Providing Care To Incarcerated Patients

Screen Shot 2018-09-13 at 11.46.50 AMForensic Nurses provide healthcare to those incarcerated in the criminal justice system in a variety of settings such as jails, prisons, and juvenile detention centers. Many Correctional Nurses feel safer in this environment than working in traditional settings where security may be less vigilant.

The inmate patient population has many distinct characteristics to keep in mind when providing care. Although each patient is an individual, the population, as a whole, is likely to have these characteristics that should be taken into consideration when providing care.

  • Inmates have a biological age older than their chronological ages. Many experts consider the incarcerated patient to be 10 years older than their chronologic age when it comes to the ravages of age and illness. So, many correctional settings consider elderly inmates to be 55 years and older.
  • Less educated and less health-literate than the general population, inmates are more likely to have learning disabilities and have difficulty understanding basic health information.
  • More infectious disease, especially HIV, Hepatitis C, sexually transmitted disease, and tuberculosis are found in this patient population.
  • Inmates have higher rates of mental illness than the general public, especially depression, mania, and psychotic disorders. Mental illness can contribute to criminality. Borderline personality disorders that lead to poor impulse control, self-injury, and aggression are often present.
  • This patient population also has higher rates of traumatic brain injury and post-traumatic stress disorder that can also lead to poor impulse control, erratic behavior, and inability to concentrate or understand health instruction.
  • High levels of drug, alcohol, and tobacco use in this population increases the likelihood of withdrawal issues, liver toxicity, and respiratory conditions.
  • Increased risk of suicide is found in this patient population as compared to the general population. This is a concern in any stage of the incarceration but especially of concern at entry into the jail and after sentencing when hopelessness, shame, and guilt are at their highest.

Although graduate Nurses have been successful in assimilating into the role of Correctional Forensic Nurse, the autonomous nature of the role and need for excellent assessment skills warrants experience in general Nursing practice before entry into the specialty. In particular, a background in emergency and/or mental health Nursing is helpful. Currently, certification is not required to enter a position as a Correctional Forensic Nurse, however, certification is available through the National Commission on Correctional Health Care (NCCHC) and the American Correctional Association (ACA).

Are you a Correctional Forensic Nurse? If so, what do you believe Nurses should know before considering this specialty? Please comment below!

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