Summer Correctional News Round-Up (podcast)

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cnt-podcast_cover_art-1400x1400Regular panelists Johnnie Lambert and Gayle Burrow join Lorry to talk about the latest correctional healthcare news stories. Even amidst some busy summer plans, they pause to share their thoughts on unfolding events.

Ohio Stops Putting Kids in Isolation

Mental health management is a key issue in corrections in this era. We have seen many a story about the need for more mental health services and also the need to curtail solitary confinement in managing mentally ill inmates. Ohio’s Department of Youth Services has reached an agreement with the Justice Department to stop using solitary confinement in their youth prisons. Placing kids in solitary confinement just doesn’t seem like a good idea. There are some startling revelations about youth treatment in this article and accompanying audio interview from Ohio Public Radio.

Ammonia Capsules for Seizure Evaluation? 

Our next story comes from Dr. Jeff Keller’s Jail Medicine Blog. A recent post recommends using ammonia capsules for assessing seizures (particularly determining true unconsciousness). Many acute care, emergency, and correctional settings have actually banned the use of ammonia capsules as dangerous. Could the use of ammonia capsules also be considered unethical? Panelists weigh in on what they are seeing in other correctional settings.

Causes of Stress for Correctional Officer (and Correctional Nurse) 

This third story shares results of dissertation research on the causes of correctional officer stress. Correctional nurses can experience similar stresses working with the same population and many of the same work environment conditions. This was a survey of 197 officers working in minimum, medium, and maximum security settings. The two most common causes of stress were insufficient salaries and overtime demands. Other stressors included lack of input into decision making, prison security level, and lack of support from administration. The most popular methods for coping with this stress were exercising, seeking religion, support from family, and participating in social activities.

Farm to Table Program

This last story has so many good things to offer us. A Farm-to-Table program was recently started at San Diego’s Richard. J. Donovan Correctional Facility. They have 20 inmate farmers working 3 acres of farmland with the goals of teaching them community gardening, composting, and water-wise gardening using raised bed gardens. A nice addition to this story is that the idea was conceived and initiated by a California Correctional Health Care Services Executive. Many advantages accrue from such a program. Recidivism is only 5-10% with farm prison reentry vs the average of 61% in California.

Correctional Officers are from Mars; Nurses are from Venus –Communication in Corrections (podcast)

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cnt-podcast_cover_art-1400x1400Do you feel like you are working in another world when you enter your correctional facility? Then this episode is for you. Art Beeler, former Warden of the Federal Medical Center in Butner, NC, shares his unique perspective on good communication between officers and nurses. Art has some great advice for working with officers. As correctional nurses we are continually walking the balance between custody and caring to do our jobs.

Here are some key tips:

  • Understand and acknowledge the different perspectives between security and health care. Everyone has a role to play in every situation.
  • Good communication is role modeled from the top. First line managers, especially, must show respect and collaboration among the disciplines.
  • Don’t dismiss officer health concerns of inmates. When an officer contacts health care staff about an inmate, even if the issue seems unfounded, the patient still warrants an evaluation.
  • Courtesy and respect among the staff is important. The correctional environment, by its nature, can be negative.
  • Don’t ignore name-calling or disrespectful communication. Address it directly when it happens.

In the Nursing News

Sounding the Alarm – Patient Safety and Quality Healthcare

Unattended alarms ranks as a top safety issues in acute care settings. An article in the online journal Patient Safety and Quality Healthcare outlines strategies to attend to healthcare alarms. Correctional healthcare may generally have less alarms, but those working in large infirmaries may find this article useful. A four tenet approach is advocated for tackling alarm issues.

  • First, address the culture around the safety issue. An organization may find that over-riding alarms or ignoring them is condoned in the culture of a particular unit or the entire facility.
  • Next deal with the infrastructure supporting the unsafe practice. This can include the layout of the unit or staffing patterns.
  • The third tenet is to consider practices. Here is it best to engage front-line staff in developing a process for alarm notification, verification, and response. What alarms, for example, can be changed from the default to better meet the needs of an individual patient?
  • The final tenet is technology. Questions to investigate in this area include whether staff are correctly using the monitor technology – both as intended and to the full extent.

