This monthly news round-up includes comments from Pat Voermans, advanced practice nurse recently retired from the Wisconsin Department of Corrections, and Mari Knight, Mid-Atlantic Transition, Training and HSA Support Nurse for Conmed Healthcare Management.

Story #1: Indiana Inmates Provide End-of-Life Care

Our first story comes from the Indiana Prison System where they are providing hospice care in the Wabash Valley Correctional Institute. Inmate volunteers have cared for 50 of their colleagues in the program. They receive 40 hours of caregiver training and provide assistance with nutrition and hygiene as well as companionship. Hospice programs with inmate volunteers are not new in corrections but it is nice to see some press about the program. This article suggests another alternative of compassionate release for dying inmates. Is there an advantage to either option?

Story #2: Prisoners Who Have Sex Risk Separation in UK

A recent commission in the English and Welsh prison system found that a policy of separating prisoners who are in a sexual relationship was discriminatory toward openly gay prisoners. The item also notes that attempts to control consensual sex behind bars undermines efforts to promote safe sex and reduce the spread of HIV. This certainly seemed to me a different perspective than we are seeing in the US with our recent ramp-up of the Prison Rape Elimination Act. What is your take on the British perspective? The report indicates that there is no real data on consensual vs coerced sex in the UK prison system. Have you seen that to be true in the US system, as well?

Story #3: CA Prisons Hunger Strikes End

No news round-up is complete without a story from the California Prison System. They regularly make the news as one of the largest and most controversial state prison systems. Inmates organized a strike that commenced July 8 to protest gang isolation policy that left many in practically permanent segregation. As many as 30,000 inmates were involved in the hunger strike with less than 100 actually persisting from start to finish. The prison system made no changes in the policy but California lawmakers promised to take up the isolation policy in legislative hearings. California inmates have staged 3 strikes in the last 2 years. What are the effects on healthcare delivery in a situation like this?

Story #4: Ireland’s Prison Service to Pilot Overdose Drug

Our final story is also from across the pond. The Irish prison system is piloting a program to provide known illegal drug users with Naloxone (Narcan) on release from prison to help avoid overdose deaths. It is well documented that there is a high rate of overdose deaths of recently released prisoners.  I heard about a similar program being piloted in the Rhode Island prison system at the Summer ACA conference. Do you think this is a good idea?

Thoughts on Coercive Showering in Prison

This week a nurse leader in a state prison system contacted me about nurse involvement in forcing inmates to shower. Custody administration was requesting that nurses assist in the process as a hygiene issue. This is just one of many ethical dilemmas correctional nurses can face. Instinctively it seems wrong to force a patient to shower, but what principles would support a nurse’s refusal to participate in this practice? I polled correctional nurse leaders from around the country on practices and policies on this subject and found unanimous support for nurses to refuse to participate in this practice. In particular, it violates the patient’s autonomy and self-determination. Although it may be unpleasant for others in the patient population to be around  someone with poor hygiene, it is not life threatening to the patient or those around him.