In this podcast, recorded in 2010, Lorry talks with correctional health care leader, Becky Pinney, MSN, RN, CCHP-RN. At that time she was President, Metropolitan Corrections Systems, for Prison Health Services with multi-facility responsibilities for PHS sites and regions. She, like so many of us, became a correctional nurse by ‘mistake’ when asked by a relative to work in a correctional facility. Becky found satisfaction in the correctional specialty through the autonomy of practice and the public health aspect of the specialty. Providing health services and patient education to an underserved population can be very satisfying.

Jails and prisons have differences. Becky compares a jail to an emergency room where the patient comes in with the possibility of emergent needs. In addition, in the jail setting, these patients likely have not had many health care services. Often the patient is not with you long enough to get into a treatment program as the length of stay is frequently less than 20 days.  However, this population can regularly return to jail for a variety of offenses and may be started on treatment again and again with that treatment not continued after release. Prisons, on the other hand, can operate like a public health clinic where you are able to get to know the patients and have a long-term relationship with them.

Clinical Systems

Jail clinical systems are individualized based on the patient population and setting. Understanding the drivers of clinical need provides a foundation for the nursing processes and systems to be developed.

A Typical Day in the Life of a Jail Nurse

It might be said that there is nothing typical about a day of work as a jail nurse, but Becky provides some insight into some commonalities, like getting through a security checkpoint to enter the facility.

• Once inside, the jail will likely have a central medical unit but may also deliver care in the housing areas, particularly if this is a large jail complex.
• Intake in the booking area is a significant part of jail nursing practice. This involves a history, screening, medication verification and identifying any chronic conditions.
• Besides intake, there is also a sick call process where patient health concerns are addressed
• Medication administration takes a great deal of nursing time in a jail. Inmate identification can be a challenge in a jail setting where patients quickly move in and out of the system.
• Finally, jail nurses provide emergency response to injury and illness throughout the facility

Wide Array of Skills Needed

While nurses may specialize in many traditional settings, most jail nurses must provide a wide array of clinical services. Some tasks would be provided by ancillary staff in other settings such as drawing blood for lab tests or taking EKGs. In a jail setting, with little additional staff, nurses commonly perform these functions. Nurses need to be handy and creative to work in this setting!

What type of nurse will enjoy jail nursing?

Becky suggests that some nurses are more likely to enjoy jail nursing. These nurses:

• Are confident of their skills
• Enjoy a challenge
• Like autonomous practice
• Appreciate making a difference in the lives of their patients

Becky thinks this was the best decision she ever made in her nursing career. Do you agree? Share your comments about correctional nursing in the comments section of this post.