This is a continuation of a list started in an earlier post. Correctional nurse experts Kathy Wild, RN, MPA, CCHP and Royanne Schissel, RN, CCHP, offered advice to correctional nurses during the 2013 NCCHC Spring Conference.  Here are five more ways you can land in court.

#1- Treat your patient as an inmate – It is easy to slide into a punative perspective in dealings with inmates. After all, some of them have learned that they can get what they want through manipulation and deceit. Yet, according to Earl Nightingale, our attitude toward others determines their attitude towards us. As nurses we are called to treat all patients with respect and dignity. We cannot disrespect or abuse the patients that we are responsible to treat.

#2-Don’t share critical health care information with others – HIPAA release forms are not needed for every situation. Check out this earlier post about sharing confidential patient information in the correctional setting. We often need to share important health information with custody officers. Officers, especially housing officers, are part of the treatment team and need to be aware of significant medical conditions that may need early medical attention.  Communication is important.

#3- Don’t follow up on something because “It’s not your job” – Nurses are responsible for positive patient outcomes. Yet, in some correctional cultures, staff are willing to do specific tasks and no more. Some correctional settings still ascribe to a functional care delivery pattern where some nurses only perform sick call while others only perform medication administration activities. “It’s not my job” is not an appropriate response where patient outcomes are concerned and does not absolve nurses from responsibility in a bad outcome where something could have been done to improve a patient outcome.

#4-Don’t follow current protocols – Protocols often guide nursing actions in the correctional setting. They are particularly important for nursing sick call and emergency responses. Written protocols should be available at all times and staff should know where protocols can be found. For example, the only copy of clinical protocols should not be locked in a supervisor’s office. Skipping protocol steps is a frequent problem in legal cases. Referring to the protocols frequently will ensure that this does not happen. Relying on memory is not good practice. Another legal concern with protocols is keeping them updated with any new changes in practice. At a minimum nursing protocols need to be reviewed and updated annually.

#5-Don’t look for other employment when you are not happy with your job – Correctional nursing is not for everyone. The environment can be unfriendly and the patient population challenging. If you don’t enjoy your work you can fall into practice patterns that can land you in court. Indications that you don’t like your job can include calling inmates names, calling other staff members names, having a bad attitude, or taking shortcuts with patient and staff safety. Some nurses are unable to overcome concerns that inmate patients are dangerous. Yet, you can’t help a patient when you are afraid. If you see these indications in yourself, consider other nursing options. Maybe correctional nursing is not a good match for you.

What do you think of this list of risky practices? Have you been tempted or pressured to let your guard down in any of these areas? Share your thoughts in the comments section of this post.