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Top Correctional Nurse Legal and Ethical Issues (Podcast Episode 124)

Patricia Blair, PhD, LLM, JD, MSN, CCHP-A is a nurse attorney practicing in Texas. She serves as the American Bar Association representative on the National Commission on Correctional Health Care Board of Directors and frequently writes and speaks on ethical, legal, and policy issues in healthcare. She will be speaking on legal and ethical issues for correctional nurses at the 2016 National Conference on Correctional Health Care.

Correctional nurses are particularly vulnerable to legal and ethical issues due to the added concerns of constitutional rights and the need to meet community standards of healthcare in a challenging setting. The complexity of delivering health care in a secure setting combined with the need to meet security policy and procedure also contribute to these issues. According to her extensive experience, Dr. Blair suggests the following legal and ethical issues of highest concern in correctional nursing practice.

Top Legal Issues

Indifference Standards: Nurses working in correctional settings must be aware of the civil rights implications of health care. Constitutional law has established that lack of adequate health care while incarcerated is an abridgement of the Eighth Amendment to the Constitution for sentenced inmates and the Fourteenth Amendment to the Constitution for detainees. Nurses are legally bound to provide necessary health care and to avoid being deliberately indifferent to incarcerated patient needs.
Scope of Practice: Budget constraints and isolation from the traditional health care system can lead to nursing practices that are beyond the scope of licensure. Dr. Blair is particularly concerned with the increased use of LPN/LVN nurses in place of registered nurses as they can be placed in positions beyond their education or knowledge.
Privacy and Confidentiality: Security and safety needs often require health care to be delivered in the presence of officers. The privacy and confidentiality of health information can be jeopardized in these situations.

Top Ethical Issues

Respect of the Patient: Respect for human dignity is challenging in a setting where all your patients have been sentenced or are detained for criminal behavior. Yet, most nurses are unaware of patient criminal history in traditional settings. As correctional nurses it is important to lay aside any criminal information about a patient and respond to them based on their inherent human dignity as an individual.
Patient Advocacy: Facility structure and standard operating procedure can thwart efforts to get incarcerated patients the health care they need. Sometimes the barriers lead to nurses not following through in their advocacy efforts, such as going through the chain of command when peer collaboration fails.
Accountability: Nurses are accountable for providing adequate care when on duty. Correctional nurses can be required to have a broad array of skills in order to meet patient needs in a particular secure setting. Thus we must be acutely aware of personal practice strengths and weaknesses. Correctional nurses are accountable for the necessary knowledge and skills for the setting of employment. This may mean developing new skills and acquiring new knowledge.

What do you think are the top legal and ethical issues you face in correctional practice? Share your thoughts in the comments section of this post.

Want to hear directly from Patricia and also other correctional healthcare leaders from across the country? Click here to register for the 2016 National Conference on Correctional Health Care in Las Vegas.

Best Practices for Correctional Nurse Critical Thinking

By Lorry Schoenly Leave a Comment

Fran Tompkins RN, MS, CCHP-RN, CCN/M, is Nursing Training and Education Supervisor with Correct Care Solutions, Nashville, TN. This post is based on her session “Critical Thinking: Best Practices for Best Results” taking place at the 2016 National Conference on Correctional Health Care in Las Vegas, October 22-26, 2016. Learn more about the conference and register HERE.

Critical Thinking is “…the disciplined intellectual process of applying skillful reasoning as a guide to belief or action.”

-Paul, Ellis and Norris

The correctional environment and patient population can lead to imbalanced thinking just when we need to be clear-headed. Biases in our mental process, both conscious and unconscious, can derail our efforts to critically appraise a clinical situation. For example, a middle-aged patient complains of chest pain for the 3^rd time in 2 weeks. The previous times he had a complete work-up that showed no cardiac disease. The housing officer tells you this guy had no signs of distress and she thinks he is faking ‘again’…and there is a long line of patients waiting for sick call. What to do?

Short Cuts – Good and Bad

Cognitive short cuts help us reach conclusions or decisions quickly. Driving is an example: when we drive automatically, we can conserve cognitive energy for alternative uses. The problem arises when something out of the ordinary happens and we are caught without being prepared: a blowout, or someone changes lanes into our lane without looking. Now we are placed in a reactive situation: trying to problem solve without preparation.

