Chronic Care: Are You Really Making Sense?

Plastic English letters isolated on white backgroundManaging chronic conditions is a major process in every correctional setting. The chronic care visit is an ideal time for patient teaching and reinforcement. Correctional nurses often provide a large part of patient teaching in a collaborative chronic care clinic. Areas of teaching include

  • The disease process
  • Lifestyle adjustments
  • Medication effects and side effects
  • Self-care activities

Unfortunately, there are few ready-made patient educational materials that suit the correctional setting. Most materials must be adapted to the restrictions of a secure facility and the limitations of diet and exercise imposed on our patients. As described in an earlier post, many of our patients have learning disabilities or little formal education. For all these reasons, correctional nurses need to be sure written materials are adapted to our environment, easy to understand, and make sense to our patients.

Even the general population has trouble understanding most patient education materials, as this Institutes of Medicine paper indicates. Therefore, we need to improve the readability of any patient handout used in our setting. Fortunately, there are free resources available to help us – like this guide created by the Centers for Disease Control.

Back to Basics

Here are some basic principles for creating clear and understandable patient education materials for low literacy patients taken from the CDC guide:

  • Include graphics and pictures to demonstrate important principles
  • Limit text to need-to-know information that uses action terms to directly tell the patient what they need to do
  • Use a  positive, friendly, and conversational writing style
  • Use simple words with limited use of medical and scientific jargon.
  • Limit statistics and use general terms, such as many or few, instead.
  • Format the teaching material for maximum understanding – font size of text should be as large as possible to improve readability – at least 12 points


Once materials are written and formatted, readability should be tested. The best test is to pilot with a sample of your patients; however, readability can also be factored using MSWord functions or online readability services. A very simple test of readability is the number of multiple-syllable words in the document. The Simple Measure of Gobbledygook (SMOG) is a quick online option.  The test counts the multiple-syllable words in three strings of 10 sentences within the document and then comparing the count to a table to determine reading level.

Culture and Language

Once you have your basic material together, check it for cultural appropriateness. Are the visuals representative of your patient population? Are there any trigger words that might be offensive to members of your patient community? Are there familiar terms that need to be added for clarity? Again, you may want to pilot test with key members of your patient groups. Also consider whether translation is needed; for example some settings have a large Spanish-speaking population.

Start with a Good Foundation

As you can see, writing patient education materials that make sense is hard work. You may want to start with some foundational materials created by experts. In that case, there are plenty of materials from national associations and government sites that can be adapted for the criminal justice setting. Here are a few links to get you started:

How do you teach patients in your setting? Share your thoughts in the comments section of this post. 

Photo Credit: © Vladimir Voronin –

Managing Nursing Sick Call Requests (podcast)


cnt-podcast_cover_art-1400x1400Jessica D. Lee MSN CCHP, Vice President of Nursing Support Services for Corizon Health, shares key components of a well-managed nursing sick call process. She should know! In her position, Jessica manages policy and procedure development and implementation for nursing care provision in over 500 jails and prisons. She has helped many jails and prisons improve sick call delivery.

Nursing sick call is one of the key ways ambulatory care is delivered in a correctional setting. This process allows inmates to request to be seen for a medical condition. Here are some of the basic elements of nursing sick call from the episode:

  • Each patient needs education on procedures for requesting medical attention. This usually happens at intake and needs to be provided in understandable terms.
  • The request process can take various forms and may be through a written request or a daily walk-in system.
  • Triaging requests is also a key component. Unlike emergency care, in the correction it is the review and prioritization of the request so that there is a disposition or decision. The patient may need to be seen immediately or routinely. Requests may be referred out to another professional such as a dental visit. Whatever the outcome of the triage process, the patient needs to be informed. Other requests may be informational, such as finding out the results of a diagnostic test or the need for refill of a medication.
  • Protocols are also important. Usually there are written guidelines telling the nurse to obtain assessment data based on the health history and initiating concern. Protocols also provide direction for the interventions to take based on the data collected.
  • Appropriate referrals are also needed for an effective sick call process. These are based on assessment findings when treatment indicated is beyond the nurse’s scope of practice.
  • Timeframe is important. Nurses must determine if the patient needs to be seen by another provider immediately or if the referral can be merely routine.
  • Patient education is a priority for every nursing encounter. This is certainly true for nursing sick call. In particular, the nurse needs to be sure the patient understands the outcome of the sick call visit and steps they need to take after the visit.

