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2022
The Correctional Nurse Newsletters from 2022
April 2022
In keeping with our documentation topics from the last couple of months, I wanted to share one other phenomenon I see very often when I review health records – the use of words/phrases that look good on paper but are meaningless. I have coined the term “empty phrases” for them.
May 2022
As I sat down to write this month’s newsletter, for a moment I thought to myself, “What can I say that is new, different, and exciting for our very special Nurse’s Week month? What can I share that will be inspirational?”
2022
The Correctional Nurse Newsletters from 2022
January 2022
As you know, I am a great advocate for correctional nursing, and frequently discuss scope of practice. I was recently asked by a Correctional Nurse what to do if she was asked to perform an intervention or make a clinical judgment that exceeded her scope of practice. She was not currently faced with the situation, but was thinking about it beforehand so that she was prepared. She shared that it did happen to a colleague, who made the decision to practice beyond her scope, using the thought process that the physician would “back her up” if someone “had a problem with it.”…
February 2022
Our Inspiration this month is a quote from Mother Teresa about the impact of words, and I have always believed that words are powerful, not only when spoken, but when written. As healthcare professionals, we must be diligent to use non-stigmatizing and non-biased language in our health record documentation. I recently reviewed the documentation of a patient encounter in a health record that clearly conveyed the personal opinion of health staff member about the patient and his presenting complaint.
March 2022
I was recently on-call for a facility with many new-to- corrections nurses, and I found myself conducting a mini- training every time one of them called me for the first time; I was very happy to do it. We discussed what information I needed as the on-call provider to start my differential diagnoses formulation and then to develop my treatment plan for that patient. This included verified vital signs (meaning if any measure was abnormal, manual measurements must be taken before they called if appropriate (blood pressure, pulse); a brief patient health history from the health record and a description of the presenting problem; objective findings that included lung, cardiovascular and abdominal evaluation for just about every complaint; and the nurse’s observation of the patient.
2021
The Correctional Nurse Newsletters from 2021
October 2021
I hope this finds everyone healthy and doing well as we enter the Fall season. This month I would like to share a situation that happened to me a few weeks ago, hopefully to underscore the importance of obtaining past records and reading them. I was covering a medium-large facility, and the nurses ordered past records on a gentleman who was newly arrested. He had several medical issues, but his most pressing was chronic back pain. The records came quickly, were scanned that day, and immediately showed up in my “Alert” queue. I read the records and noted, almost in passing at the time, that this gentleman had a CT scan last spring that indicated he needed further studies, but the next step, an MRI, was contraindicated because there was a “metallic object” quite large near his right orbit. The paperwork indicated that they would do the MRI if/after the metallic object was removed…
November 2021
Happy November!
I want you to know that I am very grateful to each of you for reading this Newsletter and I truly appreciate the feedback you send. I appreciate what you do every day for your patients and that you are a positive representative of Correctional Nursing. I say it often, but please know that your patients are also appreciative of what you for them, even if they don’t always tell you.
In September, the American Correctional Nurses Association presented its first webinar entitled Promoting Wellness and Self-Care for the Correctional Nurse. Dr. Annette Maruca shared a number of self-care strategies Correctional Nurses could use to enhance their wellness, including the simple act of being grateful. One quoted study found that healthcare workers who wrote down things for which they were grateful twice a week had a reduction in perceived stress and depression.
December 2021
Some months, the topic for my narrative for the newsletter seems easy, and others, not so much. While my clinical, educational, and consulting practices always give me ideas to share with you, when the time comes to write, sometimes my mind goes blank – or worse, it goes in many different directions, and I find myself straying far from the original idea. This month, while I was happily writing about gratitude, I received a call from a correctional nurse who was placed in a challenging situation and was asking me to help her figure out how to address it. This prompted me to change the topic for the month to the ethical situations in which we may find ourselves as Correctional Nurses. We will discuss gratitude another time!More so than our hospital and community colleagues, Correctional Nurses are often faced with ethical decisions surrounding the nurse – patient relationship; our role as a patient advocate; and the delivery of nursing care.
2021
The Correctional Nurse Newsletters from 2021
July 2021
I am curious, before being critical…..
