Thanks for visiting Essentials of Correctional Nursing today. We have been on line almost three years, with posts nearly every week. Our mission is to provide interesting and practical tips regarding the best practices in correctional nursing. This blog and our book, Essentials of Correctional Nursing are resources for nurses practicing in correctional settings, especially those who are or are pursuing certification in the specialty. So how did we do this year?
Readership increased 28% this year over last. In November we reached an all-time high of 140 visits to our blog on average every day. Although we have readers from 146 countries, the majority are located in the U.S., Canada, the U.K. and Australia. By the way, the biennial international conference on correctional nursing takes place this next year in Canada (October 7-9, 2015) and presentation proposals are being accepted now. This is a great conference and the nurses from other countries are fascinating!
All of our posts (135 and growing weekly) can be accessed in the archive by using the search field or by clicking on the categories of interest listed on the right side of the page. This year our posts dealt with subjects concerning Nursing Practice, Populations with Special Health Needs, and Professional Issues. The following is a brief descriptive summary.
Nursing Practice: We spent nine weeks exploring the problem of misuse of alcohol and/or drugs. Identifying, monitoring and managing withdrawal symptoms are among the most common features of correctional nursing practice. In this last year we have seen how prescription drug misuse is fueling the use of heroin especially in urban areas across the states. We also touched on nursing practices to prevent drug diversion. Nursing assessment and intervention to manage withdrawal in advance of symptoms goes a long way toward preventing morbidity and mortality while in custody.
We devoted six posts to the specifics of nursing sick call, another signature of correctional nursing practice. Sue Smith, author of the chapter on sick call in Essentials of Correctional Nursing says that “…sick call can be a thing of beauty” allowing registered nurses to practice to the fullest extent of their knowledge and skill (page 304). Even more importantly it is the primary means available to inmates to achieve relief from troubling symptoms and pain and fulfills the principle of daily access to care required by the constitution.
Other areas of nursing practice that were discussed this year are also unique to correctional nursing. These included tips on how to manage difficult patients in the nursing encounter, assessment of skin conditions (most frequent complaint in nursing sick call), and the nursing care of patients on hunger strike. Lastly this fall we covered Ebola, along with everyone else. We hope you found the resources on Ebola provided from other correctional systems helpful and timely.
Populations with Special Health Needs: An often used phrase in correctional settings is “firm, fair and consistent” emphasizing that disturbances or other security risks are minimized when all inmates are treated the same. While it is true that perceived unfairness leads to complaints and unrest, the reality is that the health needs of inmates are not the same and require individualized attention. Our posts looked at unique and nuanced approaches to the nursing care during incarceration of women (a series of eight posts), youth (a series of four posts), veterans and the deaf or hearing impaired. Another feature unique to correctional nursing is that we are generalists and must be able to provide appropriate and responsive health care for patients with widely varied needs.
Professional Issues: The National Commission on Correctional Health Care (NCCHC) published new accreditation standards for prisons and jails that went into effect in October. One of the changes was to require peer review of nursing practice. To assist nurses in developing and participating in peer review programs, four posts were devoted to defining and describing peer review, suggesting ways to implement peer review and providing examples of peer review processes. We expect that this requirement will apply to nurses in juvenile settings as well when NCCHC revises these standards in 2015.
Delegation is the most popular subject of all our posts so we devoted another four posts to this topic. We discussed the principles as well as the most common barriers to delegation. We also reviewed communication skills and explored organizational models that facilitate delegation and supervision. These posts also coincided with publication of Nurses Scope of Practice and Delegation Authority, a white paper on the NCCHC website which addresses the assignment of nursing personnel in correctional facilities.
Correctional health care as it is provided today has been profoundly shaped by the law; more so than any other field in health care delivery. The legal parameters of correctional nursing were explored in three posts. Defining and establishing working environments that support professional nursing practice was suggested as one sure way to reduce risk of malpractice or other legal intervention. Grievances are another unique feature of the correctional setting and health care is a frequent source of inmate complaints. Since grievances are a precursor for litigation one of our posts provided tips and techniques to make best use of the complaint process. It also had the most comments from readers. We reviewed a study of nurses’ professional liability claims in another post that suggested the following ways to reduce liability:
- Practice nursing consistent with state law and organizational policy.
- Communicate professionally, accurately, respectfully and be inclusive, complete, appropriate and timely.
- Maintain clinical competencies relevant to the population served.
- Advocate for patients to prevent harm.
While there is a lot to write about in correctional nursing it would be great to know if we are covering the subjects you are most interested in. Take a minute to share your suggestions by replying in the comments section of this post. Your ideas will inspire us to write in 2015 so we hope to hear from you soon. In the meantime…
Have a Safe and Prosperous New Year!
It’s not too late to order another copy of the Essentials of Correctional Nursing. Get $15 off and free shipping by ordering directly from the publisher using promotional code AF1209.
Photo credit: © Roman Dekan – Fololia.com