Nursing sick call is central to good correctional health care. Nurses are very often gate-keepers to other medical care in the correctional setting. It can be a good indication of weaknesses in other areas of the program such as intake and chronic care.

Sick call can also be a risky part of correctional healthcare with some common problems. Listen to this episode of Correctional Nursing Today for Jennifer’s take on common problems for nursing staff and nurse managers.

What do you find most challenging when delivering nursing sick call in your setting? Share your thoughts in the comments section of this post.

Other News on the Podcast:

  • In this podcast I comment on my recent CorrectionsOne column on restraint chairs. Link:  CorrectionsOne column on Restraint Chairs.
  • Also, I am traveling south for some sun the end of March so there will be no March 2014 Correctional News Round-Up.
  • Keep up with correctional healthcare news by following me on twitter, facebook, or linkedin.

Encouraging Patients to Participate in Self-Care

TrappedOne of the challenges of correctional nursing is engaging patients as full participants in their healthcare. Depending on the organizational culture, you may have limited opportunity to encourage your patients to manage their healthcare needs. Yet, the majority of our patients will be released to the community and they need to take on the responsibility for their health and well-being. Here are a few barriers we must overcome to be able to involve our inmate-patients in their healthcare.

Paternalistic Culture

Some correctional settings have a culture that devalues the patient and discourages patient input in other areas of life. A correctional culture based on order, control, and discipline could stall efforts to actively engage patients in care decisions and therapy monitoring.  A paternalistic culture can develop in a correctional setting where inmates are controlled and are not expected to make personal decisions. This hinders patient engagement in their healthcare and reduces motivation toward self-care activities.

Patient Preparation

The patient population can be ill-prepared to actively participate in their own health care. Limited English proficiency and low literacy levels can make self-care difficult. The inmate patient population is less educated than the general population and is twice as likely to have learning disabilities. It is also difficult to get an accurate evaluation of literacy from the patient’s self-report as inmates are more likely to over-estimate their reading and comprehension abilities. The patient’s unwillingness to participate in their own care can also be a barrier.

Practitioners Behaving Badly

Practitioner behaviors can also inhibit patient involvement. Involving patients in care provision involves a time-commitment that clinicians may be unwilling or unable to make. In addition, a continuing paternalistic medical culture combine with pervasive attitudes about the correctional patient population can result in an authoritarian stance toward the patient that inhibits involvement. Here are some practitioner behaviors that block patient involvement. Have you seen any of these behaviors in your setting?

  • Defending an action and blocking continued expression of concern
  • Interrupting and finishing sentences for the patient
  • Deliberately changing the subject when uncomfortable
  • Citing policy as a reason for an action
  • Minimizing patient’s concerns
  • Condescending comments about patient concerns
  • Not following through on promises

A primary role of the nursing profession is that of patient advocate. Correctional nurses can advocate for patient involvement in their healthcare. Even small changes can make a difference.

How do you involve patients in self-care in your setting? Share your thoughts in the comments section of this post. 

Photo Credit: © Stocksnapper –

Scope and Standards: Prevalence of Correctional Nurses

foule de pélerins à lourdesBefore I accidentally became a correctional nurse, I didn’t even know the specialty existed. However, I soon learned that, although we work in a hidden practice setting, there are many correctional nurses. Unfortunately, we are almost invisible to the larger profession. Take any nursing survey that asks for your specialty area and you will see what I mean. I have never seen a place to check for correctional nursing. Most often we are filling in the open space next to ‘other’.

The taskforce revising the Correctional Nursing Scope and Standards of Practice had quite a time searching for verifiable information on the number of correctional nurses working in American jails and prisons. We finally settled on reporting numbers from the Health Resources and Services Administration (HRSA) data from the National Sample Survey of Registered Nurses. This survey estimated a total of 20,772 registered nurses working in correctional settings. That is almost 1% of all nurses working in the US (0.08%).