These tenets are also helpful to guide improvement processes for other safety issues. Consider poor documentation of sick call visits. Using the four tenets, consider how the department culture is affecting this issue and what infrastructure could be implemented to support good documentation during sick call visits.  Involve the staff in providing information about practices that leads to a policy revision to support good practice, and then, see if there is any technology that could help capture sick call visits.

Antipsychotics: Adverse Events That Send Patients to the ED (requires free Medscape Account Login)

An editorial by Dr. Lee Hampton, a medical officer at the CDC, cites antipsychotics as having the highest emergency room visits for adverse effects of other primary categories of psychiatric medications. The antipsychotic drug class includes medication such as haloperidol (Haldol), quetiapine (Seroquel), and risperidone (Risperdal). A study using ER visits at 63 US hospitals over the course of three years found antipsychotic adverse events to be three times more common than anti-anxiety medication, four times more common than stimulants, and five times more common than antidepressants. Of course, the implications for correctional nurses are that patients will be initiating sick call visits for antipsychotic side effects, so it is important to be knowledgeable about how they present. The most common adverse effects noted in the study were movement disorders like trismus (jaw spasms), dystonias (sustained muscle contractions cause twisting and repetitive movements or abnormal postures), and extrapyramidal symptoms such as the lip smacking of tardive dyskinesia or the inability to initiate movement or remain motionless. Also, the atypical antipsychotics such as Seroquel and Risperdal can lead to hyperglycemia and new onset diabetes. Take into consideration the use of antipsychotic medication when evaluating your sick call patients. An appointment with a mental health provider for medication management may be in order.

Five Mistakes New Correctional Nurses Make

Mujer  arrepentida equivocada cubriendo sus ojos.I’ve worked with a lot of new correctional nurses over the years; many of them succeeded and embraced the unique nature of our specialty. Some, however, quickly abandoned their positions even before they gave themselves time to adjust to their new role. Sometimes it is just not a good fit. For example, some nurses just can’t bear to hear the bars click shut behind them when they enter the sally port after security clearance. However, many times nurses make preventable mistakes that land them in trouble on the ‘inside’. Based on my experiences, here is a list of common mistakes nurses can make in their first correctional position.

Not paying attention to security procedure

Many seasoned correctional nurses will tell you that working behind bars is one of the safest jobs aroung. In fact, correctional nurses have more security presence than most emergency rooms or mental health units in traditional settings. That being said, nurses must know the security procedures and follow them. For example, nurses need to know where officers are located and how to activate the alarm system. We also need to let others know where we are headed and when we expect to return when moving within the various facility areas. And, whenever possible, travel with someone else. Nurses who don’t pay attention to security procedure can find themselves vulnerable to injury or assault.

Disrespecting correctional officers

Correctional officers are professionals, too, and deserve civil and respectful treatment. Nurses who are arrogant or act superior to their correctional colleagues don’t last in the specialty. We may come from different worldviews and we may have differing opinions, but both professions have a vital role in the facility. The happiest correctional nurses are those who build collegial relationships with the officers with whom they work.

Not treating the inmates like patients

Some nurses enter the correctional setting and find affinity with the officer role, even identifying with it. These nurses easily absorb the jail culture and abandon their nursing perspective. In a poor environment, this can easily degenerate into a cynical and punitive attitude toward the patient population. Research into correctional nurse working styles identified four types:

  • Idealist: Nursing perspective is a primary consideration and does not understand the security perspective
  • Realist: Respects the security perspective while continuing to function from a nursing perspective
  • Situationalist: Alternates between a security orientation and a nursing perspective depending on the situation
  • Acceptor: Identification with the security perspective with no application of nursing perspective while in the correctional setting

By focusing on becoming a realist, new correctional nurses can successfully navigate in the criminal justice system while providing substantive nursing care to their patients.

