Ranee Wright BSN RN CCHP Happy Forensic Nurses Week Changing the Dynamic Is anyone currently working in corrections or have ever worked as a Correctional nurse How many of you have ever thought about working in corrections ID: 612550
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Slide1
Correctional Nursing
Ranee’ Wright, BSN, RN, CCHPSlide2
Happy Forensic Nurses Week!!!!Slide3
Changing the Dynamic!!
Is anyone currently working in corrections or have
ever worked as a Correctional nurse
?
How many of you have ever thought about working in corrections?
Have you ever thought about what the role of the correctional nurse is?Slide4
Objectives
IAFN definition and description of forensic psychiatric nurses and correctional nurses
Introduction to Wisconsin DOC facilities
Patient Populations that are incarcerated
Correctional Nursing RolesSlide5
Virginia Lynch
Forensic
Nursing
came about by Virginia Lynch in 1986 when she put together the first curricula for the specialty
.Forensic Nursing is an emerging specialty in nursing.
Forensic Nurses
need to have superb assessment skills, but before that a high level of suspicions.
In 2012, the ANCC recognized
Forensic Nursing
as a specialty and nurses now have the ability to become an
Advanced Forensic Nurse- Board Certified. Slide6
Definition
The
IAFN has adopted this definition of the specialty:
Forensic nursing is
the practice of nursing
globally
when health
and
legal systems
intersect. Slide7
Forensic nursing practice
The systems in which forensic nurses practice vary, depending on location, funding sources, community standards, and legal influences, and include:
Healthcare
Investigative
Criminal justiceCorrectional
Public sector
Social
services
Educational
Private sector International organizationsSlide8
2011 IAFN Correctional Nursing task force
Needed to advance forensic correctional nursing
Clearly
define the
roleNursing is largest group of health care professionals in CorrectionsYet little is known about them Forensic Correctional
Nursing is not restricted to
institutions
95% will release
Need collaboration with other disciplines
Cannot
be performed alone, need security,
administrators,
ect.
Need to evolve correctional nursing
Move Forensic Correctional Nurses towards self-actualized professional identitySlide9
Psychiatric–Mental Health and
Correctional NURSESlide10
Psychiatric–Mental Health and Correctional
Settings
applies
knowledge of psychiatric principles and nursing theory to the care of persons in acute care, community-based, or correctional settings who have psychological or mental
disorders.
may
encounter patients
who commit
or are likely to commit crimes or trauma against themselves or
others
because of their mental or emotional state
possesses
particularized knowledge and competencies in the assessment, care, and evaluation of individuals with mental disorders as they relate to criminal behavior. Slide11
Psychiatric–Mental Health and Correctional Settings
applies
principles of forensic psychiatry and nursing to clinically assess, evaluate, and treat individuals or populations with crime-related mental disorders.
possesses
expertise in providing care for patients with mental disorders in secure settings and refining that care to minimize the patient’s risk of victimization, self-injury, or injury to
others.
h
as
interpersonal
skills in responding to psychological trauma and abuse, neuropathology and criminology, and role transitions in victims and aggressors.Slide12
Correctional Nursing
It has a lot to do with mental health. Slide13
Mental health timeline
1840- Dorothea Dix
Conducted state wide investigation of care for the insane poor in
Massachusetts
Criminally insane caged and put in cellars1844- Visited all the counties, jails, and almshouses in New JerseyPrisoners chained naked, whipped with rods1845- First establishment of a state mental facility
1866- after the civil war focused on crusade to improve care of prisoners, disabled, and mentally illWMHI- 1873
1898- Green Bay Correctional Institute establishedSlide14
De-Institutionalization
Pre-1950’s
Lobotomies
Insulin induced
therapies1950’sPsychotropic medicationsMoved to half way houses, nursing homes, ect.President Kennedy Health Care Reform1980’sCommunity- based care
Reagan Administration- War on DrugsDid this increase the prison population?