To those of us active in the profession, however, this seems a low number. Could it be that more nurses work in criminal justice? The way nurses are employed to work in a correctional setting may skew survey findings. For example, correctional nurses may be employed by a university medical system (like those working in Connecticut and New Jersey prison systems. Many jails are staffed by nurses working for the public health department. Nurses may provide care to inmates but work for private companies such as those who manage dialysis units within prison systems.

Maddie LaMarre, in a chapter on nursing practice for Clinical Practice in Correctional Medicine (2006), cited an estimated 2-3% of US nurses work in corrections. With Bureau of Labor Statistics of over 2.6 million employed registered nurses in 2008, this would suggest between 52,374 and 78,561 correctional nurses. The figure does not include the many LPN/LVN nurses practicing in the specialty.

Also not reflected in the National Sample Survey are nurses who work in correctional settings in a part time or per diem capacity. Some prison settings in remote areas must rely on traveling nurses to meet healthcare needs. Many settings regularly employ agency nurses to fill gaps in the schedule.

Without a professional association specifically dedicated to correctional nursing practice, there is no reliable collection on information on the number and characteristics of correctional nurses. More the pity.  Correctional nursing might be more visible with an accurate idea of the number and strength of the specialty.

How many correctional nurses do you think there are in the country? Share your thoughts in the comments section of this post.

The full Correctional Nursing Scope and Standards of Practice, 2nd Ed. Is available through Amazon.

Photo Credit: © piccaya –

Under the Influence: Impaired Nurses in Corrections

pill on a hookOne in ten doctors and nurses abuse drugs or alcohol. Is this surprising to you? It is to me. Although this number (10-15%) is equivalent to abuse rates in the general public, those of us in healthcare have a special responsibility to be able to think and act clearly as we are responsible for providing safe patient care. Drug abuse is particularly concerning in healthcare as there is increased access to addicting substances. This can be especially true in correctional healthcare, a low tech setting with fewer barriers to access. For example, very few correctional systems have electronic lockout systems such as pyxis.

Some impaired healthcare professionals gravitate to a correctional setting with the perception that the system has fewer safeguards than a traditional setting; so drug diversion is less likely to be detected. Unfortunately, this may be an accurate appraisal, especially in smaller or disorganized settings where strong narcotics security is not in place. Even well-managed settings can become lax about shift narcotics counts or double-lock systems. Here are a couple successful diversion methods from my own correctional management experience. Could any of these happen in your setting?

  • The foil backing of a bubble pack of oxycontin was slit. Pills were replaced with a similar looking over-the-counter medication and taped back in place. Bubble packs of the same medication were banded together and the middle pack was tampered with. Nurses were only counting the number of packs each shift.
  • An entire page of a narcotics ‘red book’ was sliced from the book along with the full pack of medication. Nurses were counting based on what was in the drawer rather than what was in the book index so it was unclear when the theft took place.
  • A hospice patient was on liquid morphine at fairly high doses. A sealed box of multiple bottles was double locked in the long-term inventory. When active stock was depleted, the sealed box was opened to find that it no longer contained all the original bottles. The count had been done for some time by just looking to see that the box was still in long-term inventory so it was unclear when it had been tampered with.

According to the National Council of State Boards of Nursing, there are four risk factors for narcotic diversion. How does your setting line up with these risks:

  • Access:  Relatively easy access to narcotics in the clinical area
  • Attitude: A relaxed attitude toward narcotics security in the setting
  • Stress: A high stress work environment including shift rotation and frequent short staffing
  • Lack of Education: Staff members are not regularly educated or warned of narcotic diversion concerns

One of the greatest ethical challenges you may face as a nurse is confronting a workmate who appears to be abusing substances. An atmosphere of suspicion and feelings of betrayal can poison work relationships. Many nurses would rather look the other way than deal with the after math of talking to a colleague or reporting suspicious behavior. An article from American Nurse Today has some helpful information on signs and symptoms of a substance abusing nurse:

Physical Signs

  • Tremors
  • Slurred speech
  • Watery eyes
  • Sweating
  • Unsteady gait
  • Runny nose
  • Change in grooming

Behavioral Changes

  • Frequent mood changes
  • Angry outbursts
  • Defensiveness
  • Lack of concentration
  • Blackout periods
  • Frequent lying
  • Poor judgment


  • Wearing long sleeves even when it is hot
  • Unexplained absences from the nursing unit
  • Medication errors
  • Reports of lack of pain relief from assigned patients
  • Offering to medicate co-worker patients
  • Increased narcotic sign-outs

Being aware of drug diversion or of staff members working impaired is both an ethical and legal concern. We have a responsibility to our patients and other team members to address concerns about a colleague’s substance abuse behaviors. In fact, we have a responsibility to our impaired colleague to initiate action so that they get the help they need to overcome their addition.