Treating the inmates like patients in other settings

This one sounds contradictory of the previous mistake but hear me out. While we must treat inmates like patients, nurses make mistakes when they treat incarcerated patients like they might a frail elderly hospitalized patient. What I mean is that the common signs of compassion and care provided in a traditional setting such as a shoulder squeeze or other touch can be misinterpreted in the correctional setting. Successful correctional nurses find other avenues to show care or concern.

Leaving the nursing license at the door

I know it can be hard to believe but I have seen this more than once. Nurses start working in a correctional facility and fall into practices that are definitely unsupportable to a licensing board. These practices can be as mundane as poor or missing documentation. They can also be as egregious as participating in a use of force against an inmate. A nursing license governs every employment setting, no matter how untraditional it might be.  New correctional nurses are successful when they practice within their licensure requirements when ‘behind the wall’.

Do any of these sound familiar? What advice do you give new correctional nurses? Share your thoughts in the comments section of this post.

PS – For a short time, you can get a free downloadable copy of my new ebook – The Correctional Nurse Manifesto by signing up for my email list. Use this link

Photo Credit: © gosphotodesign – Fotolia.com

April 2014 Correctional Healthcare News Round-Up (podcast)

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cnt-podcast_cover_art-1400x1400In this monthly round-up of correctional healthcare news Lorry is joined by Sue Smith and Denise Rahaman.

Story #1 Hepatitis C Prevalence and Treatment

Communicable disease makes the news this month with research out of Emory University under the direction of Dr. Ann Spaulding; well–known in correctional circles. Her group found that 17.4% of prisoners are infected with HCV – under earlier estimates of 25%.

This finding is coupled with a second story from USA Today questioning whether prisoners should get expensive Hepatitis C treatment. The cost of treating a single person is $65-170,000 per year using recently developed drug treatment. How do we deal with this ethical dilemma of “treat or not treat”?

 Story #2 - Inmates with HIV benefited from treatment in prison

Disease treatment is certainly effective in prisons, as highlighted by our second story out of Infectious Diseases News. Dr. Jaimie Meyer and colleagues from Yale School of Medicine found that the highly structured environment of prison is good for HIV treatment. I think we have all seen that to be true in our own experience, but, would you agree with Dr. Mike Puisis’ response that there is still much more to be done?

Story #3 – New NCCHC Standards Published

Story number 3 is about the much anticipated new accreditation standards from the National Commission on Correctional Health Care (NCCHC). Although education about the standards began last fall, they were unveiled for the first time earlier this month at the spring conference in Atlanta. I have mine on order but am already beginning to digest the changes. Facilities are scrambling to review changes and make program alterations accordingly. The implementation date for the 2014 Standards is October 1, 2014.

According to the NCCHC website

  • Facilities with on-site accreditation surveys scheduled on or before October 1, 2014, will have the choice of being surveyed under the 2008 edition or the 2014 edition of the standards.
  • Facilities surveyed under the 2008 edition would then be required to submit a plan to meet the 2014 standards by October 1, 2014
  • Facilities with on-site accreditation surveys scheduled after October 1, 2014 will be surveyed under the 2014 standards.

The Standards Change also affects those sitting for the Certified Correctional Health Professional (CCHP) exam:

  • Exams conducted before or on October 1 will refer to the 2008 Standards.
  • Exams conducted after October 1 will refer to the 2014 Standards.

Story #4 – Prison Terminal Documentary on HBO

Our last story is some happy news for our friend and independent film producer Edgar Barens. His film, Prison Terminal: The Last Days of Private Jack Hall, was nominated for an Oscar this past month. It has been airing on HBO and providing a public forum to discuss terminal illness and hospice care behind bars. As a note to our listeners, more information about the video can be found at prisonterminal.com.

There are many articles available, I selected one from Newsweek. In this interview Edgar is quoted as saying “We still owe people like Jack a dignified death”. In many ways, I think that sums up a lot of what correctional nursing is all about – no matter the crimes of an individual – By virtue of their humanity, we owe them respectful care.

