Healthcare Staffing

Correctional nursing is a highly specialized field of nursing that involves caring for the medical needs of detainees and inmates. These nursing professionals treat a wide array of medical problems each and every day, from acute illnesses to medical emergencies. 

Working as a prison nurse requires staff to be mentally flexible and able to shoulder a lot of different responsibilities at the same time. In addition to demonstrating their knowledge of complex medical conditions, they will need to show custodial and people skills, establishing and maintaining positive relationships both with the prisoners and the other members of their team. They will need to be able to make quick decisions on the fly and provide high-quality care while also maintaining security, control and paying attention to the environment and emotional needs of prisoners. 

Prison nurses are part of an extensive network of wardens, line managers, team leaders, vicars and even priests meaning the chances of them having to work alone are close to zero.

Intake Screening: Correctional nurses screen inmates entering the facility for a variety of immediate medical and mental health needs such as alcohol or drug withdrawal, suicide potential, trauma, infectious diseases, and chronic medications. This screening assists custody with housing placement, initiates scheduling for ongoing health visits, and determines if the inmate must first be seen in an acute care setting for injury treatment. 

Chronic Care Clinic: Inmates are scheduled for regular appointments in the medical unit to manage chronic conditions such as hypertension, asthma and arthritis. In addition, chronic care clinic visits might be scheduled to attend to infectious processes or pregnancy management. Although a chronic care visit involves contact with a physician or advanced practitioner, correctional nurses provide key elements of chronic care management including patient education and medication compliance review.

Medication Administration: Because many medications, even over-the-counter preparations, can be misused in the correctional environment, these medications must be administered individually through a medication pass or pill line process. Several times daily the inmate population requiring medication doses report to a nurse for administration. This may be centralized in the medical unit or decentralized with nursing staff administering medication in the housing unit.

Nursing Sick Call: Nurses provide episodic health care services to correctional patients through a request system called Sick Call. Inmates request treatment, usually in writing, and are seen by a nurse. Standardized protocols allow administration of over-the-counter medications for simple conditions like athlete’s foot, constipation, or the common cold. If the nursing assessment indicates an acute condition, a follow-up appointment with a physician or advanced practitioner is arranged.

Those who do choose to work in this field will have plenty of opportunity to forge a long-term career for themselves, as good prison nurses are always in demand. Many will develop a regular shift pattern at one facility, while others move from place to place, depending on where they are needed. 

Often, the first introduction to correctional health care practice is during an elective medical residency, and that's all it takes for many doctors to find their calling. Yet, it takes a special kind of person to provide health care for accused murderers, rapists, and drug addicts. But with better pay, better hours, retirement benefits and free malpractice insurance, these are some reasons why physicians are picking prisoners over civilian patients.

The nature of the job is almost identical to that of a standard physician, except for the overall environment. Instead of working with patients who go home, the correctional medicine physician works with patients who stay on site until their release. In jails, physicians treat lots of acute pathology cases; they are the true experts in assessing and treating acute withdrawal syndromes, like alcohol and heroin and under the Eighth Amendment of the U.S. Constitution, correctional facilities must provide medical care to inmates. It's a right all Americans have when they find themselves in the correctional system.

Essential standards of care in a correctional facility include an initial health assessment, which includes a questionnaire to collect information on prisoners' medical, dental and mental health histories, as well as vital signs, a physical exam, screening for communicable diseases and immunizations.

Correctional medicine is a highly demanding sub-specialty and can be ideal for those seeking to avoid the traditional billing and coding hassles, correctional medicine is also a Fee-for-Access rather than the Fee-for-Service model in the outside world, which is rather attractive to transitioning physicians. 

In most cases, prisoners in our country’s correctional facilities aren’t in their best shape. The wear and tear of prison life and the inherent dangers of this environment make any existing conditions even harder to address. Lots of inmates suffer from chronic conditions. However, transporting them to proper medical facilities is just not a logistical possibility. Instead of hours of security measures, sitting in traffic, and getting the right clearances to move prisoners, it makes more sense for allied health professionals to enter prisons themselves.

With more inmates tending to be over the age of 50 reporting at least one chronic illness these factors indicate a significant need for allied health in correctional facilities. 

One of the most common ways that allied health in correctional settings manifests is through the use of telemedicine. The allied professional set-up includes dual-screen monitors, one displaying the patient and the other showing his or her electronic health record. These prisoner-allied health interactions are some of the few instances where inmates have the ability to communicate anything about their personal needs despite the presence of guards. During these video conference calls, face-to-face consultation is possible even though it’s not a true direct line-of-sight with each individual.  

If you are a well-rounded clinician who has the ability to engage with complex offenders and has a genuine passion in making a real difference, this field may be right for you.