Have you witnessed drug diversion or impaired nurse behavior in your setting? Share your insights in the comments section of this post.

Photo Credit: © Photobank –

Nurse Perceptions of Correctional Health Care (podcast)


cnt-podcast_cover_art-1400x1400In this episode of Correctional Nursing Today Karen Marchand-Singleton discusses her research involving nurse perceptions of correctional healthcare. Karen performed this research as part of her master’s degree program and hopes to expand her sample in future research. Karen’s entry into correctional practice started when her son, who has hemophilia, was detained at a local jail. She had not been exposed to correctional nursing before and was unsure of the medical treatment her son would be receiving. She took a position at a nearby jail to find out and discovered she loved the specialty.

As a nurse manager at that same facility, Karen found it difficult to recruit nurses into the correctional setting. This led her to pursue this research topic to find out what the perception was of correctional nursing in the healthcare community. Her research sample was based on her South Carolina locale where she did live interviews with 20 nurses. These nurses had backgrounds in acute care, home care, hospice, and corrections. Her structured interview involved 10 questions about their understanding and exposure to correctional nursing.

Her results indicate that we have a ways to go to improve the awareness and image of correctional nursing. Few study participants had a clear understanding of the specialty and only one had been exposed to the field during initial schooling. Her findings indicate a need for more dialog in the general nursing community about correctional nursing practice. Correctional nurses need to interact with nurses outside the specialty at general conferences and become a part of the larger nursing community.

Do you think the correctional nursing specialty is invisible? Share your thoughts in the comments section of this post.

What’s Bugging You? Lice Identification and Treatment

baboon grooming another closeup isolated on blackDuring a jail intake for a homeless man brought in for vagrancy, a nurse sees some tiny insects flying about his clothing and he is scratching at them as she interviews him. She is concerned that an infestation may result and initiates a protocol for lice which involves shampooing and showering with the insecticide permethrin and a special laundering process for all clothing. Was this the right action?

Correctional nurses need to be aware of various infestations as a high percentage of inmates in some locales are prone to head, body, and pubic lice. Once these little hitchhikers enter a facility they can spread by direct physical contact or through sharing of personal items like clothing, bedding, or towels. Was this patient infected with lice? Let’s look at some information about these little critters.

Do lice fly?

Lice remain on a person’s hair or clothing and wander to the skin to blood feed once or more often each day. They have tiny straw-like mouthparts – similar to those of mosquitoes – that they use to suck blood from skin capillaries. They’re unable to burrow into the skin. Lice never develop wings, so they cannot fly.  They’re also incapable of jumping. So, this patient did not have lice.

Lice cause itching

Lice may cause an allergic reaction that can cause itching. For head lice, the itching tends to be mild and temporary.  Body lice tend to cause far more itching, and even make the infested person feel ‘lousy’. Public lice tend to cause much itching in the affected area.  This patient’s itching may be caused by the insect in question but further investigation is needed.

Lice are not very common

Lice are not nearly as prevalent as is generally believed, and other creatures and objects on a person are frequently mistaken for lice.  Other insects include fleas, ticks, mites and bedbugs. None of these insects have wings, though. The homeless man in our case may merely have gnats or fruit flies about his person.

Lice are relatively tiny – as small as a poppy seed and as large as a sesame seed. A screener must have good eyesight, be close enough to see the creature, use a magnifying lens, and some expertise to identify lice; distinguishing them from other insects. In fact, other kinds of insects and even bits of debris are frequently mistaken to be lice. As in this case, misdiagnosis and unnecessary treatment can be frequent.