We place ourselves in automatic drive every day when we recognize common patterns of patient behaviors and assessments. Cognitive shortcuts can help us quickly put the puzzle together to rule out appendicitis or recognize early signs of alcohol withdrawal.

Unfortunately, we can just as easily take mental short cuts that short circuit good clinical judgment. Errors are not caused by not knowing, but by the well-intentioned efforts of hard working people in imperfect systems using flawed thinking. It’s not that we do not KNOW, it’s how we THINK about our patients that gets us into trouble. Deciding that the patient with chest pain is feigning illness based on past experiences and the officer’s evaluation can spell trouble.

Best Practice Tips

Best practices to help develop correctional nurse critical thinking skills include:

Using each other for reference points. Bounce your theories off fellow staff members. Ask questions like “What do you think about this patient?” or “What have I missed?” can encourage deeper thinking. Even retroactively, these situations become learning opportunities.
Practicing reflective thinking and encouraging it in others. Debrief challenging situations and talk about what you were thinking and feeling during the event.
Encouraging each other to read, write, listen and speak critically. Use a worksheet for caregivers to objectively and constructively self-criticize their own thinking.
Discussing current cases and care decisions at staff meetings and during new staff orientation. Stories have been the best teaching methods since preschool. Start the conversation early, and keep it going!
Avoid labeling patients by their condition. Naming a patient by their diagnosis “the diabetic in A pod” or perceived adaptive behaviors “He’s a Momma’s boy” gets us into trouble by creating a lens we begin to use with all our patient encounters. .

What do you think about the challenges of critical thinking in correctional nursing practice? Share your experience in the comments section of this post.

This post is part of a series discussing topics addressed during sessions of the 2016 National Conference on Correctional Health Care. All posts in this series can be found HERE.

What Correctional Nurses Need to Know about Hemophilia

By Lorry Schoenly 1 Comment

Angela Lambing, MSN, ANPC, GNPC, is a Clinical Support Specialist with Bayer HealthCare. This post is based on her session “Hemophilia: What You Need to Know” taking place at the 2016 National Conference on Correctional Health Care in Las Vegas, October 22-26, 2016. Learn more about the conference and register HERE.

Jena, an RN working in a medium security state prison, is making sick call rounds. In housing unit C she is approached by an inmate in his late 30’s. He is barely able to hobble into the sick call room. He says he has hemophilia and is experiencing a bleed in his right ankle after having to walk with shackles for several hours earlier in the day. He also said he told those at intake two weeks ago that he had the condition and needed an infusion three times a week but no one has set him up with anything yet.

The 411 on Hemophilia

Hemophilia is an X-linked recessive bleeding disorder. Mothers carry the gene and pass on to their sons. This results in a bleeding disorder described as Hemophilia A (FVIII deficiency) or Hemophilia B (FIX deficiency). Severe hemophilia (<1% Factor level where the normal range is 50-100%) causes acute bleeding episodes, bleeding after injury, and spontaneous joint bleeding that leads to end-stage joint disease. The mainstay of therapy is replacement of the missing factor to raise levels to a near normal. This reduces bleeding risk.

A Common Inmate Condition?

While over 20,000 men are estimated to have hemophilia in the US, it is unclear how many incarcerated men have the condition. Given that this is a male-dominated disease and more inmates are male, it is expected that correctional nurses, like Jena, may encounter patients with the condition.

Hemophilia Issues Behind Bars

If you have a patient with hemophilia, they are likely to know more about the condition than you do. Take their lead about treatment and injury. This is a life-threatening condition that can need immediate attention. Here are a few important areas to consider for hemophilia patients.

Bleeding may not be objectively evident: Listening to the patient who states he is having a bleed, even though it might not be readily evident. If you wait until you see swelling, warmth, or pain, it may be too late. By then, blood is already in the joint, causing damage.
Treatment coordination: Develop a relationship with the patient’s primary provider who manages their hemophilia. As an expert in management of this disease, they are an excellent resource and liaison for treatment.
Security coordination: Hemophilia is an example of a medical condition that our officer colleagues need to know about. They need to be aware of the high potential for bleeding events from head injury or fights. Work details may need modified as repetitive motion can lead to joint bleeding.
Patient self-care: Treatment for this condition requires the replacement of the missing factor. This is given in an infusion by IV push. Patients are trained at an early age to start their own IVs, prepare the medication and give it to themselves IV push. Your patient may know the best veins to use or know their way around the equipment. On the other hand, our patient population is known to make poor health decisions. Some hemophilia patients may not be managing their condition well and, therefore, have severe joint disease from frequent bleeds.
High cost of treatment: Factor infusions are expensive. Work with the patient’s regular hemophilia infusion center to develop a cost-effective option for the 3-times-per-week infusions many with hemophilia require.

