Introduction to Correctional Nursing

1. Introduction to Correctional Nursing

2. What is a Correctional Nurse? Correctional health care entails providing comprehensive, quality care to incarcerated individuals in a safe, cost-effective manner consistent with community standards. The Correctional Nurse is motivated, knowledgeable, and effective in addressing the health needs of the prisoner population – and does so very independently.

3. SAFETY While there is an inherent risk to working in any correctional setting, safety and security is the number one priority for all staff and prisoners. Through specific protocols, extensive security training and practice, the Correctional Nurse safely provides quality care to an underserved population. Some Correctional Nurses say they actually feel safer in the prisons due to security control measures vs what they’ve experience working in an Emergency Room at a community hospital.

4. Is Correctional Nursing a Specialty? Yes! Much like OB, Psych, or ICU nursing, Correctional Nursing is considered a specialty, yet has a very broad scope: • Patient Education • Annual Health Screenings • Nurse Sick Call/Complaint Triaging/Prescribed Treatments • Sports Injuries • Work Related Injuries • Medication Administration • Vaccination Clinics • Transfer Assessment Screenings • Emergency Care/Trauma • Mental Health/Crisis Intervention

5. Patient Education Incarcerated individuals come from all walks of life and range from those with no formal education to those with the highest academic credentials. Yes, there are prisoners who were Physicians, Dentists, Attorneys, or CEOs before incarceration! We all know that patient education is important and depending on the prisoner being dealt with, education can be provided in the simplest of terms or very in-depth. This gives the Correctional Nurse the opportunity to make the same educational difference to prisoners as those served in the community.

6. Annual Health Screenings The Correctional Nurse is well-versed in Health Maintenance care. Once yearly, each prisoner is provided a formal visit to address: • Vital signs • Testing for Tuberculosis and education • Infectious disease status review and education • Chronic disease review and education • Immunization status and administration • Medical acuity assessment • Assessment of assistive device needs • Age Related Screening (identifying need for lab work, DRE, etc.)

7. Nurse Sick Call The Correctional Nurse holds “sick call” for prisoners with routine and urgent health care concerns. This is an opportunity for the nurse to use communication and assessment skills for implementation of nursing interventions for optimal outcomes. Much like an office practice in the community, a wide variety of complaints are addressed. Questions about medications, suspicious skin lesions, common cold symptoms, GI issues, chest pain, and any other conceivable complaint or issue is encountered by the nurse. Nurse sick call also consists of services and treatments ordered by the Medical Provider and include wound care, chronic disease monitoring, vital sign monitoring, and laboratory specimen collection. Standing orders as well as other protocols cover and assist the nurse in practicing independently but when nursing interventions are not a reasonable course of action for the situation, or previous interventions were not successful, a referral to a Medical Provider can be made to meet the needs of the patient.

8. Sports Injuries Exercise and recreation are good for the mind and body. As their behavior dictates, prisoners are given opportunities to participate in sports and other recreational activities but with that comes inevitable injuries. The Correctional Nurse is skilled in the assessment and treatment of sports injuries within the scope of practice to include: • Joint immobilization per protocols • Pain medication per standing orders • Equipment needs (crutches, ace wraps) • Referral determination – none vs. routine vs. urgent • Housing needs (temporary ground floor cell or bottom bunk)

9. Work Related Injuries To promote rehabilitation, encourage positive activities, and meet provisions of parole, many prisoners have jobs at the facility they’re housed at. Some examples include: • Law Library Clerk/Assistant • Porter (Janitor) • Kitchen Worker • Yard Worker • Maintenance Worker • Prisoner Observation Aide There are times where prisoners sustain work related injuries in the more strenuous assignments with cuts and back strains being the most common. The Correctional Nurse is proficient in addressing these types of issues when they occur through assessment and follow up when indicated. Days off from work, clearance for return to work, or removal from work assignment are part of what the Correctional Nurse deals with.