When in doubt – don’t treat

Treating everyone who enters a facility is not a good idea; nor is it cost effective. Treatment focused just on those infested is consistent with sound medical practice.  It can also dramatically save time and precious funds; while reducing the risk of lawsuit. The standard medications used in prisons for delousing contain the insecticides permethrin and pyrethrins. These have become less effective as resistance is becoming widespread.

When positive lice identification is confirmed, treatment can be ordered as follows:

  • Head lice can be treated with one or two 10-minute applications of a pediculicide.
  • Body lice usually require no treatment to the person. Instead, a person with body lice should bathe and change into prison-issued clothing. The infested clothing should be disinsected by proper laundering, or disposed of.  If body lice are detected on the body hairs of a person, a full-body treatment with a pediculicide is needed.
  • Pubic lice would necessitate treatment to the affected area only.

Ongoing prevention measures for lice include frequent (at least weekly) laundering of clothing and linens, and early recognition and treatment of genuine infestations.  The Federal Bureau of Prisons Lice and Scabies Protocol of March 2011 recommends the following actions:

  • Be sure laundry temperatures are set to at least 130 degrees Fahrenheit to kill lice and their eggs on linens and clothing. Use a hot cycle for drying, as well.
  • Educate inmates about lice and how to get treatment if they observe lice. The FBOP Protocol includes inmate education handouts that might be helpful.
  • Inmates should not be transferred to other facilities until 24 hours after initiation of treatment.  If moved before the 2nd treatment application (7 days), communication and continuation of treatment should be provided.

How are you managing lice, bedbugs, fleas, and ticks in your facility? Share your thoughts in the comments section of this post.

Photo Credit: © Sascha Burkard –

Scope and Standards: New Definition of Correctional Nursing

ANA StandardsHow has professional nursing practice in the correctional setting changed and evolved over the last decade? When discussing any concept, the first place to start is with a definition. How has the definition of correctional nursing changed over the years?

To start with, the very name of our specialty has moved from corrections nursing to correctional nursing. This name change indicates a movement away from purely defining nursing practice based on location. Similar evolutions have taken place in such specialties as emergency nursing (no longer Emergency Room Nursing) and Perioperative Nursing (no longer Operating Room Nursing).

Definition of Corrections Nursing in 2007

Corrections nursing is the practice of nursing and the delivery of patient care within the unique and distinct environment of the criminal justice system.

As the general definition of nursing has progressed, so has the definition of correctional nursing. This edition of the Correctional Nursing Scope and Standards of Correctional Nursing unveils an expanded definition of correctional nursing which mirrors the 2010 ANA definition of nursing.

Definition of Correctional Nursing in 2013

Correctional nursing is 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, advocacy, and delivery of health care to individuals, families, communities, and populations under the jurisdiction of the criminal justice system.

Nurses practice professionally in every setting. Therefore, the core components of correctional nursing include protecting, promoting, and optimizing the health and abilities of patients. Nurses in all practice settings, including corrections, prevent illness and injury while alleviating suffering. Correctional nurses, as those in other settings, diagnose and treat the human response to illness and injury. They advocate for their patient’s health and deliver health care to individuals, families, communities, and populations.

The location of care – under the jurisdiction of the criminal justice system – does give context to the practice of nursing. The criminal justice system presents the unique environmental constraints and ethical dilemmas of our specialty. In addition, the criminal justice system creates a unique patient population for nursing care. This patient population has demographic characteristics and illness patterns that require specialized nursing knowledge. The combination of environment and patient can lead to specific patient advocacy situations for correctional nurses.

What do you think of the new definition of correctional nursing? Share your thoughts in the comment section of this post.

The full Correctional Nursing Scope and Standards of Practice, 2nd Ed. Is available through

A New Year Reading List

Do you plan to do some reading in 2014? It can be hard to find good books in our specialty. Here are some books I recommend for both professional and recreational reading. By purchasing through these Amazon affiliate links, you can give back to CorrectionalNurse.Net and help cover the cost of keeping this blog running (web hosting, podcasting streaming, and graphics fees).

