A 16 year old female is escorted to the medical clinic in a large urban jail where she is being held for arraignment for a carjacking incident. The housing officer is concerned that she has been vomiting after meals and is now refusing to eat. She appears young for her age and is underweight for her 5’6” frame. What concerns do you have if this adolescent is under your care?
No matter the age, jail is not the healthiest of places to spend time, but the growth and development needs of adolescents far outstrip the resources in many correctional settings. Correctional nurses need to be especially focused on youth in their facilities to be sure they get the attention they need. What physical development concerns should be of high priority for your youthful patient population?
Power Food – Power Struggle
A typical correctional diet is not meant to meet health spa standards but cost constraints can make some menus downright unpalatable. Turns out our 16-year-old was not tolerating the balanced but bland higher-starch diet provided. In addition, the emotional distress of incarceration can trigger appetite loss for some. Dietary intake can be one of the few life processes still in a teen’s control when behind bars. Refusing to eat or voluntarily vomiting food can be a response to a controlled environment.
Adolescents, however, need increased nutrition during growth years. Rapid development requires higher levels of protein and calcium along with zinc and iron. Some institutions provide additional milk to youthful offenders to accommodate protein and calcium needs. Food high in iron and zinc include red meats and fortified breakfast cereals. Are they available in your institution?
Young women, like the patient above, are more prone to iron deficiency. They are also prone to body-image issues that can affect nutrition. Our patient needs evaluated for an eating disorder considering her underweight appearance and post-meal vomiting.
Even in the best of situations youth are not getting enough exercise, especially females. Prison can further reduce activity through limited time out of cell. Youth, particularly those confined in adult facilities or jails, may be wary of contact with other inmates. Encouraging and supporting exercise activities can improve adolescent health while reducing stress.
Besides good nutrition and increased activity, adolescents need quality sleep for growth and development. Sleep while incarcerated can be disrupted by security schedules, stress, fear, and uncomfortable surroundings. Help your youthful patients establish a sleep pattern that works in their housing unit. Provide sleep hygiene information and tailor it to your particular facility and housing unit routines. Find more sleep information over at CorrectionalNurse.Net.
Do you provide healthcare to troubled youth? Share your experiences in the comments section of this post.
To read more about the unique aspects of juvenile health care in the correctional setting see Chapter 11 in the Essentials of Correctional Nursing. The text can be ordered directly from the publisher and if you use Promo Code AF1402 the price is discounted by $15 and shipping is free.
Photo Credit: © Antonio Gravante – Fotolia.com