Correctional Nursing Today Podcast

Keeping You Current on Happenings in Correctional Nursing and Correctional Health Care

Correctional Nursing Scope of Practice Issues 06/26/2012

Correctional Health Care News Round Up - May, 2012 05/29/2012

Maintaining Perspective with Inmate Patients 05/06/2012

Correctional Health Care News Round Up for April 2012 04/30/2012

Correctional Health Care News Round Up for April 2012 This episode was recorded live from the national conference of the American Correctional Health Services Association (ACHSA) in San Antonio, TX. The episode includes commentary from regular panelist, Catherine Knox, MN, RN, CCHP-RN, an independent consultant with nursing and leadership experience in the Oregon Department of Corrections, the Washington Department of Corrections, and California Prison Health Care Services. Also commenting is Gayle Burrows, RN, BSN, MPH, CCHP, recently retired Director of Corrections Health at Multnomah County Detention Center in Portland, OR. Both panelists are active in ACHSA and have received the Distinguished Service Award from the association. Ethical Issue for Correctional Nurses is the theme this month with several articles highlighting the unique dilemmas we can face. Hunger Strike http://www.correctionsone.com/correctional-healthcare/articles/5052075-After-Utah-inmates-starvation-bill-seeks-force-feeding-OK/ After a 19-year-old inmate starved to death in his cell in Salt Lake County Jail, the Utah State Legislature passed a bill allowing jailers to forcibly feed or hydrate an inmate on at least a short-term basis. Correctional nurses are involved in monitoring the health of these striking inmates and may have ethical conflicts in participating in forcibly feeding an unwilling patient. Panelists discuss ethic issues involving patient autonomy. Isolation and Seclusion http://www.azcentral.com/news/articles/2012/04/02/20120402arizona-accused-abuses-prisons.html Amnesty International has accused the Arizona Prison System of abuse in the use of isolation and seclusion interventions. They claim that Arizona's state prisons overuse solitary confinement in cruel, inhumane and illegal ways, particularly for mentally ill prisoners and juveniles as young as 14. Correctional nurses monitor the health of confined inmates and provide medications and needed treatments while they are secluded. This may lead to the observation of degrading treatment and moral distress in participating in the functions of these confinements. Restraint Chairs and Pepper Spray http://www.huffingtonpost.com/2012/01/11/jail-abuse-nick-christie-pepper-spray-florida_n_1192412.html A combative and uncooperative 62-year-old Ohioan arrested in Florida for public intoxication died after repeated pepper spraying and a forceful take-down to a restraint chair. Correctional nurses are called upon to review medical charts for contraindications for use-of-force. Participation in these procedures, even peripherally from a medical perspective, can be unsettling and distressing. The following documents were discussed as guides for correctional nurses grappling with ethical dilemmas in jails and prisons: The Nurses Code of Ethics: http://www.nursingworld.org/codeofethics The International Council of Nurses Position Statement: http://www.icn.ch/images/stories/documents/publications/position_statements/A13_Nurses_Role_Detainees_Prisoners.pdf The Corrections Nursing Scope and Standards of Practice: http://www.nursesbooks.org/Table-of-Contents/Standards/Corrections-Nursing-Scope-and-Standards-of-Practice.aspx /episode/index/show/cornrstdy/id/1932221

