Do Correctional Nurses Care?
How is the concept of caring unique in correctional nursing practice? Nurse theorist, Jean Watson, proposes several themes to describe caring in nursing practice. We discuss the concept of caring in Chapter 2 Ethical Principles for Correctional Nursing including Watson’s theory. We are celebrating caring in correctional nursing during Nurses Week 2013 and would like to hear your stories about how nursing practice at your facility exemplifies one or more of these themes:
Watson’s Transpersonal Caring
1. Care is provided in a transpersonal relationship in which there is a moral commitment to protect and enhance human dignity
2. Caring is the intention of doing for another and being with another who is in need
3. Care is authentic presence where the nurse honors the patient’s dignity and vulnerability
- Most inspiring top 3 entries will receive a signed copy of Essentials of Correctional Nursing
- All entries will have the opportunity for a guest post on Essentials of Correctional Nursing Blog
- 500-750 Words
- Can be submitted in body of email or as a Word attachment
- Choose one of the following options
- Share an example story from your correctional nursing experience demonstrating one or more of Watson’s Transpersonal Caring elements listed above
- Answering the question – Do Correctional Nurses Care?
- Identify which of the Transpersonal Caring element you are using as a basis for your essay
- Include full name, state, and email contact
Submission Deadline: May 1, 2013
Submit to: firstname.lastname@example.org
Read more about caring in correctional nursing in this prior post.
Professional Practice Support
The intent of the book is to support correctional nurses by providing guidance and resources about the best practices to deliver nursing care that reduces suffering and improves the quality of life for incarcerated individuals, their families and the community at large. Nurses who work in other settings also encounter patients who are incarcerated or who have been incarcerated. These settings include emergency departments, specialty clinics, hospitals, psychiatric treatment units, community health clinics, substance abuse treatment programs and long term care settings. Explanations and resources are provided in the book so that nurses in other settings are comfortable assessing and responding to the health needs of these patients. Students in graduate and undergraduate nursing programs may use the text to prepare for a learning experience in the correctional setting or to understand health care needs of this population in relation to community health.
Photo Credit: © Minerva Studio – Fotolia.com
Correctional nursing practice is complex. Nearly 1 out of every 100 people in the United States is incarcerated in a jail, prison or juvenile detention facility. Health needs of this population are characterized by disproportionate rates of mental illness, alcohol and drug dependence, victimization, traumatic injury, and both chronic and infectious disease. Minorities are over-represented among the incarcerated so correctional nurses are vigilant in the identification and treatment of conditions that represent greater morbidity and mortality for these groups and deliver care with cultural competence. Chapters are devoted to the nursing care provided to patients who have chronic disease, infectious disease, mental illness, pain, or who are in withdrawal. Other chapters describe the unique health needs and resulting nursing care for specific populations including women, juveniles, or individuals at the end of life.
Challenging Care Setting
The setting for delivery of nursing care is challenging. Correctional facilities operate to carry out criminal sanctions imposed by the court; not to deliver healthcare. Yet correctional facilities are obligated by state and federal law to provide healthcare to prisoners and other detainees. The operation of correctional settings and the legal obligation for care can create ethical challenges for nurses around issues such as patient privacy and self-determination. The setting also challenges a central tenet of nursing, the concept of caring. The Essentials of Correctional Nursing describes how nurses safely navigate the correctional environment to create a therapeutic alliance to center their nursing care on the patient.
Nurses have been described as the backbone of correctional health care. They are the eyes, ears, hands, heads and hearts that respond to medical and mental health emergencies. During daily sick call and other routine healthcare encounters correctional nurses listen to any patient’s health concern and watchfully encourage others who are unable or unwilling to raise a health concern. Nurses must apply their knowledge, skill and ability to the assessment and diagnosis of the full range of health conditions presented by this population and determine both the urgency and priority of subsequent care. Nurses are often the primary gatekeeper to other health care professionals in the correctional setting. Chapters devoted to health screening, medical emergencies, sick call and dental care describe how nurses identify, respond to and manage these health concerns in the correctional setting.