1986- Oshkosh Correctional has 2,055 inmates
2016- GBCI population 1,062 with a capacity of 749
A place for the mentally ill???Slide15
United States Prison populations 2013
2,220,300 in correctional institutes
Prisons
Jails
4,751,400 on supervisionProbationParole6,899,000
TOTAL
427,790
Security and correctional officers
Nurses
Unsure exact
26% increase by 2020
Agency nurses
Travel nurses
Bureau of Justice Statistics Bureau of Labor StatisticsSlide16
Wisconsin Department of correctionsSlide17
Wisconsin
Department of Corrections
O
perates
36 adult institutions 10,000 employees statewide.DOC is responsible for 22,000 inmates Supervision
of 68,000 adult offenders500 juveniles committed by the courts to secure state juvenile
facilities Slide18
Vision Statement:
To achieve excellence in correctional practices while fostering safety for victims and communities.Slide19Slide20
Wisconsin Correctional institutes
Chippewa Valley Correctional Treatment Facility
(capacity
450
)Columbia Correctional InstitutionDodge Correctional InstituteFox Lake Correctional Institute
Green Bay Correctional InstituteJackson Correctional Institute (capacity 988)
Kettle Moraine Correction Institute
Milwaukee Secure Detention Facility (capacity 1040)
New Lisbon Correctional Institute (capacity 1010)
Oakhill Correctional Institution (capacity 688)
Oshkosh Correctional Institution
Prairie
du Chien Correctional
Institution
(capacity 424
)
Racine Correctional Institution (capacity 1798
)Slide21
Wisconsin Correctional institutes
Racine Youth Offender Correctional Facility (capacity 927)
Redgranite
Correctional Institution
Stanley Correctional Institution (capacity 1550)Sturtevant Transitional Facility (Capacity 1550)Taycheedah Correctional Institution (Capacity 898)Waupun Correctional Institution
Wisconsin Secure Program facility
(capacity 500)
Black
River Correctional Center
(capacity 114)
Drug Abuse Correctional Center (capacity 300)
Felmers O. Chaney Correctional Center (capacity 100)
Flambeau Correctional Center (capacity 80)
Gordon Correctional Center (capacity 80)Slide22
Wisconsin Correctional institutes
John C. Burke Correctional Center (capacity 280
)
Kenosha Correctional Center (capacity 115
)Marshall E. Sherrer Correctional Center (capacity 58)Milwaukee Women's Correctional Center (women's prison, capacity 112)McNaughton Correctional Center (capacity 102)
Oregon Correctional Center (capacity 120)
Robert E. Ellsworth Correctional Center (women's prison, capacity 333
)
Sanger B. Powers Correctional Center (capacity 70
)
St. Croix Correctional Center (capacity 120 male and 12 female
)
Thompson Correctional Center (capacity 120
)
Winnebago Correctional Center (capacity 250)Slide23
Other types of institutionsSlide24
DHS- Division
of Care and Treatment Services
Mendota Mental Health Institute
Winnebago Mental Health Institute
Wisconsin Resource CenterNorthern Wisconsin CenterSand Ridge Secure Treatment Center
Central Wisconsin CenterSouthern Wisconsin CenterSlide25
Winnebago mental health institute
1880- 529 patients
1960- 987 patients
1980- 310 patients2010- 291 patientsSlide26
Patient populationsSlide27
Always Keep in Mind:
Biological age is older than chronological age
50 years old is elderly
Less educated and less literate
Many
infectious
diseases
Higher rates of mental illness
Higher rates of traumatic brain injury
High levels of drug and alcohol and tobacco use
Increased risk for suicide.Slide28
Other Things to Consider:
Medical Needs
Chronic disease
Acute illness
E
mergencyPsychiatric needs
Medication side effects
Delusions/ hallucinations
Psychological Needs
Personality disorders
Self-harm
Suicide risk
AODA
Needs
Withdrawal
A
buseSlide29
Correctional Nursing
It sounds easy, but it is not for everyone!Slide30
Why Become a correctional Nurse???Slide31
Autonomy
Nurses are the primary care provider, medical staff are likely to have limited hours and available on-call.
First Care providers to evaluate patient concerns and triage.
Nurses are evaluating patient symptoms and determining and delivering treatment based on medically-approved protocolsSlide32
Assessment
The autonomous nature requires excellent assessment skills AND good clinical judgment to make sense of the assessment
Must be thorough and accurate and conveyed to medical and mental health providers when necessarySlide33
Patient Education
Patients are less likely to be informed about health status
Need to teach new health habits all the time and with new diagnosis make for a good teaching moments
Learning disabilities and poor reading skills require creative teaching skillsSlide34
Scope of practice
Correctional nurses use their full scope of practice in providing nursing care.
The variety of conditions in non traditional settings and need to provide as much health care as possible within the facility maximize nursing care practice.