This past weekend, I participated in a large Health Fair for the homeless in the parking lot of a local church. This included not only healthcare, but showers; washers and dryers to do laundry (both on trailers designed to be mobile); barbering services; and tables of clothing. Food was available as well (to eat there and groceries to take with). Our healthcare services included screening for COVID and HIV, as well as vital sign and glucose screenings. We also provided medical evaluations and wellness exams. Some of the individuals I saw were patients I have seen and treated in the past who were there for their follow-up visits, but most were new. We had one person leave via ambulance after their evaluation revealed a strong indication for DVT, and another whose remarkable hernia will be fast-tracked to a surgeon who sometimes donates his services for our patients at the community clinic. Anyone in need of mental health services was also referred to our provider at the community clinic [our clinic is free and we only see patients who do not have insurance – you would be amazed at how many people that is!]…
August 2021
Last month, I had the privilege of presenting the KeyNote address for the Nursing Conference of a large eastern Department of Correction. I spoke about Correctional Nursing history and professional practice, and Mary Muse’s Proposed Framework for Correctional Nursing Practice. As always happens when I am researching a topic about which I will be speaking, I find something “new;” something I probably have seen in the past many times, but at that moment, was not relevant to me. It is like suddenly “seeing” all the Chevrolet Sparks on the highway once you have purchased one. This time, it was the term “professional nursing practice.” We all use it, but what does it really mean? I went on a search and found many elements of it – like professionalism and the importance of having a framework, but there was not a succinct definition. Many, many organizations included a description of the professional nursing practice in their organization. Many included a model or framework and use of the Nursing Process, which I was very happy to see. All included a reference to the American Nurses Association’s Nursing: Scope and Standards of Practice for Nurses (2015) as the foundation for its organization’s professional nursing practice…
September 2021
According to the American Nurses Association, specialization involves focusing on nursing practice in a specific area, identified from within the whole field of professional nursing. A nursing specialty includes a specified area of discrete study, research, and practice as defined and recognized by the profession. Finally, specialists are those who elect to focus their professional practice to their identified specialty.
After my last newsletter in which I discussed my recent presentation that included an introduction to Muse’s Proposed Correctional Nursing Framework, I heard from several readers (thanks!), including Deborah Shelton, Professor of Nursing and President of the American Correctional Nurses Association, who reminded me that a framework, like Muse’s Proposed Correctional Nursing Framework, is a “place” to organize ideas. To develop a specialized theory of Correctional Nursing, additional work must occur. In this proposed f ramework, there are concentric rings that represent variables and ideas. The relationship between these variables and outcomes must be described by theory, and it must be tested and validated. Dr. Shelton suggests that the next step in developing a theory of Correctional Nursing is literature review and research…
2021
The Correctional Nurse Newsletters from 2021
April 2021
I moved last month, and during all the sorting and packing, came across a box of nursing and correctional health books. (Yes, printed pages with pictures – some even had hard covers!) that I clearly have packed and moved a couple of times now. It was suggested that I finally put these “antiques” in their final resting place. Opening the box and looking through the books was a gift, and before I knew it, two hours had passed. For most books, I remembered when I had purchased it and why. Many were because of teaching or my early classes offered on The Correctional Nurse Educator.
Intellectually, I know that the internet is the best source of current information on a wide variety of topics, including nursing, medicine and mental health, where new research is being published daily. I now exclusively use the internet when writing and updating The Correctional Nurse Educator classes and when researching the educational presentations I give, but there is something special about holding a book in your hands, turning the pages and perhaps, if it is yours, highlighting those passages that are especially noteworthy or meaningful…
May 2021
This month, I had another topic to share with you, but after hearing multiple stories of our Correctional Nurse colleagues having difficulty coping with the strains and stressors faced on a daily basis, I decided that Self-Care was a better discussion. From experience I will tell you that often we, the stressed, are the last ones to know!
I am sure that I don’t have to tell you that we, on the front lines of Correctional Nursing, are stretched beyond belief. We are asked to do more with less, and we must “figure it out.” We must prioritize our duties, understanding that an emergency could occur at anytime. We remember that our patients rely on us for their medications, triaging their health problems, addressing those conditions that we can, and ensuring that they have access to healthcare. This can be a daunting task and responsibility, especially when the resources that were limited before are even less now. However, as Correctional Nurses, that is exactly what we do best, and we do what we need to so our patients continue to get the care and treatment they need…
June 2021
I was recently asked to agree with the statement that “all inmates lie about their symptoms,” most often to get out of jail/prison for a “field trip” to the local emergency department. I did not, because I do not agree. While I have certainly known of situations when it was determined that the patient was feigning illness, it was only after all potential medical/mental health causes of their symptoms were ruled out. It is certainly not all patients, nor is it even the majority of the patients we see in correctional facilities who are not truthful about their symptoms.