Also in this episode:

Scope and Standards: Population Served

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

Many of us entered the nursing profession to help those in need. I can’t think of a needier patient population than those in correctional facilities. The demographic make-up and specific health needs of our patient population contribute to what makes correctional nursing a specialty. Because our patient population is defined by location and jurisdiction, rather than disease or health need (as in most traditional settings), correctional nurses must be proficient in a broad array of conditions and, often, a variety of ages and genders. For example, a small jail may house detained men, women, and juveniles. While, larger systems such as a state or federal prison system have the volume and support necessary to separate populations by gender and age.

Although the majority of prisoners in the US criminal justice system are white, there is a disproportionate number of minorities behind bars. Therefore, conditions found more frequently in black and Hispanic populations are prevalent in the inmate patient population. According to the CDC, blacks are three times more likely to have diabetes and strokes and have a higher death rate from HIV disease. Likewise, the CDC reports Hispanics having higher rates of death from these conditions along with higher rates of chronic liver disease. Therefore correctional nurses must be proficient in assessing for and treating these conditions.

Coming from disadvantaged backgrounds, with less access to regular healthcare services, the incarcerated patient population has many untreated conditions and a high burden of chronic disease. A study of jail and prison inmates found higher rates of diabetes, hypertension, asthma, and prior MI than the general population. The correctional nurse may be a first contact with the healthcare system. Therefore, correctional nurses must be proficient in evaluating symptoms that might indicate an undiagnosed chronic condition. For example, I have seen newly diagnosed diabetes and asthma in the correctional setting.

Our patients are also prone to infectious disease with high rates of sexually transmitted infections, tuberculosis, and blood-borne infections such as HIV, HCV, and HBV. Many have poor hygiene practices and a cramped correctional environment can contribute to the spread of infection, like norovirus, throughout a facility. Correctional nurses often become infection control specialists; containing a varicella outbreak, reporting food poisoning to the health department, and educating patients to reduce transmission.

The inmate patient population has high rates of mental illness. Every correctional nurse is a mental health nurse! Among the mental conditions over-represented in the incarcerated are mania, major depression, psychotic disorders, and borderline personality disorder. Not only must correctional nurses understand the assessment and treatment of these conditions but must be aware of the implications of personality disorder, sociopathic, and psychopathic tendencies on the nurse-patient relationship.

The often violent and abusive backgrounds of the correctional patient population means higher rates of traumatic brain injury, post-traumatic stress disorder, and suicidality. Correctional nurses must be astute in detecting the potential for self-harm and seeking to prevent it. Histories of abuse require sensitivity in nurse-patient interactions to avoid triggering panic, anxiety, or suspicion. An understanding of the effects of traumatic brain injury is needed when providing patient instruction.

Finally, our patient population is highly substance involved. Drugs and alcohol are a way of life for so many under our care. An extensive study found nearly 85% of all U.S. inmates involved with alcohol or illegal drugs. You can bet that means withdrawal concerns when they enter the criminal justice system. Our patients are also willing to coerce others (including you!) to obtain drugs for them while they are ‘inside’. Their desire for alcohol can lead to hooch-making from spoiled fruit and potato peels – that can be deadly. Amazingly, alcohol –based hand sanitizer has also been ingested in the correctional setting.

In summary, it is clear that correctional nurses work with a unique patient population that requires specialized knowledge, skills, and attitudes. Did you see your patient population in this description? Share your thoughts in the comments section of this post.

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 amazon.com.

Top Six Posts of 2013

six balloonsThank you for being a part of CorrectionalNurse.Net this past year! Your comments and suggestions make this blog a helpful resource for nurses new to the specialty and those interested in keeping abreast of the latest news and information important to working in jails and prisons. In fact, my goal for this blog is:

Informing, encouraging, and inspiring nurses who care for vulnerable, marginalized patients in the low resourced, ethically challenging criminal justice system.

