Correctional nursing is the delivery of evidence-based nursing to protect, promote, and optimize health and abilities; prevent illness and injury; facilitate healing; alleviate suffering through the diagnosis and treatment of human response with care and respect; and advocate for individuals, families, groups, communities, and populations under the jurisdiction of the justice system (ANA, 2020).

I had the privilege of participating as a member of the work group appointed by the American Nurses Association (ANA) to review and edit our correctional nursing scope and standards of practice document.  Our work began in 2018 with monthly workgroup sessions and more frequent committee meetings; our work spanned over a year. The third edition of Correctional Nursing: Scope and Standards of Practice was published by the ANA in November 2020, and it highlights advances in correctional nursing since 1985 when we were first recognized. In upcoming posts, we will discuss some of the key concepts of our scope and standards of practice.  Today, we will explore what makes Correctional Nursing a Specialty.

What, specifically, makes correctional nursing practice a specialty? When a nursing specialty is recognized by the ANA, determinations are made about the distinguishing features, characteristics, and observable practices of the specialty.

Distinctive Features

Correctional nursing occurs in a unique setting – the  justice system. Within the justice system, correctional nursing practice may occur in primary/ambulatory care clinic, an urgent/ emergent care clinic, an inpatient infirmary/hospital setting, community-based facilities, and in palliative/hospice care. In addition to the clinical roles necessary to work in these settings, the correctional nurse provides substance abuse care, sexual abuse care, mental health care, transitional care, medication management, health promotion screening and teaching, individual and group health education, and patient advocacy. A correctional nursing practice may encompass direct patient care, activities associated with the advanced practice registered nurse role, and executive leadership, team decision making, and board room responsibilities.

Although the majority of practice is in jails, prisons, and juvenile detention facilities, the new scope and standards also acknowledge that correctional nursing takes place in other settings such as parole, probation, community half-way houses, specialty units within hospitals, joint Mental Health-Department of Correction (DOC) hospitals, and DOC-managed nursing homes.  

Over time, correctional nursing practice has evolved into a variety of essential roles ranging from primary health care, mental health services, hospice, telemedicine, geriatrics, discharge planning, chronic care management, and program management and administration. Today’s correctional nurse is a valued and respected member of the correctional healthcare team

Distinguishing Characteristics

There is more autonomy for the nurses providing care in the correctional setting than in more traditional settings such as hospitals. Therefore, correctional nurses must be acutely aware of their scope of practice and potential licensure issues. Nurses working in correctional settings may be asked to perform actions beyond their scope and licensure, and they must be able to define their limits and only practice within their licensure parameters. Correctional nurses need to be able to embrace this autonomy and be prepared to practice to the fullest extent of their licensure and training without exceeding their scope of practice.  

Unique Observable Practices

Examples of particular observable practices in correctional nursing include the medication delivery system, the types of patient advocacy in which correctional nurses engage, and the unique need to balance patient health needs with the safety of the nurse, other staff, and the public. It can be a challenge to deliver nursing care to incarcerated individuals in the correctional environment, but the rewards of providing nursing care to an underserved population, and in doing so, impacting the health of the greater community are great!

Do you agree that correctional nursing is a specialty? Share your thoughts in the comments section of this post.