the victim is found to be lifeless, aggressive intervention with CPR and emergency medical transport is warranted. Another study found overall mortality associated with hanging was 33%. Those who survived to admission to the hospital had a relatively low rate of severe functional disability. Initiate medical intervention immediately when a hanging is found.
A significant percentage of hanging victims will have spinal fracture, therefore spine immobilization and jaw thrust maneuvers should be taken into account at the scene. In order to accomplish this, easy access to a rescue tool, such as this seatbelt release device, is needed to quickly lower the person to the floor for emergency resuscitation intervention.
Myth #4: Every hanging is a crime scene. The inmate can’t be cut down until the location is photographed and evidence accumulated.
There have been reports of medical staff being delayed from attending to a hanging victim while crime scene investigation takes place. Minutes are precious in emergency treatment and can make a difference in ultimate survival. Cut down the victim and initiate emergency medical intervention as soon as the scene has been secured. Saving a person’s life trumps all need for determining criminality. Nurses must advocate for immediate patient treatment in this situation. Even better, pre-empt an emergency situation like this by reviewing a hanging medical intervention process with custody administration before a hanging event.
What has been your experience with post-hanging treatment. Share in the comment box below.
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Moral Distress and Correctional Nursing
Just returned from a fantastic National Commission on Correctional Health Care (NCCHC) conference. This year the Nurse Manager Round Table tackled moral distress and burnout for correctional nurses. It was an energizing discussion as about 40 nurse leaders from jails and prisons around the country grappled with the issue and suggested some remedies.
Moral distress in nursing is described as a psychological imbalance or disequilibrium that occurs when nurses finding themselves in situations where they feel unable to do the right thing. This conflict can cause physical, emotional and spiritual suffering. The residual build up of continuing moral distress can lead to burnout and burden.
Correctional nurses have unique situations that lead to moral distress. Examples include conflict with custody over inmate access to care, a higher volume of healthcare needs than resources available to meet them, and continuing need for guarded evaluation of potential manipulative patient behaviors. Other potential sources of moral distress include nurse-physician conflict, disrespectful interactions, workplace violence, and clinical ethical dilemmas.
Nurse Managers at the round tables had many ideas to combat moral distress:
- Acknowledge that moral distress exists in our practice.
- Educate staff on the causes and symptoms of moral distress.
- Provide venues for verbalizing distress and seeking solutions such as an open-door management practice, support groups facilitated by an outsider, and constructive solution seeking during staff meetings.
- Seeking ways to reduce moral distress through communication among the disciplines and across disciplines with custody.
- Establishing policies about civility and actions to take when in a morally distressing situation.
These suggestions are aligned with those recommended by the American Association of Critical Care Nurses in 2006.
Have you found correctional nursing to be morally distressing? How do you deal with it? Share your experiences in the comments section.
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Are Correctional Nurses Outcasts?
Unfortunately, many correctional nurses do not even realize that they are engaging in a specialty practice. Belonging to a specialty practice is very exciting and something to be proud of; but practicing in a specialty area also has significant responsibilities.
Specialty areas are so designated by the American Nurses Association because the practice has unique aspects that make it different from general nursing practice. Having unique practice aspects brings with it the need to educate the nurses about the practice and to ensure that they have the skills necessary to practice competently within the practice. And since education is as much about role socialization as it about gaining knowledge, nurses need to be made aware of the behavior expected in the specialty area.
One of the “problems” with correctional nursing is that it is relatively unknown and isolated from mainstream nursing. One of the reasons for this is that mainstream nursing and academia, like the larger society, have a tendency to associate correctional nurses with inmates, who are social outcasts. This leads to a very definite bias against correctional nurses, who are often seen as being unworthy and perhaps unable to get a “good” nursing job.
Yet another reason for the isolation lies with correctional nurses themselves. Too often, we demonstrate that we are uncomfortable with our specialty by refusing or hesitating to tell others where we work. Another problem is that we have been very slow to develop a knowledge base about our specialty. There is very little correctional nursing research, and what little research is completed is often critical of correctional nurses. Furthermore, we do not publish our stories – either in correctional healthcare publications or mainstream nursing publications. This has two effects – it does not contribute to our knowledge base and it is yet another way of demonstrating shame in our chosen practice.
What do you think? Are correctional nurses outcasts in professional nursing? How can we change this?