This blog has been around for more than 4 years now and has over 250 informational posts in a variety of categories. Search by key word using the search field in the upper right or by category using the drop-down menu on the right sidebar.

Here are the six most popular posts in 2013. Check them out if you missed them when they originally aired. Stay tuned for more great information in the year ahead. I hope you visit often and include your views by commenting frequently.

#6 Confidentiality, HIPAA, and the Correctional Nurse

Concern continues for the confidentiality of patient medical information. Correctional nurses must navigate within a security system that often requires the exchange of medical information for safety and good patient care. What medical information can be shared? This post provides information directly from the HIPAA code that specifically addresses the correctional setting.

#5 Women’s Health in Prison

Women may only constitute 7-12% of the incarcerated population, but their healthcare needs can be great. Maybe increased interest this year can be attributed to the popular Netflix show “Orange is the New Black” – a portrayal of life in a female federal prison.

#4 Taser Injury – The Stunning Truth

Correctional nurses take care of an extensive variety of conditions and some that are rare in more traditional settings. Taser injury is one such unusual care situation. This post covers assessing and treating post-taser wounds as well as what conditions render persons at high risk for increased injury from being tased.

#3 8 Medication Rights – Not 5?

Just when you think you are up-to-date something changes. That is life as a practicing nurse. This post adds three new ‘rights’ to the classic 5-rights of medication administration and is actually reposted from the blog of a fellow nurse. A great review!

#2 Interview Guide: Part I   Part II

Many nurses discover this blog while looking for help in preparing for their first interview for a correctional nursing position. This 2-part series shares tips for determining if a correctional setting will be a safe work environment along with questions that may be asked during the interview.

#1 Dental Issues for Correctional Nurses

By far, dental issues were the greatest learning curve for me in entering this specialty. This post has some great pictures provided by Dr. Stephen Mitchell and is a big help for nurses who need to know what is routine and what is a possible emergency when dealing with dental conditions.

What was your favorite post of 2013? Share your thoughts in the comments below.

Photo Credit: © Kyrylo Grekov – Fotolia.com

December 2013 News Round-Up (podcast)

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cnt-podcast_cover_art-1400x1400Regular panelists Johnnie Lambert, Mari Knight, and Margaret Collatt help us close out the year with discussion of December 2013 correctional healthcare news. Let’s roll……

Story #1: Eye Care Rare Among Low Income Diabetics – Implications for Correctional Nursing?

Our first story, while not specifically about correctional healthcare has a very real connection for our consideration. A Reuter’s news story reports on a study finding that young low-income diabetics are not attending to their eyes. Our inmate population fits this profile – young, low-income and often diabetic. Are their implications for our patient care here?

Story #2: Psychiatrist Shortages in Corrections?

Our next story is from the California Prison System. California Healthline reports that the state prison hospital has had to cut services and reduce admissions due to a psychiatrist shortage.

Story #3: Orange is the New Black and Women’s Prisons Portrayal

Story #3 from the Washington Post lauds the Netflix series ‘Orange is the New Black’ as a fairly accurate portrayal of a women’s prison. Do you think having a program based on a women’s prison might be helpful in raising awareness of incarcerated women and their plight?

Story #4: Mother Antonia Passes

Our final news item is the sad report that Mother Antonia Brenner has passed on. She was dubbed the Prison Angel for her work with the poor and imprisoned in Tijuana, Mexico. She has an amazing story. Her prison worked grew from her charity work among the poor in California where she was a twice divorced mother of eight children. Eventually she moved into a cell in the Tijuana Prison to more fully experience the lives of those she served. Hers is an inspiring story of kindness and sacrifice.

What is your take on the December news? Share your thoughts in the comments section of this post.

Christmas is About the Children

Little child decorating christmas tree

With my grandson nearly 3 years old, our Christmas this year is full of toys and wonder and a reminder of the Babe long ago who brought hope to the world; whose birth we are celebrating. Christmas is definitely a time for children and a reminder of how many children have parents behind bars in our country. These young victims of their parent’s crimes suffer grave consequences, including separation from their parents during the holiday season.