Our responsibility as correctional nurses is to listen to the patients’ complaints, conduct an appropriate and thorough physical/mental health evaluation of the patient (including a complete set of vital signs), and then, consult with the provider for any abnormal findings. This is not difficult, but requires a solid assessment skills foundation. If you were not taught these skills, or have not used the skills learned in nursing school or during your site orientation in a while, then it is your responsibility as a nurse to identify, acknowledge and address these deficits. It is a sign of professional strength and growth to do so…
2021
The Correctional Nurse Newsletters from 2021
January 2021
I read recently that most people are happy that 2020 has ended, hoping that the unprecedented times and the massive death toll will quickly become a blurb in the history books. I encourage you to keep 2020 upmost in your mind as you go about your daily routines and care for your patients! This pandemic is far from over, even with the initiation of the vaccine program, and we must remain vigilant. Continue your infection control practices and don’t become complacent! As Correctional Nurses, we have the means and opportunity to share our knowledge about health with our patients and colleagues through our interactions and teachings, which will truly impact lives and communities. Please don’t assume that everyone knows everything they need to know “by now” [as I overheard recently at a facility]. Instead, remember that knowledge is reinforced and learned through multiple educational sessions.
This month, I also wanted to talk a little about documentation, and share an experience I had with a student recently…
February 2021
These past few weeks, controversy has erupted over the COVID-19 available vaccines, and who should receive them. While different states are approaching the immunization schedules differently, in all states the timing of the immunization of incarcerated persons has been a debated topic. The latest information (disclaimer: it does change daily) is that the COVID-19 case rate is four times higher in state and federal prisons that in the general public, and since March 2020, at least 227,333 incarcerated persons have tested positive and at least 1671 have died. In addition, at least 54,496 prison correctional staff have tested positive, and 105 deaths have been reported. According to the draft state proposals for immunization “roll-out” submitted to the Centers for Disease Control last Fall, 15 states had correctional staff prioritized in Phase 1, while only eight states had incarcerated persons included in Phase 1. Disconcertingly, seven states did not include correctional staff in any phase and 10 states did not include incarcerated persons in any phase…
March 2021
Picture this. You are the nurse passing medication and Ms. Jones comes to the cart and shows you a small cut on her right hand. She asks for a band-aid, and you give it to her, reminding her to keep the cut clean and to drop a sick call if it gets worse. The following two days you are off, but she continues to request and get band-aids from the medication cart nurses. When you return to work and begin passing medications on her unit, Ms. Jones approaches the cart and you see right away she does not look good. She is diaphoretic, walking slowly and holding her right arm in her left. On closer look, her right hand is reddened with 2+ swelling on the dorsum. There is a central, pus-filled lesion about 2.5 centimeters in diameter. You stop medication line and get Ms. Jones to the medical clinic. where it is determined that she must get to the emergency department for diagnostics and treatment. She ultimately received intravenous antibiotics and wound debridement that required a three day stay in the hospital…
2020
The Correctional Nurse Newsletters from 2020
October 2020
Last month I was fortunate to do a week-long training at one of my contracted jail sites. It was invigorating to meet nurses just beginning their correctional nurse practice, and to hear the experiences of the seasoned correctional nurses there. As I discussed Correctional Nursing in my first session, I decided to include in our October Newsletter some of the information I shared. For some of us, this is not new information, but I think it is important to keep reminding ourselves (and others) how important our work really is!
November 2020
This is the month when we traditionally give thanks. Certainly 2020 has been an interesting and chaotic year, and it looks like this will continue into 2021. This doesn’t mean, however, that we are not grateful for our health, family and friends. Perhaps, the trials of this year have enabled us to see with greater clarity what is truly meaningful in our lives. Our work, and sharing our time and knowledge with our patients every day of the year is a wonderful gift that we give, that also gives great returns to us…
December 2020
It is hard to believe that we are at the end of 2020! It seems like yesterday that we were welcoming in “the 20’s.” This year has brought “unprecedented times,” which I am sorry to say are no longer “unprecedented” as we endure yet another surge in COVID-19 cases and deaths. From the adversity, however, has come well-deserved appreciation for the work done by nurses, nurse practitioners, physicians, physician assistants and everyone involved in healthcare.
As holiday-time approaches, please remember that we usually see an increase in attempted self-harm and suicide.. .
July 2020
… Today, I start with a question. What do you do when your vital sign machine gives you a reading that is below or above the expected normal range, like a blood pressure of 160/108 or 170/120 or 90/64; or a pulse of 124 or 56? I hope that your answer was “repeat the measure without the machine.” Abnormal blood pressures should always be verified with a manual measurement, and listening with your own ears is the ultimate verification! If the pulse was from the machine or palpated radially, use your stethoscope and auscultate the patient’s heart at its apex (“apically”). Remember to document all of your actions, including the “machine” readings as well as your manual verification readings…
August 2020
I hope that you have had a good month since we last communicated. While I had hoped that COVID conversations would be at a minimum by now, it seems that this is not the case; and the situation, while becoming the “norm,” continues to require vigilance and common sense.