10. Medication Administration The Correctional Nurse is knowledgeable of the medications he or she administers. In community hospitals, the nurse gives the patient each dose of medication at the prescribed times. In a prison environment, there is a mixture of “restricted” and “KOP” or “Keep on Person” medications. In the case where the prisoner has the capability to understand and comply with the treatment plan, he can keep certain medications in his cell to take himself, just like we do at home. Some medications are automatically restricted, such as controlled substances, antiepileptic medications, and all psychotropic medications. There are times where a prisoner has a history of overdose or doesn’t understand the medication education provided. In those cases, the nurse has to administer each dose to the prisoner.

11. Vaccination Clinics The Correctional Nurse is experienced in administering vaccinations to prisoners. This could be individually or in mass numbers. • Hepatitis A vaccine as ordered by a Medical Provider • Hepatitis B vaccine per standing orders or as ordered by a Medical Provider • Pneumovax as ordered by a Medical Provider • Tetanus vaccine per standing orders • Anything else deemed necessary by the Medical Provider The Influenza vaccine is offered yearly to all prisoners unless there is a nationwide shortage and limited doses are available. When that occurs, prisoners with certain diseases will be offered the vaccine first.

12. Transfer Assessment Screenings Prisoners transfer between facilities for several reasons, such as: • An increase or decrease in security level • Programming • School needs • Medical or Psychiatric needs • Pre-parole or discharge • Backfilling bed space • Court writs The Correctional Nurse ensures that the facility a prisoner is transferred to has the necessary services available to meet his medical, dental and mental health needs. Likewise, each prisoner that transfers into any facility is screened by a nurse to ensure needs are met and maintain continuity of care.

13. Emergency Care/Trauma The Correctional Nurse is skilled at providing emergency and trauma care in a myriad of situations, such as: • Natural events, i.e. chest pain, asthma exacerbations, sickle cell crisis • Assaults and fights • Accidents • Self-injurious behavior Some examples of emergency/trauma care that the Correctional Nurse excels at is: • CPR • AED usage • Airway maintenance • Cervical spine protection • Control of bleeding • Immobilization

14. Mental Health/Crisis Intervention It is often the Correctional Nurse that is the first responder when there is a mental health issue or crisis occurring. The goal is to keep the prisoner safe and secure the proper treatment needed. Just as it occurs in society, prisoners will attempt suicide, suffer mental breakdowns, intentionally harm themselves, and need medication adjustments. Some of the mental health services available to prisoners in a routine and urgent situations include: • Counseling/Supportive Therapy • Psychotherapy • Psychiatric treatment • Crisis stabilization • Adaptive skills residential placement • Suicide prevention/intervention The Correctional Nurse becomes proficient in administering psychotropic medication, recognizing signs and symptoms of mental illness and making the appropriate referrals, responding to crises/emergencies, and working closely with mental health staff to ensure the needs of the patients are met.

15. Career and Advancement Opportunities With many facilities in the Department, there are career opportunities for nurses and mental health staff along with the ability to advance. Nursing • RN/LPN • Nursing Supervisor • Health Unit Manager • RN Clinical Assistant Mental Health • Psychologist • Social Worker • Mental Health RN • Unit Chief

16. Civil Service Benefits • Full-time State of Michigan classified employees are entitled to benefits that include health, dental, vision, life, disability, flexible spending accounts and many voluntary benefit options. • Employees are also given a 4% mandatory 401k contribution with up to an additional 3%, dollar for dollar employee match contribution, for a total possible employer contribution of 7%. • Accrued sick and vacation time. • 13 paid holidays.

17. To apply, please visit www.michigan.gov/statejobs • Candidates must apply online by clicking on the job title they are interested in and clicking on the "Apply" link! • First time users will need to create a NEOGOV account and select a Username and Password. • After the account has been established, applicants can build an application by clicking on the "Build Job Application" link. • This application can be saved and used to apply for more than one job opening. • An applicant must meet the minimum qualifications of the position for which they are applying. • Prior to hire, an individual must submit to and pass a pre-employment drug test and medical examination.