If you are a registered or practical nurse with clinical experience, good assessment skills, and able to function independently, correctional facilities could be a good place to exercise your nursing judgment and skills. Prisons and jails that do not have full time doctors, especially those located far from large population centers and hospitals, rely upon nurses to make correct clinical decisions and act promptly.
In many ways, correctional nursing is much like hospital nursing, albeit with more responsibility. The nurse might be the first healthcare professional to see an inmate patient who has been injured in an altercation, as well as maintaining daily nursing care. Acting quickly to give first aid or recognize and treat an adverse drug reaction fall squarely upon the nurse's shoulders.
Nursing discharge planning and patient education can play an even more important role in the correctional facility than in the hospital. When inmate patients are paroled or finish their sentences, since no follow-up can be scheduled, patients must be convinced of the importance of seeking care. It is imperative to explain to patients who may be anxious about returning to the outside world why they must be seen in outside clinical facilities to follow up their treatments. A former inmate with tuberculosis released into the community could become a public health hazard if he or she does not seek medical care or is not compliant with medications. A patient treated for psychiatric problems needs to have continuity of care to avoid being a hazard to self and others. Good education by the discharge nurse can play a vital role in preventive care of the patient, his or her family, and society in general.
Correctional nurses must graduate from accredited programs of registered or vocational nursing and hold either a current Registered Nurse (RN) License or Licensed Practical Nurse (LPN) license. Although it is not strictly required, a program accredited by NLNA CCNE is helpful in starting a nursing career. At least a year of experience in an acute hospital making daily nursing decisions and honing your skills in the real world will give you the skills and confidence you need for success.
Continuing education is another big plus for the nurse desirous of helping inmates. Providing care for chronic illnesses such as diabetes and hypertension can be frustrating under the best of circumstances. Nurses are only too aware that patients are notoriously noncompliant when it comes to caring for chronic disorders. Inmates frequently lack education and have had a history of sporadic care. Explaining basic information such as the names of drugs the patient is taking and what they are for is mandatory in this population.
Sadly, healthcare personnel who are there to help can be vulnerable to being manipulated by patients, sometimes with disastrous personal and professional results. Continuing education from nurse educators familiar with the problem can provide the armor nurses need to be able to keep their professionalism and not be manipulated by inmates.
Suicide is an ever-present threat in correctional facilities, and nurses must know what to look for in patients in need of suicide precautions. A unique condition called excited delirium, related to methamphetamines, is another potentially deadly problem seen by correctional facility nurses. How will you recognize and deal with it? Continuing education in suicide prevention provides the answers.
A certification called the Correctional Certification for Healthcare Personnel, (CCHP), provided by the Convention for National Healthcare, is one way to make oneself more marketable, although it is not a requirement at most correctional facilities.
The job description for correctional facility nurses might seem deceptively simple, resembling as it does that of a typical hospital. Nurses review medical records, interview patients, formulate care plans, carry them out, reassess in the light of treatment, and keep accurate records. They coordinate care with other healthcare personnel. They provide emergency first aid as needed. Nurses plan discharges and educate patients as they must in all healthcare facilities, but with more independence than nurses enjoy in most hospitals.
Salaries and job outlook are good due to the need for healthcare in this population. Prison inmates have a high degree of illness and injury, including HIV, TB, and drug abuse, and the Eighth Amendment to the US Constitution makes healthcare mandatory. Although starting salaries average only about $45,000 annually, average salaries for nurses in correctional facilities average $50,000 to $60,000 and those with a high degree of experience make $87,000 to $90,000 per year. With extra shifts and overtime, experienced prison nurses can make six-figure incomes. The demand is expected to grow, according to the Bureau of Labor Statistics. This can be viewed as a double-edged sword. One reason for the high demand and high salary is exposure to potentially dangerous work environments, and some nurses, though professional, can have difficulty dealing with patients known to have committed violent crimes.
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