When most people think of nursing, they picture hands-on patient care—taking vital signs, giving medications, or performing wound care. While these activities are core to our profession, nursing practice is much broader. According to the American Nurses Association (ANA), nursing practice encompasses direct and indirect patient care and includes roles in administration, education, research, consultation, and policy.

For correctional nurses, understanding this full scope is not just professional knowledge—it’s the foundation for safe, effective, and ethical care in a secure environment.

Direct Patient Care

Direct patient care is the most visible aspect of nursing practice. It involves face-to-face interactions where the nurse engages directly with the patient to assess, diagnose, plan, implement, and evaluate care. Examples include:

• Performing intake health assessments for newly incarcerated individuals.
• Administering medications and treatments.
• Monitoring chronic conditions like diabetes or hypertension.
• Responding to emergencies such as chest pain or seizure activity.
• Providing health education about disease prevention, treatment adherence, and self-care.

In corrections, direct care is often shaped by operational realities—security escorts, limited clinic time, and restricted movement. These constraints make every patient encounter critical. As the American Correctional Nurses Association (ACNA) emphasizes, each interaction is an opportunity to both treat immediate needs and build trust.

Indirect Patient Care

Indirect patient care includes all the nursing activities that influence patient outcomes but do not involve direct, face-to-face contact with the patient. These can be just as critical to patient health as direct interventions. Examples include:

• Documenting health assessments, interventions, and patient responses in the health record.
• Participating in infection control surveillance and outbreak response planning.
• Coordinating referrals to specialty care or arranging diagnostic testing.
• Developing policies and procedures to ensure safe medication administration.
• Conducting quality improvement projects or chart audits to identify care gaps, and then developing a Corrective Action Plan to address the deficiencies identified.
• Providing nursing education, both degree-related and more often, continuing education/professional development based on current, evidence-based knowledge

In the correctional setting, indirect care might mean working with custody to adjust housing for a patient in medical isolation or collaborating with mental health staff to create a crisis intervention plan.

Beyond the Bedside

Nursing practice extends into leadership, education, and research. The American Association of Colleges of Nursing (AACN) highlights that nurses contribute to healthcare advancement through:

• Educating patients, peers, and students.
• Leading clinical teams or administrative initiatives.
• Engaging in evidence-based practice and quality improvement projects.
• Advocating for policy changes that improve health outcomes and access to care.

For correctional nurses, this might involve developing health education programs for the incarcerated patients, mentoring new staff, or participating in studies that improve care delivery in secure environments.

Why Scope Matters

Knowing the full scope of nursing practice empowers nurses to use their skills fully and advocate for the resources they need. As the ANA and ACNA emphasize, recognizing both the visible and behind-the-scenes components of care is essential to providing safe, ethical, and high-quality nursing services.

Please take a moment and share your thoughts about direct and indirect patient care in the comments section below.