Few other roles allow for a nurse to practice to the full scope of licensure
Nurse Practice ActCode of Ethics for NursesNursing Scope and StandardsSlide35
Science of unitary human beings
MARTHA ROGERSSlide36
“
Nursing’s story is a magnificent epic, of
service to mankind
, it is about people, how they are born, and live, and die; in health and sickness, in joy and in sorrow, its mission is the
translation of knowledge into human service
. It is the intellect that synthesizes many learning into meaningful interactions. Nursing promotes symphonic interactions between man and environment, to
strengthen the coherence and integrity
of the human field, and to direct and redirect patterning of human and environmental fields for realization of maximum health potential.
To promote human betterment wherever people are
, on planet earth or in outer space.”Slide37
5 personality traits of a correctional nurse
Openness
Non-judgmental
New experiences
ConscientiousnessSelf-regulated, plan aheadExtroversionNeed a good balance
AgreeablenessAlso need a good balance
Inmate vs. staff
Neuroticism
Handling stress
Staying calm Slide38
Primary roles
So what exactly are the nurses doing?Slide39
Intake
Screening:
Correctional forensic nurses screen inmates entering the facility for a variety of immediate medical and mental health needs:
alcohol or drug withdrawal
suicide potentialtraumainfectious diseaseschronic medicationsThis 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.Slide40
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 forensic nurses provide key elements of chronic care management including patient education and medication compliance review.Slide41
Med
Administration:
Because
many medications, even over-the-counter preparations, can be misused in the correctional
environmentThese 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.Slide42
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.Slide43
I GOT Skills!Slide44
Ten skills needed as a correction nurse:
Dental assessment
Ear assessment
EKG
Labor and Delivery
Phlebotomy
Physical therapy
Respiratory
therapy
Skin assessments
Splints/slings
TB skin testingSlide45
6 signs you
were
DESTINED
to be a correctional nurse!Slide46
You can stand your ground with
bullies
Many times there are challenging ethical situations where you need to stand up for what is right
Remember you are a patient advocate, you need an unshakable core of beliefs
You also need to be tolerant of others beliefs and valuesSlide47
You are good at Getting people to Confess
Are you generally able to get people to tell a secret?
Nurses need to obtain a truthful response
Correctional patients usually are hiding something:
Drug useAlcohol consumptionSuicide contemplationSlide48
No one can pull one over on you
Patients are always looking at ways to manipulate.
Correctional nurses need to remain objectively caring while always being alert for the con!Slide49
Foul language and dirty words don’t bother you
Plenty of patients talk dirty and pepper their language with 4 letter words.
Many do it for surprise or shock value
Others swear to bully or manipulate
Listen past the language to address the real issues. Slide50
You don’t embarrass easily and nothing surprises you
Patients are prone to exposing body parts or tossing body fluids
Nursing rounds on high management units can be embarrassing and anxiety producing for nurses.
A matter-of-fact no-nonsense attitude toward socially unacceptable behavior will rule the day. Slide51
You have always been able to balance your life
Hearing patients stories of abuse and trauma can take its toll.
We may see harsh treatment among staff and inmates.
As caring healers we may want to take on that burden.
Effective nursing in the criminal justice system requires were are fully there for our patients while keeping balance in our own life. Slide52
National commission on correctional health care
NCCHC's
leadership in setting standards for health services in correctional
facilities. Slide53
Certified correctional health professional
CCHP Certification
Recognizes
the professionalism
involved in all aspects of correctional health care. Participants have earned the highly regarded CCHP designation by demonstrating mastery of national standards
Special knowledge and skills expected of leaders in this complex and ever-changing field.Slide54
CCHP-RN
CCHP-RN
certification makes a
difference
to the patients whose care is provided by certified correctional nurses to employers who desire top-notch nurses on staff to the nurses who attain the credential.Slide55
In Conclusion………Slide56
references
American Nurses Association and International Association of Forensic Nurses. (2015).
Forensic Nursing Scope and Standards 2015.
Retrieved October 22, 2016, from International Association of Forensic Nurses:
http://c.ymcdn.com/sites/www.forensicnurses.org/resource/resmgr/Docs/SS_Public_Comment_Draft_1505.pdfLamb, H. R., & Bachrach, L. (2001). Some Perspectives on Deinstitutionalization . Psychiatric Services, 1039-1045.
Schoenly, L. P.-R. (2015). Correctional Nursing. Retrieved October 22, 2016, from International Association of Forensic Nurses: http://www.forensicnurses.org/?page=correctionalnursing
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Any questions?
raneemwright@hotmail.com