Jena had to fast track a solution for this inmate. She called for assistance and had him transported by stretcher to the prison infirmary. The prison medical director contacted the patient’s primary provider and arranged for an emergency transfer to the local hospital. The patient received factor infusions and was monitored for other bleeding such as intracranial bleeding. By the time he had returned to the prison, arrangements had been made for regular infusions and the Health Services Administrator had scheduled staff inservices on the condition.

National Resources

By the way, federally-funded hemophilia treatment centers are located in each state within the US. These centers are experts in management of the disease. General hematology/oncology practitioners may not be experts or have the latest and greatest information related to this condition. You can find the nearest hemophilia treatment center (HTC) by visiting this site and typing in your city or state.

Do you have patients with hemophilia? Share your experience in the comments section of this post.

This post is part of a series discussing topics addressed during sessions of the 2016 National Conference on Correctional Health Care. All posts in this series can be found HERE.

Scope and Standards: Principles to Guide Correctional Nursing Practice

By Lorry Schoenly Leave a Comment

It has been a while since my last post on the Correctional Nursing Scope and Standards. Time to think again about the foundations of our professional practice in the criminal justice system. The scope of our correctional practice is guided by principles of our profession that transcend location or patient population. These 11 principles of correctional nursing practice remind us of just how values-driven our practice must be.

1-Primary Duty to the Patient: We have a therapeutic duty to our patient at all times. This duty is to restore and maintain health, prevent illness, and promote health and wellness through education. Our duty is not to become part of security or to deliver punishment.

2-Interprofessional Collaboration: Not only must we collaborate among other health professions to fulfill our primary duty, but we must strive to include our officer colleagues in our health mission.

3-Encouraging Health Care Responsibility: Our patients will not always have us around to keep them healthy. More than 95% of them will leave the correctional facility. We have a duty to encourage responsibility for health maintenance.

4-Professional Patient Encounters: As correctional nurses we struggle to maintain the balance of care and compassion while being mindful of professional boundaries with a risky patient population.

5-Treating Patients with Dignity and Respect: The general population (and sometimes our officer colleagues) does not think very highly of our patients. It can be easy to absorb this perspective. Yet, our calling is to treat all patients with dignity and respect.

6-Patient Confidentiality: Preserving patient confidentiality can be a challenge when nursing care must be delivered cell-side or with an officer present.

7-Cost-Effective Quality Care: Keeping up with the latest evidence-based practice concepts is important for correctional nursing practice; as is keeping costs down and creatively using available resources.

8-Including Family and Significant Others in Care: While family and significant others may be absent from the correctional practice setting, they are still an important part of nursing practice. Engaging family to encourage health promotion and keeping them informed of health status is a priority.

9-Collaboration with Correctional Staff: Like principle two, this principle emphasizes the contribution of security administration and staff to the health of our patient population. Good working relationships among officer and health care staff improve the delivery of health care in any correctional facility.

10-Encouraging Life-long Learning: There is always something new to be learned in correctional nursing. However, there is always a time crunch, as well! Encouraging life-long learning needs to be a part of our personal practice and, hopefully, supported by our leaders.

11-Contributing to New Knowledge: Research into improved correctional nursing practices is needed to continually grow as a specialty.

As you can see, these principles would be helpful to guide any professional nursing practice. They are, however, vital for practicing professionally in the criminal justice system. When faced with a decision about how to respond in a risky situation in the correctional setting, these 11 principles can shine a light on the best path to take.

What is the most challenging principle of correctional nursing for you? Share your thoughts in the comments section of this post.

This post is part of an ongoing series discussing key components of the Correctional Nursing Scope and Standard of Practice, 2^nd Ed. Review prior posts in this series here. Purchase your own copy of this highly recommended book through Amazon.

August 2016 News Round Up (Podcast Episode 123)

By Lorry Schoenly Leave a Comment

Podcast: Play in new window | Download

Catherine Knox, Gayle Burrow, and Kim Pearson join Lorry to talk about the latest correctional health care news.