Professional Reading

Essentials of Correctional Nursing

schoenly-7.inddNo surprise that my first recommendation is our book on the basics of nursing care behind bars. This book provides essential informaiton for any nurse to get up and running in the specialty. It also includes plenty of information for seasoned correctional nurses about professional practice issues. But, don’t take my word for it. Here are a couple reviews to help you decide:

“I have been searching for a resource like this for the entire 11 years I have worked in correctional health care. As a Nurse Educator, I am constantly searching for current research-based information to share with the correctional nurses I instruct. Lorry has definitely hit the mark with this book.The information is complete and well-organized, and covers issues all correctional nurses enounter daily. Every correctional nurse should own this book.”

“This is THE resource for correctional nurses. As a nurse manager, it sits on my desk. This is the definitive book of nursing in jails and prisons. The authors and editors have done a great job of capturing the essentials that nurses need to know to practice. Read this and you will be grounded in your practice, knowing why things are important as well as what needs to be done.
If you are preparing for certification, this should be the first book in your reading list. If you are new to corrections, this is your guide and starting point. If you are a seasoned nurse, this book will help fill in the gaps and let you know what the best practices and national thought is, moving you beyond your experiences and into the world of expert opinions. If you are a manager, use this to help orient your nurses.”

Correctional Nursing Scope and Standards of Practice, 2nd Edition

ANA StandardsIt was my pleasure to be a part of the ANA Correctional Nursing Scope and Standards Workgroup that produced this latest edition. I wrote the ethics section on pages 18-21, by the way. This book is an incredible resource no matter what your position. As a staff nurse you can see the full scope of correctional nursing practice and use the standards to evaluate your own competency or create a personal development plan. As a nurse manager you can create job descriptions, policies, competency and orientation programs from the material. This book should be on every correctional nurse’s bookshelf right next to the Essentials of Correctional Nursing!






Games Criminals Play: How You Can Profit from Knowing Them

GamesI used this book as background for writing my chapter on staff safety in the Essentials of Correctional Nursing. It is an older book (1981) but manipulation techniques are classic. This book is practical and definitely not a scholarly work. You can find some good principles for avoiding harm in your nurse-patient relationships. Here are a couple reviews that tell it all:

“Games Criminals Play is a very easy to read, straight-forward account of the manipulations inmates are so skilled in often as a means of survival, and how easily susceptible the correctional employee can be. Accounts given demonstrate how easily the manipulations can begin; how difficult they can be to terminate, and how to proactively and professionally ward off the inmates’ manipulative games. The book would serve anyone new to the corrections environment very well.”

“I think that this book should be an annual training requirement for EVERY correctional employee! It reminds us that even a ‘veteran’ can be manipulated, and or set up by convicts. The game never changes, Only the players”



The Art of the Con: Avoiding Offender Manipulation

Art of ConLike the book above, this one is written from the officer perspective but has good information to help correctional nurses. If you like a lot of examples of ways our patients might be manipulative, you can find them here. The difficulty with both these books for nurses is balancing the caring/custody dichotomy. You need to keep that in mind when reading books from the criminal justice perspective. Comments from readers:

“This book really helped me realize how NOT to be a victim of manipulation. I’m usually very trusting and want to believe in the best of people. This book helped me to remember that I am in the criminal’s environment when I am there. They are not in mine.”

“A must have for any or all corrections personnel. I am a nurse working at a state prison and this book gives me the life saving tools needed to avoid any situations that a inmate will place you in without your having the slightest notion what is happening to you. It is a must have to avoid the master manipulation that goes on in the corrections system with the inmates.”



Recreational Reading

Orange Is the New Black: My Year in a Women’s Prison

OrangeI read this book before it was picked up as a series on Netflix and also interviewed author Piper Kerman on women’s healthcare in prison several years ago on the Correctional Nursing Today podcast. The book is engaging and provides an inmate perspective on life in a women’s prison. Comments from other readers:

“It is difficult for many people to have compassion for people who are in prison or to care about their living conditions since they “made their bed”, but I think books that remind us of our common humanity with “others” are important and worth reading.”

“It is an interesting read about how an educated woman was thrown into a world in which she was unaccustomed and how she survived a year in prison. As expected the Netflix series takes quite a bit of poetic license with the story, but that need to be reviewed on its own merits. It is an enjoyable read with an interesting and well-thought-out reasoning for why the war on drugs is a failure and why our nation’s mandatory minimum laws need reform (with suggestions about how to reform the laws without letting the guilty get away with their crimes unpunished).”