Photo Credit: © JJAVA – Fotolia.com
The American Nurses Association (ANA) recognized correctional nursing as a specialty within professional nursing in 1985 with publication of Corrections Nursing: Scope and Standards of Practice. The ANA standards are interwoven into each chapter of the Essentials of Correctional Nursing and are used by correctional nurses to guide nursing practice with resulting improvements in patient care.
Photo Credit: © myper – Fotolia.com
Accreditation and Certification
Improvements in the delivery of care have been achieved by the establishment of standards and accreditation offered by the American Corrections Association (ACA) and the National Commission on Correctional Health Care (NCCHC). Both the ACA and NCCHC offer certification exams for nurses to demonstrate their expertise in correctional health care. The Essentials of Correctional Nursing was written to provide the content and structure to support nurses in studying for these certification examinations.
Photo Credit: © Arcady – Fotolia.com
Understanding Research Application
Research is a foundation of correctional nursing practice according to the ANA Scope and Standards for the specialty. Nurses must understand how to integrate research findings into practice and at a minimum, participate in research activities. In addition, the corrections environment can pose ethical situations requiring nurse actions to protect human subjects during research activities. The ANA Scope and Standards of Corrections Nursing Practice expect nurses to integrate research into their practice by participating in various research activities and using the best evidence to guide practice decisions. The Code of Ethics for Nurses also directs nurses to participate in advancing the profession through, among other things, contributions to knowledge development in the field.
Conducting and using research in practice can seem daunting to correctional nurses. Lack of resources is just one of many barriers to research utilization. However, correctional nurses can use research principles in many ways, such as evidence-based practice efforts, best practice evaluation and quality improvement projects. Correctional nursing practice can be refined and defined through a nursing research agenda. Clinical issues specific to the specialty practice can be investigated to expand the knowledge base and improve patient outcomes.
Essentials of Correctional Nursing provides extensive information on how to apply research to practice and use evidence to guide clinical change.
Photo Credit: © Gjermund Alsos – Fotolia.com
Ethical Dilemmas of Correctional Nursing Practice
Ethical issues abound in any nursing practice and may be acute in correctional nursing. Correctional nurses can use professional codes and values to guide their actions in an ethically challenging environment. By understanding the ethical foundations of professional practice, nurses working in corrections can make thoughtful patient-centered decisions about their responsibilities in any particular situation.
Correctional nurses have a professional obligation to practice ethically. Several codes of ethics are available to correctional nurses including the ANA and ICN Code of Ethics for Nurses as well as the ACHSA Code of Ethics. These professional codes identify the foundational values, duties and loyalties of the nurse to a patient. The nurse-patient relationship is primarily based on a caring ethic, even in the boundaries of a correctional environment. Correctional nurses face moral distress and have opportunities to practice moral courage in advocating for the health and safety of inmate-patients. Correctional nurses can be faced with unique ethical dilemmas such as participation in body cavity searches, hunger strikes and forced medication administration. The use of an ethical decision making framework and application of professional codes of ethics can assist in determining appropriate action. Correctional nursing practice based on ethical principles can be satisfying as well as beneficial to the patient and colleagues.
Essentials of Correctional Nursing provides a guide for nurses to practice ethically in this challenging clinical specialty.
Photo Credit: © Maridav – Fotolia.com
Correctional nurses participate in all of the interdisciplinary organizations including the American Correctional Health Services Association, The National Commission on Correctional Health Care, the American Corrections Association and the Academy of Correctional Healthcare Professionals; often serving in leadership positions on boards and committees. The Essentials of Correctional Nursing was written and reviewed by experienced correctional nurses who have contributed thousands of hours to the work of these organizations.
Photo Credit: © Yuri Arcurs – Fotolia.com