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Correctional Nursing Alert: Ectopic Pregnancy
A young woman in custody at a large urban jail has continuing abdominal pain over a 14 hour period. She is found unresponsive in her cell and rushed to the hospital where she is pronounced dead on arrival. Autopsy reveals a ruptured ectopic pregnancy. Was this death avoidable?
Ectopic pregnancy, where a fertilized ovum implants somewhere outside the uterus, is an emergency event every correctional nurse should consider when confronted with abdominal pain in a female inmate of reproductive age. Indeed, this condition is particularly common among women with a history of genital infections or infertility. Smoking also increases risk. Therefore, the female inmate population is at increased risk for ectopic pregnancy.
Potential causes of acute pelvic pain are
- Appendicitis
- Ectopic Pregnancy
- Endometriosis
- Ovarian Cyst or Torsion
- Pelvic Inflammatory Disease
Assessment Findings
Abdomenal pain caused by ectopic pregnancy can include vaginal bleeding. If pregnancy status is unknown, obtain a urine pregnancy test while contacting the physician. Patients with this condition can become unstable quickly. If a tubal rupture takes place, the pain will intensify and signs of shock such as low blood pressure and rapid thread pulse will be evident. Intraperitoneal hemorrhage can cause referred pain to the shoulder area and a very tender abdomen.
Nursing Actions
This is a medical emergency requiring fast action and immediate transport to acute care. Initiate emergency protocols which can include establishing an intravenous access and fluid loading. Seek immediate medical evaluation for any potentially pregnant patient with unexplained abdominal pain. Ruptured ectopic pregnancies is a leading cause of maternal mortality in the first trimester resulting in 10-15% of all maternal deaths. Shock and death can follow quickly and immediate stabilization and transport to emergency treatment is necessary.
Have you had an experience with an ectopic pregnancy in a jail or prison setting? Tell us your story in the comments section of this post.
Who am I and What Am I Doing Here?
Some days it is hard to remember why you are a correctional nurse. Can I get an ‘Amen’ from the gallery? Maybe you just got done convincing the laundry that you really DO need sheets in the infirmary this morning. Or, possibly you’ve just been told that the duty officer was pulled to a housing unit for a contraband sweep and there is no one to escort the afternoon med pass. Then again, it could be that an inmate-patient (AGAIN) tried to convince you in sick call that he must have tramadol for his sinus headaches, it is the only thing that works, could he please see the doctor right away.
How do you maintain your raison d’entre (reason for existence) in the midst of the chaotic world that is correctional nursing? I have found it helpful to return to a list of principles found in the ANA Scope and Standard of Correctional Nursing to re-center my practice and remind my frustrated soul what it is all about.
Principles of Correctional Nursing
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From American Nurses Association, 2007, pp6-7
This list reminds me that the essence of correctional nursing is caring for and respecting the human dignity of the incarcerated. Somehow that helps me rise above the current fray. Limited resources, challenging patients, competing security priorities, and ongoing concern for personal safety can thwart anyone’s efforts toward principled nursing practice. A frequent return to the core values and goals undergirding correctional nursing practice reminds me of the meaning and importance of our role.
What do you do to regain your ‘mojo’ in your nursing practice? Share your thoughts in the comments section.
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Are You Emotionally Intelligent?
I was challenged by this question at a session of the Summer American Correctional Association (ACA) Conference in Orlando. Joyce Conley, PhD of G4S Americas and Dana Clark, PhD of Organizational Talent Solutions presented the concept of emotional intelligence (EI) and the implications for leadership in corrections to a diverse group of correctional professionals. At first, EI does not sound like a good match for the correctional environment. Emotions are not often shared or encouraged in our setting. As a nurse, orientation to the correctional environment often included admonitions against being too ‘warm and fuzzy’. Tears and drama are out, too. We get enough drama from our detainees! However, I learned that those notions of EI are totally mistaken.
Emotional intelligence is actually the set of emotional and social skills that influence the way we perceive and express ourselves, develop and maintain social relationships, cope with challenge, and use emotional information in an effective and meaningful way. All these skills are important to effective leadership in any environment, but especially in the stressful correctional setting.
Turns out emotional intelligence leads to better decision-making and team cooperation. In fact, empathy, a key element of EI can move an adversarial relationship to a collaborative one. Collaboration is a major component to leadership effectiveness. As one participant mentioned – You can’t get to where you are going alone.
So, are you emotionally intelligent? Do you think this is an important concept for correctional nurses? Share your thoughts in the comments section.
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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 […]