Tips for Dealing with Traumatic Brain Injury 03/31/2012

Tips for Dealing with Traumatic Brain Injury Barbara Curtis, MSN, RN, Director of Nursing Service, Washington State Department of Corrections talks about the high prevalence of traumatic brain injury in the correctional patient population and responses to the condition. Barbara has been an RN for over 30 years with 20 of those in emergency services both as administrator and clinician. She has been with correctional nursing for 11 years. Although an estimated 2% of the general population has sustained a TBI with continuing disability, a of studies in the inmate population indicates a prevalence of over 60% . It is suggested that this condition may be under-reported for a variety of reasons. A study performed in the Washington State Correctional System found as much as 89% prevalence. That equates to 9 out of 10 of our inmate patients having some form of brain injury. The long-term effects of TBI are memory problems, inability to focus, and poor impulse control. Inmates with this condition may respond in anger, aggression or verbal disrespect to cover for their deficits. This means that our patients with TBI often show these behaviors: · Act out in anger or irritation · Forget rules of prohibited conduct · Not remembering where they should be or by when · Forgetting that they cannot go into certain areas · Increased behavioral infractions TBI treatment focuses on symptom management and compensation for cognitive deficits. A careful intake history is an important first step to diagnosing TBI and managing symptoms. The that special attention be given to impulsive behaviors, violence potential, sexual behavior and suicide risk if the inmate is depressed. Barbara suggests nurse interventions that focus on assisting patient to remember and follow direction. · Speak slowly and clearly · Give the patient time to register the information and respond · Provide memory tools like writing down health instructions · Give only a few directions at a time and keep it simple She also emphasizes the importance of awareness of the condition for both custody and health care staff. /episode/index/show/cornrstdy/id/1903323

Correctional Health Care News Round-Up for March 2012 03/25/2012

Correctional Health Care News Round-Up for March 2012 In this month’s correctional healthcare news round-up Lorry Schoenly talks with regular panelists, Catherine Knox and Sue Smith, about aging and disability issues in correctional healthcare. Catherine is an independent consultant with nursing and leadership experience in the Oregon Department of Corrections, the Washington Department of Corrections, and California Prison Health Care Services. Sue Smith also has a long history in correctional nursing. She has worked in various capacities for the Ohio Dept of Rehabilitation and Correction including staff nurse, nurse administrator and nurse educator. Human Rights Watch reported that the number of aging prisoners is soaring and that correctional officials are ill-prepared to run geriatric facilities. The article includes some concerning statistics including the news that “The number of sentenced prisoners age 55 or older grew at six times the rate of the overall prison population between 1995 and 2010.” http://www.hrw.org/news/2012/01/26/us-number-aging-prisoners-soaring Growing numbers of aging inmates means more immobility, hearing and visions impairments and more disabling or terminal illness. It also means more cognitive impairment. Our next news item comes from the New York Times and discusses the California Men’s Colony dementia program. This program is one of a growing number of prison programs developed to deal with diminishing cognitive capacities in the aging inmate population. http://www.nytimes.com/2012/02/26/health/dealing-with-dementia-among-aging-criminals.html?_r=1 Another response to elderly inmates was documented in the news recently with a focus story on the hospice program at Vacaville in the California system. Several responses to aging and dealing with the sick and chronically ill inmates also showed up in recent news. Hospice programs have been growing in the correctional setting. According to the National Hospice and Palliative Care Organization, 75 prisons and jails in 41 states have a form of hospice program available to dying inmates. When the first programs started in prisons there were no standards for delivery of hospice services in correctional settings. Many programs now involve fellow inmates in peer-support roles that benefit both the dying inmate and the care provider. Correctional nurses have an opportunity to profoundly affect the outcome of terminal illness and assist inmates to have a ‘good death’ even while incarcerated. http://www.seniorhomecareinformation.com/hospice-care/program-at-vacavilles-california-medical-facility-gives-special-care-to/ Some states are looking into alternatives that place older and debilitated inmates in settings outside the wall. Connecticut is seeking a nursing home option for some of their older prisoners according to an article from the Connecticut Mirror. It says the state is seeking to contract with a nursing home for about 95 beds for parolees and patients from state institutions. Is this a good solution? Some legislators and citizens of the state have concerns. http://www.ctmirror.org/story/15565/state-seeking-nursing-home-take-sick-disabled-prisoners Texas has a different response to the older and sicker inmate. An article in the Star-Telegram says the state is seeking early release for more and more sick inmates. Says” The Tx Parole board approved 85 medical releases in fiscal 2011- the most in five years and more than double the 40 approved in 2009”. Is this a good solution to the aging issue? http://www.star-telegram.com/2012/02/29/3774188/texas-is-seeking-early-release.html /episode/index/show/cornrstdy/id/1897602