To Help A Criminal Go Straight, Help Him Change How He Thinks

Our first story might be considered a mental health issue. High levels of mental illness in our patient population is a growing concern in our specialty. This story out of NPR Public Health, though, is a commentary about the need to help inmates change how they think. Commentator Jack Bush quotes one of my favorite philosophers Viktor Frankl, who said, “Everything can be taken from a man but one thing: The last of the human freedoms-to choose one’s attitude in any given set of circumstances, to choose one’s own way.” Yet, Bush contends that criminal behavior is the result of attitude and a destructive way of thinking. He cites success with the use of cognitive behavioral therapy to reduce recidivism by up to 35%. This sounds like a promising behavioral health treatment. Panelists discuss their experiences with cognitive behavioral therapy and the “Thinking for Change” program that Jack Bush uses.

Mentally Ill Inmate Spent 1,001 Days in Solitary Confinement

Another big mental health concern in correctional health care is the over-use of solitary confinement. The Miami Harold recounts the story of a NC state prison inmate who was in solitary confinement for almost 3 years. Not surprisingly, he had mental illness prior to incarceration, and, also not surprisingly, he was worse when he was released. It is a sad story repeated multiple times across the country. It is heartening to see an NCCHC position statement on solitary confinement. Panelists discuss how solitary confinement is being reduced in many correctional systems and the struggles to find meaningful alternatives in some settings.

Newly Released Inmates Account for 1 in 10 Fatal ODs

Health Day reports that almost 10% of fatal adult drug overdoses may involve recently released prisoners, according to a Canadian Study. Catherine found a US study that supports this number and the CDC has a report out on the rising trend of opioid overdose deaths in the general population. The increase is an astounding 200% from 2000 to 2014. Our patient population definitely includes a high proportion of drug dependency with opiates on the rise. Panelists discuss what they are seeing in practice.

For Rikers’s Most Troubled Inmates, Art Offers Hope

From Artsy.net comes an extensive story about art therapists who provide services in the mental observation units at Riker’s Island. They currently have 11 art therapists working at Rikers and hope to gain funding for even more. Like correctional nurses, these therapists must make accommodations for the environment and patient population. Panelists discuss the possible advantages of this type of therapy in the correctional setting. Here is a link to an interview with a correctional art therapist from a prior podcast.

Join the conversation. Share your thoughts on these news stories in the comments section of this post.

Correctional Nurse Dental Academy: Is This Normal?

By Lorry Schoenly 5 Comments

It is well known that FBI agents entering the counterfeit currency division spend a lot of time studying bills. At first, you might think they would study all the various ways that currency could be faked, but, instead, they first learn to be experts at the real thing. Then, it is easy to spot the phony bills.

What does this have to do with correctional nursing? As you strive to develop skill in the unfamiliar area of dental conditions, it is helpful to know what normal looks like in order to spot a problem when you see it. Sure, knowing what meth mouth looks like and differentiating a partial from a bridge is helpful, but can you tell what a normal mouth looks like?

Have an Assessment System

Having a system makes you speedy and thorough, whether it is getting out the door in the morning or assessing a patient’s mouth for issues that need attention. For mouth and dental assessment, try this standard format.

Outside to inside – Start with the lips and move inward until you get to the throat.
Front to back – Same principle start closest to you and move deeper into the mouth area.
Left to right – this is the direction we read and can be a standard way to check mouth structures.

Practice, Practice, Practice

When first learning a new skill, it is important that your practice sessions are frequent and close together. Consider ways to get extra dental assessment exposure like volunteering for intake assessment or asking for some time with the facility dentist when they are holding clinic. Once you have your system in place, dental assessment sessions can be less frequent but need to happen regularly enough to keep up your system and skill.

What is Normal?

So, what is normal when you are assessing those pearly whites (OK, so maybe only a few of your patients will actually have nice looking teeth!)? Here is what a normal mouth should look like.

Lips and buccal mucosa should be pink, soft, moist and smooth. Note any pallor, cyanosis or blistering.
Teeth should be white and smooth. Note any missing teeth or ill-fitting dentures.
Gums should be moist and firm without retraction. Note any receding or bleeding gums.
Tongue should be pink, move freely, and without tenderness.
Floor of mouth should be smooth and without mass or lesion.
Palate and oropharynx should be pink and smooth. Note any discolorations, swelling, or boney growths.

