'INSIDE LOOK' ON CORRECTIONAL NURSING: A UNIQUE NURSING SPECIALITY, THE

New Jersey Nurse, Jan/Feb 2005 by Laffan, Susan

People often ask, "What does a jail nurse do?" Nurses who work in correctional facilities realize that clients are patients first and "criminal" second. Medical care must be provided to all clients regardless of their "crime".

An important concept that must be realized when working in a correctional facility is that security is the number one focus in that facility. There are safety measures in place, and policies and procedures to assure the safety of all who are within the confines of that facility. All employees must have a criminal history check prior to employment, and items brought into work could be subject to search at any time, and some items such as scissors may be prohibited.

To answer the question "What does a jail nurse do?" let me describe a typical day within a correctional facility.

Upon entering the facility, nurses must go through a metal detector to gain access to that facility. I would than proceed to the medical unit to begin my shift. The first order of business would be to get report from the previous shift. This would include issues such as whom and the reason why the client is housed in the medical unit, any treatments or paperwork that needs to be completed, or if there was any special issues regarding any particular clients. We would than proceed to count narcotics and sharps.

Once the shift got underway, we would prioritize what tasks needed to be completed during the shift. There are facilities that have a medical infirmary with cells designated as "medical cells". Those clients who require more intensive nursing care are housed in this unit. Clients who would fit this category may include, those clients being observed for detox signs and treatments, unstable chronic care issues such as uncontrolled diabetics or hypertensive clients, clients receiving IV therapy or antibiotics, and unstable mental health clients. Clients with casts or prosthesis may be housed here for security reasons, since these medical devises may be used as weapons within the facility.

There is a medication pass done three times per day, where the nurses may go to the housing units to administer medication, or the inmates may come to a designated area for "pill pass". Any time a new client comes into the jail, they must receive an intake screening, where the nurse gathers new clients medical history, including current medications, chronic illnesses, mental health status, take vital signs and implant a PPD.

Nurses may assist the physician or Nurse Practitioner during "sick call". Any orders written by the MD or NP will than be transcribed by the nurses.

Nurses' sick call is done after a client requests to see the medical staff for a medical issue. This can range from symptoms of a cold, to lower back pain, to requesting an HIV test, etc. The nurse assesses the inmate and may utilize nursing protocols that have been approved by the Medical Director, or refer the client to the appropriate next level of care (i.e.: MD/NP visit, psychologist/psychiatrist, or dentist).

During any time in the shift, nurses may have to respond to the housing units, kitchen, or recreation yard for any type of "emergency." The client would be assessed and appropriate medical treatment would than take place. If the medical emergency treatment required actions not able to be performed within the jail, the client would be referred to the hospital.

Other duties may include filing, chronic care clinic visits, quality improvement reviews, and client teaching.

There are many opportunities for professional growth within the correctional nursing field. The New Jersey State Nurses Association has a Forum on Correctional Health Care. This group of correctional nurses meets bi-monthly at the NJSNA building to discuss current topics relevant to providing correctional health care.

The National Commission on Correctional Health Care (NCCHC) is a nation-wide organization that provides 2 conventions per year as well as providing the only basic and advanced certification in correctional health care called the Certified Correctional Health Professional (CCHP). In fact, on January 22nd, 2005 a CCHP examination will be given at the Ocean County Jail in Toms River, New Jersey. Susan Laffan, RN, CCHP-A, Debbie Franzoso, LPN, CCHP, and Patty Dougherty, RN, CCHP will be the proctors for this national examination.

Other professional organizations include the American Correctional Association (ACA), the Academy of Correctional Health Professionals, and the American Correctional Health Services Association (ACHSA).

As you can see, this specialty in nursing provides nurses with autonomy. A correctional nurse must have excellent assessment skills, be fair to all clients, and not be afraid of the environment and the clients they deal with. This type of nursing is definitely unique!

The executive committee of the Forum on Correctional Health Care would like to extend an invitation to any nurse who is interested in this exciting field of nursing to attend an upcoming meeting.

CERTIFICATION FOR CORRECTIONAL PROFESSIONALS: