Have you ever been asked what you do as a nurse and found yourself launching into a discussion of sick call and medication passes? It is easy to get lost in the weeds on our professional journey. That’s why it can be refreshing to periodically return to the defining qualities of the nursing profession to see the big picture.
The definition of nursing as found in the ANA Scope and Standards of Practice is
- The protection, promotion, and optimization of health and abilities
- Prevention of illness and injury
- Facilitation of healing
- Alleviation of suffering
We do this through the diagnosis and treatment of human response and we advocate in the care of
- Individuals
- Families
- Groups
- Communities
- Populations
As correctional nurses, we fulfill this definition in the criminal justice system. The location of nursing care delivery establishes our unique patient population, environment of care, and ethical dilemmas of practice.
It is invigorating to be reminded that nursing care goes beyond the post duties and task list for the shift. Certainly caring for patients in a one-on-one situation is the majority of many of our job descriptions. However, I was recently struck by the inclusion of communities and populations in the nursing definition. How do we advocate for care and alleviate the suffering of communities and populations as a correctional nurse?
What is Social Justice?
Social justice is a broad term used to describe equity in the distribution of resources and responsibilities among members of society. According to the Canadian Nurses Association, social justice in health care involves “working to prevent negative effects of oppressive practices such as discrimination against individuals on the basis of gender, sexual orientation, age or any other social factor that might affect health and well-being. In correctional nursing, social justice would include reducing dehumanizing practices within the criminal justice system and extend toward improving the health and well-being of the homeless, impoverished, and under-educated communities from which our patients and their families enter into the criminal system.
Social Justice in the Criminal Justice System
You would think that a system with justice in its title would be just but there is a lot of social injustice in the criminal justice system. You don’t have to look very far to see oppression in the power structure of many correctional settings. The desire to maintain discipline and provide for personal and public safety can lead to severe punishment and even brutality in the organizational culture in some settings. As correctional nurses, we may not ascribe to the incivility but are often required to view or even participate in the culture in order to deliver necessary health care. For example, have you ever had to witness a violent inmate take-down during an emergency man-down that resulted in the use of a severe restraint device? Did you feel there might have been a more humane way to deal with the safety issue but were afraid to speak up or felt you had no voice in the matter? How might a nursing response to restraint practices across the criminal justice system embody advocacy for the alleviation of suffering among our patient community and population?
But This isn’t a Patient Health Care Situation
As nurses in the criminal justice system, we can easily get tunnel-vision about our role within the system. Certainly, we are helped in this narrow focus by those criminal justice professionals who clearly see nursing as attending to the direct health needs of specific patients. Yet, our definition of nursing practice speaks otherwise. Our patients are the entire community of inmates within our facility and our role, among other things, is to promote their health, prevent their injury, and alleviate their suffering. Correctional nursing, then, is more than serial one-on-one patient care situations.
We Are All in This Together
Correctional nurses, as a group, can be a significant force in the criminal justice system. Our definition and Code of Ethics calls us to consider the human dignity of our patient population and the significant suffering that our patient community bears up under. Working together we have an opportunity to bring about social justice in an institution, a correctional system, and the entire criminal justice system.
Share your thoughts on social justice in the comments section of this post.
Find more information about ethical issues in correctional practice in these prior posts:
Correctional Nurse Guide to the Code of Ethics: Respect for Human Dignity
New Code of Ethics for Nurses: The Patient is Primary
New Code of Ethics for Nurses: The Right to Self Determination
Book Review: Guide to the Code of Ethics for Nurses
[The information above was originally posted on the Essentials of Correctional Nursing blog]
Marilyn Weitel RN., MSN, Ph.D. says
I am so encouraged after reading your post on social injustice in the criminal ‘justice’ system. I have often wondered what the nurse feels and how he/she reacts to those “take down” situations that you described when we have a different worldviews of of our patients/inmates. I was educated and began my career in the 1960’s when being the ‘handmaiden’ to the physician was taught and practiced. Since then, nurses have achieved more autonomy in practice and make better and effective decisions based on education and experience and not just following doctors’ orders. Do correctional nurses feel like they are following the orders of the criminal justice system by way of being directed by the C.O.’s? Are they inhibited in caring because of the nature of the system?
I will come clean and tell you that I am not a correctional nurse, however, I am a professor of nursing and include forensic nursing in my courses. My questions are only to help me understand the correctional nurses and to brainstorm solutions. I do not know how to affect the correctional system, but we as nures have made so many improvements to our practice, that I have confidence that we can change the view of those in the system for our patients in corrections.
I pray that God blesses each one of you. Thanks Lorie.
Lorry Schoenly says
Thanks for your thoughts, Marilyn! So glad you include forensic nursing in your courses and I hope that students at your school have an opportunity to experience correctional nursing. You bring up some valid questions for us all to ponder. Correctional nursing settings are so diverse that a single response is probably inaccurate. My experience is that correctional nursing practice still needs encouragement to flex the empowerment muscle, thus my posts. You make a good analogy to our handmaiden role in the 1960’s. We need to apply that to our current roles in correctional facilities. While some settings truly embrace nurses as part of the correctional team, many do not. Many correctional nurses are considered outsiders and not given voice to practices in the facility; even when these practices are not healthy for the patient population. I am sure I did not answer your question but hope others who read this post will contribute their perspective from their unique experiences.
Marilyn Weitel RN., MSN, Ph.D. says
Thank you for your response. My questions were in part posed to start a conversation. I believe you that institutions are different and one solution will not fit all. If I were a correctional nurse, based on what I have read in your literature and blogs, I think I would feel oppressed and frustrated. In one of your books ( I don’t know which) I read that Security comes first at all times. However, I think that providing the CO’s concept of security may hinder and hamper a nurse’s goals of health promotion. I respect all of you that work in these settings. I believe it takes a lot of compassion and moral strength.