Don’t Forget to Ask!

A person’s medical and dental history hold clues to potential dental issues that need attention. The following questions can reveal pertinent background for a complete dental profile.

Are you currently undergoing a dental procedure or receiving dental treatment?
Have you been hospitalized recently?
What medications are you currently taking?
Do you have any dental concerns?
Do you have any removable dental appliances such as dentures, partial dentures, or bridges?

Dental assessment is a new skill requirement for most novice correctional nurses. By having a system, practicing regularly, and knowing what is normal, you, too, can become an expert.

How did you learn to assess dental conditions when you started in corrections? Share your experience in the comments section of this post.

New Code of Ethics for Nurses: Relationships with Colleagues and Others

By Lorry Schoenly 6 Comments

The first provision of the Code of Ethics for Nurses addresses the need for compassion and respect for all individuals. While the primary focus of nursing practice is the patient, the need for compassion and respect also extends to our colleagues. Thus, nurses are ethically bound to maintain civil and caring relationships with work mates. Nevertheless, we are hearing of increasing bullying and lateral violence in the health care workplace. In fact, I regularly hear from correctional nurses about the struggle to work with mean, harassing, and even threatening colleagues. Many nurses find this even more stressful than working with the inmate population. Consider this example.

Lola is a new nurse in a medium security prison. She was recruited from her emergency nursing position at a local hospital with promises of less lifting (she has increasing chronic back pain) and better work hours. However, she is questioning this move after one week of orientation. Her work colleagues complain constantly about the work conditions and their manager. Although she was promised an extensive orientation, she is passed around among the nurses, sitting in with them as they perform various processes such as sick call and medication pass. This morning her manager is at an off-site meeting and none of the other nurses want to have her with them. Finally, Bob agrees but tells her to “Keep quiet and don’t bother me with questions while I’m on rounds”.

Caring is Not Just for Patients

Caring may be a primary concept in nursing practice but it often does not get translated into colleague relationships. Yet, our Code of Ethics clearly states that respect for persons extends to our relationships with other staff as well as to our relationship with our patients. Disrespect, incivility, and other methods of lateral violence can present overtly and covertly in the work environment. Lola is not getting a warm welcome in her new position and she can feel powerless to do anything about it, having only been there for a few days.

Prevention and Proactivity

According to the American Nurses Association, nearly 50% of nurses have experienced some form of bullying yet most of us stay silent about it. The Code of Ethics calls us to speak out when we experience bullying and, in particular, when we see other colleagues being bullied. By silently standing by, we become participants in the harassment.

Colleagues who are bullying others need to know that this practice is unethical and can be grounds for intervention. Some State Boards of Nursing include adherence to the Code of Ethics for Nurses as a part of their Nurse Practice Act. Hopefully, as awareness of the negative effects of lateral violence grows, more correctional health care workplaces will initiate a Zero-Tolerance policy toward incivility in staff relationships.

Relationship Responsibility

Our ethical responsibility toward healthy interpersonal relationships goes beyond the nurse-patient relationship to include our interactions with other nurses, physicians, team members, and officers. Poor work relationships lead to clinical errors, increased costs, and loss of quality staff (like Lola).

It would be difficult for Lola to change her work environment as a new staff member, but it may only take one staff member coming forward to address the issue of incivility to begin to make a difference. Besides seeking management support to change the work environment, each of us can seek to stop the horizontal violence.

Don’t listen to or tolerate blame, rumors, and gossip
Encourage and perform acts of kindness
Look for common ground in a conflict
Encourage forgiveness
Be a safe person to ask questions of or discuss a problem with

How about you? Is there incivility or even hostility in your workplace? How do you handle it? Share your thoughts in the comments section of this post.

The American Nurses Association (ANA) designated 2015 as the Year of Ethics for American nurses. I have personally designated 2016 as the Year of Ethics for Correctional Nurses. This year I will be blogging regularly about the Code as I write a book to help correctional nurses apply the Code of Ethics in our challenging setting. Read all posts about the Code of Ethics here.

Is It Safe? Correctional Nurse Workplace Injury

By Lorry Schoenly 4 Comments

The most frequent question I get asked by nurses considering entering the correctional specialty is “Is it safe?” That’s an understandable question as it’s hard to imagine how nursing care is provided in a jail or prison and, after all, our patient population can be scary!

