Correctional nursing

A correctional nurse working in an American prison

Correctional nursing, sometimes called forensic nursing, is a specialized field of nursing that involves caring for the medical and mental health needs of detainees and inmates. These nurses work in a variety of settings such as jails, prisons, and juvenile detention centers. In these correctional settings, nurses are the primary healthcare providers.

Roles

Correctional facilities vary widely in size and population. Correspondingly, there is a wide range of roles which correctional nurses fill. Some facilities are as large as small cities and include an in-house hospital with inpatient and emergency facilities. Most correctional nurses fall into four categories: Reception Screening, Chronic Care Clinicians, Medication Administration, and Ambulatory Care (often called, "sick call").

Intake Screening

Intake Screening is often called, "R&R Screening" for, "Reception and Release". Generally, all inmate new to the institution are evaluated by a nurse prior to being installed into their housing unit. This process has nurses screen inmates for a variety of immediate medical and mental health needs such as alcohol or drug withdrawal, suicide potential, trauma, infectious diseases, and necessity for chronic medications. Custodial officers uses this information in order to decide which part of the facility is appropriate for housing, sometimes initiating movement to another facility if the inmate's medical or mental health needs cannot be met at the initial placement. The nurse performing intake screening generally schedules the inmate for an appointment with a healthcare provider for a detailed history and physical depending on the inmate's needs and presence of chronic diseases.

Chronic Care Clinicians

Inmates with chronic health care concerns (asthma, diabetes, high blood pressure, etc.) generally have regularly scheduled appointments in chronic care clinics. Nurses here provide patient assessments and education about chronic health concerns. Generally, these clinics are overseen by a physician or other mid level provider such as a nurse practitioner.

Medication Administration

Medications, even over-the-counter ones, can be misused in a correctional environment. Most frequently, medications are be administered to patients via a medication pass or pill line process. At set, scheduled times during the day, inmates requiring medication either report to a nurse located centrally in a medical unit or receive their doses in their housing unit. In higher security areas, where patients are largely confined to cells and movement is more restricted, the medications are administered at cell front.

Nursing Sick Call

Inmates requiring episodic health care generally follow a process called Sick Call. Inmates request treatment, generally by completing a form (a "Sick Call Slip") and are seen by a nurse. Most facilities have standardized protocols which allow administration of over-the-counter medications for simple conditions like headache, athlete’s foot, and constipation without the need for communication with an advanced medical provider such as a physician. An assessment of a more serious condition, or one that falls outside the protocols, would be referred to a medical provider for further evaluation.