According to the Bureau of Justice, 1.75 million children have a parent in a state or federal prison this Christmas. Many inmates have multiple children and the Sentencing Project estimates that 1 in every 50 children in this country has a parent behind bars. These are sobering numbers amid the lights and glitter of our holiday celebrating.

Children in this situation may be lonely and feel alienated from the season’s festivities. Even if able, visiting a parent in prison during this time of year can bring more sadness than cheer; emphasizing the obvious separation.  Distance and lack of financial resources may make visiting impossible and incarcerated parents may be unable to afford providing even a token gift for a child.

If the incarcerated parent is also the primary care provider, the child may be living in foster care. More fortunate children may have a loving extended family member willing to provide support and supervision during this period. According to an economic study of incarcerated families, children with incarcerated parents are more likely to have difficulty in school with more aggressive behavior noted among boys and an increased chance of being expelled or suspended.

Most of us will not be able to make as great an impact as 2012 Miss America, Lauren Kaeppeler, who is using her platform to bring more attention to the plight of kids of incarcerated parents. Her father was incarcerated when she was a teenager and she has first-hand experience of the effects of a parent behind bars. However, every one of us can do something. Here are just a few of the organizations that are helping our patient’s children cope with the impact of prison on their lives. This Christmas season, consider contributing to one of these charities, or another you may be aware of in your community:

Prison Fellowship: Angel Tree

Camp Spaulding – New Hampshire

Children of Promise – New York City

New Hope – Oklahoma

Does your facility do anything for inmates and their children on Christmas? Could they? Share your thoughts in the comments section of this post.

Photo Credit: © allari – Fotolia.com

Vicarious Traumatization in Correctional Nursing (podcast)

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cnt-podcast_cover_art-1400x1400Have you ever felt traumatized at the end of your work day? Maybe you have gone through periods of feeling very burned out in your nursing practice. In this episode I talk with Tanya Munger about her research into vicarious traumatization of correctional nurses. She surveyed correctional nurses from around the country about their experiences with this phenomenon. Tanya Munger, MSN, FNP-BC, CNOR, CCHP, is Clinical Instructor, Department of Health Systems Science, UI College of Nursing at Rockford, IL. She worked as a nurse practitioner with UIC College of Medicine inside of the Winnebago County Jail, the second largest county jail in the state of Illinois.

What is vicarious trauma?

Vicarious trauma is the result of taking on and absorbing disturbing aspects of the traumatic experiences of others, such as our patients. As correctional nurses we work in a harsh system among patients who often have very painful background full of violence and abuse. Regular contact can result in integration of this post-traumatic stress into our own functioning resulting in a variety of alarming symptoms such as flashbacks, nightmares, intrusive thoughts, depression, and sleeplessness.

What can you do about vicarious trauma?

What should you do if you think you are absorbing the traumatic experiences of others? First, be aware of this possibility and monitor yourself. Be sure to take care of yourself, getting enough rest, health food and activity. Traumatic stress can get you off balance and it might take conscious effort to return to a balanced lifestyle. Find ways to separate yourself from your patient. Remind yourself that this is not your pain. You may be holding it or helping with it, but it is not you. Look for small and large ways to renew yourself. Do what works – which can be different for everyone. Meditation, deep breathing, yoga, creative arts are some small regular options. Larger ways might be taking a real vacation away from your worksite to totally unplug, drain your stress, and re-center yourself. Certainly, if you are experiencing serious or debilitating symptoms, it is time to seek help through counseling or healthcare services. Read more about this condition from the resource links below.

Resources

Burnout, vicarious traumatization and its prevention

For Professionals: Vicarious Trauma

Announcements – Reader Survey

Did you know CorrectionalNurse.Net is running a first-ever reader survey for the month of December? Take the survey and give your input on what you want more of in posts and resources for 2014.