Workplace safety is a concern for all nurses and, depending on the specialty, nurses need to be concerned about physical injury such as: needle sticks, contact with harmful chemicals, back injury, and violent patients. The CDC published data on occupational injury for those of us working in health care.

While physical injury may come to mind when first considering workplace safety, mental health safety can also be of concern. The ANA is now addressing bullying and incivility as a workplace violence issue. Here’s my take on these workplace safety issues as they relate to working in the criminal justice system.

Back Injury

According to the most recent data from the Bureau of Labor Statistics, nursing assistants are near the top of the list of those with the highest incidence of work-related musculoskeletal injury; and registered nurses are not far behind. While many traditional health care settings such as hospitals and nursing homes have nursing assistants providing a good bit of the ‘heavy lifting’, very few correctional settings employ ancillary care staff. Thus, correctional nurses end up moving infirmary patients, assisting with wheelchair transfers, and aiding in 4-man lifts from the yard ground to a stretcher. In addition, housing locations may require nurses to push heavy medication carts across outdoor yards or up slopes to get to an administration point. If medication carts are unable to be taken to an inmate location, such as upper tiers in a housing unit, nurses may need to use back packs or carry medication baskets up steep stairways. Back safety is of paramount importance in correctional nursing practice.

Harmful Chemicals

Many correctional health care settings have challenging space issues. Older facilities were built without attention to health care needs. Indeed, some health care units are converted cell blocks. This can mean haphazard storage and interesting supply space configurations. Combine this environmental situation with the use of inmate porters for general cleaning and you can imagine what can happen. Correctional nurses may come across mislabeled or unlabeled containers of hazardous chemicals. In addition, nurses may work without benefit of onsite pharmacy and may need to handle medications that could be hazardous. Crushing medications, a too-frequent process in correctional facilities, may lead to contact with a harmful substance.

Mental Health

Correctional nurses are at risk of mental distress from patients and colleagues. Disgruntled nurses or disillusioned officers can take out their frustrations on colleagues (that means you!). The correctional environment can often be a place of distrust and cynicism; both leading to incivility or bullying among the staff and patient population. In addition, staff mental health can be jeopardized by compassion fatigue and secondary traumatization when working with this disadvantaged population.

Needle Sticks

Needle stick injuries have decreased since implementation of safety needles in health care. Unfortunately, I still hear of use of needles without safety capping mechanisms in correctional settings. This is against OSHA regulations. Even when needles with safety mechanisms are available, they can be misused or disregarded. Don’t do it! Our patient population has high levels of blood borne pathogens. Correctional nurses need to be especially careful with standard precautions and needle safety.

Slips, Trips, Falls

Unsafe walking surfaces are a huge concern in correctional practice. Many nurses must walk distances outside to get to housing units for treatment and medication administration. Weather conditions can cause slick or icy surfaces. Older facilities may have uneven pavement or sidewalks in disrepair. Inmate location may require nurses to manage unwieldy medication carts in these situations. An interesting safety hazard I have seen in many older facilities is the use of fans or space heaters for climate control. These devices are often connected to an outlet that leaves a cord in the walkway; causing a trip hazard. Sturdy footwear and serviceable outerwear are important correctional nursing gear!

Violent Patients

When asking about the safety of being a correctional nurse, most people mean working with our patient population and not the many other safety issues described above. Indeed, personal and professional safety should be on the minds of nurses working with incarcerated patients. However, unlike working in other health care settings, our patients have been classified for level of violence and are attended by officers based on that potential. My most frequent answer to the question of safety is to frankly state “Safer than working in an urban ER. We know who the bad guys are!”. A 2014 survey of emergency room nurses published in the Journal of Emergency Nursing found almost a third of respondents had experienced some form of physical abuse by patients and families. Unfortunately, we have no comparison data for nurses working in correctional settings, but my discussion of workplace violence with correctional nurses across the country indicate the rate is much less than one in three.

Is it Safe?

So, is it safe to work as a correctional nurse? With proper awareness of our unique environment and patient population, correctional nursing is as safe as most health care settings; and maybe more safe than some.

What do you think? Is it safe to work as a correctional nurse? What do you tell people who ask you that question? Share your experiences in the comments section of this post. I want to hear from you!

Summer Reading Series: Patient Safety

By Lorry Schoenly Leave a Comment

While I am on summer sabbatical for the month of July, catch up on some important info with this summer reading series of past Correctional Nurse posts.