These next two books are on my reading list for 2014 as they were recommended by other correctional health professionals. Want to read them with me this year?

The Prison Angel: Mother Antonia’s Journey from Beverly Hills to a Life of Service in a Mexican Jail

Prison AngelMother Antonia recently passed on and her work was the topic of the December 2013 News Round-Up Podcast. Her work and sacrifice sound amazing. Here is a description from Amazon:

“The winners of the 2003 Pulitzer Prize for international reporting tell the astonishing story of Mary Clarke. At the age of fifty, Clarke left her comfortable life in suburban Los Angeles to follow a spiritual calling to care for the prisoners in one of Mexico’s most notorious jails. She actually moved into a cell to live among drug king pins and petty thieves. She has led many of them through profound spiritual transformations in which they turned away from their lives of crime, and has deeply touched the lives of all who have witnessed the depth of her compassion.”




Maximum Insecurity

41KIZXMmjJL._SY344_PJlook-inside-v2,TopRight,1,0_SH20_BO1,204,203,200_This books sounds like an insider view of what we do. Here is the Amazon description:

“After three decades as a successful ear surgeon, William Wright, MD is bored beyond belief. He dabbles with retirement, but finds idleness infuriating. He has to do something.

Then he sees an ad for a doctor’s position from the Colorado Department of Corrections at a supermax prison. Now that, he thinks, would be different. His wife has some thoughts on the matter too. She thinks her husband just lost his mind and is on a collision course with a prison shiv.

Told with self-depreciating humor and scathing wit, Maximum Insecurity describes Dr. Wright’s adventures practicing medicine in a supermax correctional facility without, he’s glad to say, getting killed even once.”



So, what are you reading for fun and profit this year? Share your picks in the comments section of this post.

Planning for the New Year: December 2013 Reader Survey Results

2014 Reader Survey Graphs-Job DescriptionThanks to everyone who participated in last month’s first-ever reader’s survey. The results are in and they will help us plan a fantastic 2014.2014 Reader Survey Graphs-Work Experience

Who is Reading CorrectionalNurse.Net?

The majority of readers participating in this survey have been working in corrections for over 5 years and are either a staff nurse or a nurse manager.



Most of you visit the site weekly and you expect to continue to read the blog in 2014. You mostly read the weekly postings but the resources are also highly valued.

Most Surprising Finding

As an educator, it was delightful to see comments from several respondents about using the blog material and podcasts for staff meetings and monthly education. I hadn’t considered that use and want to encourage more of it. Corrections specific nursing content is scarce so providing content for educational purposes is a great value add.

What You Want More Of

Participants were asked to suggest topics for future posts. Here are the topics most often suggested:

  • Current legal challenges and cases
  • Ethical cases
  • Relationships with custody staff
  • Staying safe in a dangerous environment
  • Drug abuse and withdrawal
  • Documentation Pitfalls

Changes and Updates in the Year Ahead

To make this blog more useful and a good investment of your time, I am planning on the following changes and updates in 2014.

Brand New Look with More Functionality: It has been almost 2 years since the blog had a face lift. We will be upgrading the site in early 2014 with added functionality and easier mobile access.

Encourage More Interaction: One thing I learned from this survey is how much wisdom we have in our regular readers. Besides being an information source, CorrectionalNurse.Net needs to also be a place where nurses from jails and prisons around the country can come together as a community for mutual support. With this in mind, a members-only section will be started later this year with forums and additional information so we can interact and exchange information.

The CorrectionalNurse.Net CE Store: CorrectionalNurse.Net recently became accredited to provide Nursing CE through the California Board of Registered Nursing. Stay tuned for corrections-specific continuing education offerings available this year in text, audio, and video formats.

Monthly Newsletter: CorrectionalNurse.Net will offer a free monthly newsletter starting this spring. The newsletter will highlight recent blog posts and news items, while offering exclusive information not posted on the blog.

So, what do you think of the results of our first reader’s survey and the direction we are going in 2014? Share your ideas in the comments section of this post.