This month, I wanted to share a story that reflects the importance of obtaining a thorough history and subjective information from our patients. A few weeks ago at the Free Clinic, a 43 year old woman came in for a follow-up to an emergency department encounter that occurred 3 days prior. She went to the emergency department for “heart palpations and racing” that had been occurring intermittently for the past six weeks…
September 2020
I cannot believe that a year has passed since I took over the CorrectionalNurse.Net blog, and integrated it with Nursing Behind the Wall and The Correctional Nurse Educator. What I have learned this year from writing this newsletter, posting on the CorrectionalNurse.Net blog and receiving feedback from nurses like you who read them, is that the issues each of us in correctional nursing face every day are not unique. Our colleagues are going through, or have gone through, situations that are very similar. We should learn f rom each other’s experiences! We should be comforted by the fact that we are not alone in our challenges, even if you are the only nurse in a small rural jail…
April 2020
As I sit to write this newsletter, I am focused not on the patient with thyroid disease that I had planned on sharing with you this month, but rather the COVID-19 health situation in which we find ourselves.
Words like “unprecedented,” “crisis,” and “uncharted territory” are consistently being used to describe this pandemic. Nurses, Providers and everyone who works in healthcare are being celebrated as heroes and publicly thanked…
May 2020
As I write this newsletter, we continue to be in the middle of the COVID-19 “unprecedented times”. While some say ithe situation is better, and some “non-essential” businesses are allowed to open (with restrictions), I hear from my correctional colleagues all over the United States that their practices will not be changing anytime soon. I am glad to hear that….
June 2020
I hope this finds you healthy and safe. As our politicians decide that it is “all clear” to return to social interacting, please be mindful that others in the medical field have opinions that it is very soon and that a second wave may be coming in the Fall. Good infection control practices should continue, and I am grateful that we have been brought back to the roots of our nursing…
January 2020
Happy New Year! As I look back in 2019, I am so grateful to have received the opportunity to continue this CorrectionalNurse. Net blog, and in the process, update Nursing Behind the Wall to be better utilized by all readers. It is hard to believe that this is my fifth newsletter! As I look forward, I see great opportunity to advance the specialty of Correctional Nursing, and I am so glad that you are with me on this journey!…
February 2020
On Fridays, I see patients at the Free Clinic. We are very fortunate to have many students who do their clinical rotations with us, including RNs, APRNs, PAs, and medical students, which gives me a great opportunity to talk about correctional nursing and correctional healthcare. In addition to discussing the patient conditions we treated in clinic that day, I usually share information about whatever class I am researching and writing for The Correctional Nurse Educator. The students, for the most part, are enthusiastic about learning new information…
March 2020
A few weeks ago in chronic care clinic I saw two patients who were Type II Diabetics . Both had been diagnosed a number of years ago, both were on oral hypoglycemic medications and both told me they knew all about diabetes. I could have moved on in the conversation, documenting that each knew about his disease, but instead, I asked more questions…
2019
The Correctional Nurse Newsletters from 2019
September 2019
I am thrilled to be starting this journey into the world of blogging with you! Please note our new newsletter name to better reflect all three of our sites! The integration of classes and case studies to help develop clinical decision-making with the monthly topics at CorrectionalNurse.Net is time-consuming, but so exciting and well worth it! Every month we will have a clinical topic and a professional practice topic posted on the CorrctionalNurse.Net blog. At the same time, there will be a monthly case study posted on Nursing Behind the Wall involving the clinical topic, and at The Correctional Nurse Educator, an associated class that offers accredited continuing education hours will be 50% off for the month…
October 2019
I want to thank everyone who reached out to me about our new program integration – I definitely appreciate your kind words! I also want to be sure I am posting materials that are pertinent to your correctional nurse practice, and so I am looking forward to your feedback and suggestions for future topics.
I wanted to take a moment to share a couple of reminders with you this month…
November 2019
The American Nurses Association workgroup for the Correctional Nurse: Scope and Standards of Practice has finished it work, 13 months after it began. The draft Correctional Nursing: Scope and Standards of Practice, Third Edition, will undergo its first ANA review by the Committee on Nursing Practice Standards in early December. Upon successful review, that Committee will forward the draft document to ANA’s Board of Directors for final action that approves the scope statement and acknowledges the standards…
December 2019
It is hard to believe that we are already in December! I hope that everyone had a wonderful Thanksgiving. There is not a lot to report this month in terms of new things for the correctional nurse .. .perhaps a quiet month is a good thing!…