Did you know that medical error is now the third leading cause of death in the US? That is one finding of researchers at Johns Hopkins Medical. This is astounding news for a profession bound by the ethical values to seek after the good of our patients and to do no harm. Patient safety is a primary responsibility of correctional nurses. Here are some prior posts addressing patient safety issues in the criminal justice system.

Are You Thinking Clearly? Rooting Out Biases in Clinical Evaluations

Are Your Correctional Clinical Processes Like Swiss Cheese?

Four Ways Your Patient Can Help You Avoid A Medication Error

Making Ends Meet: The Blunt End and Sharp End of Clinical Error

Patient Identification: Is the Right Patient Getting That Medication?

Three Ways to Use Inmate Grievances to Improve Health Care

What are your greatest patient safety concerns? Share your thoughts in the comments section of this post.

Summer Reading Series: Medication Administration

By Lorry Schoenly Leave a Comment

While I am on summer sabbatical for the month of July, catch up on some important info with this summer reading series of past Correctional Nurse posts.

Summer Reading 4 Medication administration is a common and frequent nursing task in most settings. There are plenty of opportunities to get things wrong….even when surrounded by fantastic resources like an onsite pharmacy and electronic information sources. Correctional nurses don’t often have these advantages, though, and medication administration can take on some interesting configurations and lead to some risky practices. Here are some past blog posts on administering medication in a correctional setting.

Top Legal Issues

Top Ethical Issues

Keep up with all the CorrectionalNurse.Net news, posts and resources by subscribing to our Monthly Newsletter. Subscribing to the newsletter also includes a copy of the Correctional Nurse Legal Briefs ebook. Lots of great information to keep you out of court!

Short Cuts – Good and Bad

Best Practice Tips

Keep up with all the CorrectionalNurse.Net news, posts and resources by subscribing to our Monthly Newsletter. Subscribing to the newsletter also includes a copy of the Correctional Nurse Legal Briefs ebook. Lots of great information to keep you out of court!

The 411 on Hemophilia

A Common Inmate Condition?

Hemophilia Issues Behind Bars

National Resources

Keep up with all the CorrectionalNurse.Net news, posts and resources by subscribing to our Monthly Newsletter. Subscribing to the newsletter also includes a copy of the Correctional Nurse Legal Briefs ebook. Lots of great information to keep you out of court!

Keep up with all the CorrectionalNurse.Net news, posts and resources by subscribing to our Monthly Newsletter. Subscribing to the newsletter also includes a copy of the Correctional Nurse Legal Briefs ebook. Lots of great information to keep you out of court!

Keep up with all the CorrectionalNurse.Net news, posts and resources by subscribing to our Monthly Newsletter. Subscribing to the newsletter also includes a copy of the Correctional Nurse Legal Briefs ebook. Lots of great information to keep you out of court!

Have an Assessment System

Practice, Practice, Practice

What is Normal?

Don’t Forget to Ask!

Keep up with all the CorrectionalNurse.Net news, posts and resources by subscribing to our Monthly Newsletter. Subscribing to the newsletter also includes a copy of the Correctional Nurse Legal Briefs ebook. Lots of great information to keep you out of court!

Caring is Not Just for Patients

Prevention and Proactivity

Relationship Responsibility

Keep up with all the CorrectionalNurse.Net news, posts and resources by subscribing to our Monthly Newsletter. Subscribing to the newsletter also includes a copy of the Correctional Nurse Legal Briefs ebook. Lots of great information to keep you out of court!

Back Injury

Harmful Chemicals

Mental Health

Needle Sticks

Slips, Trips, Falls

Violent Patients

Is it Safe?

Keep up with all the CorrectionalNurse.Net news, posts and resources by subscribing to our Monthly Newsletter. Subscribing to the newsletter also includes a copy of the Correctional Nurse Legal Briefs ebook. Lots of great information to keep you out of court!

Keep up with all the CorrectionalNurse.Net news, posts and resources by subscribing to our Monthly Newsletter. Subscribing to the newsletter also includes a copy of the Correctional Nurse Legal Briefs ebook. Lots of great information to keep you out of court!

Keep up with all the CorrectionalNurse.Net news, posts and resources by subscribing to our Monthly Newsletter. Subscribing to the newsletter also includes a copy of the Correctional Nurse Legal Briefs ebook. Lots of great information to keep you out of court!