The Role of Nurses in Prisons
Prison nurses are the “eyes, ears, hands, heads and hearts that respond” (Schoenly & Knox, 2012, para. 6) to medical and mental health issues of inmates across the world.
DescriptionPrison nurses are the primary health providers for approximately 21,000 offenders throughout Canada in Correctional Services Canada custody (CSC, 2012). 400 nurses in Ontario provide care for 9,000 inmates (Moncrieff, 2010). They work 24/7 providing the necessary care for inmates (Moncrieff, 2010). The role of a prison nurse is far spread and all encompassing (Moak, 2010). They require knowledge skill and judgment (CSC, 2012). The nurse provides care for inmates incarcerated for different reasons, of different ages, ethnicities, health statuses and medical conditions (Prison Staff Nurse, 2010). |  Photo used with the permission of photographer Brian Feulner. View more of his Prison Care photos here. |
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Prison nurses play multiple roles. They are one part security, one part ER nurse, one part primary care nurse and critical care nurse (Moak, 2010). Versatility and critical thinking are a must for this career to adjust to the ever-changing roles (Moak, 2010). The nurse must complete assessments, as well as planning and implementation of evidence based practice working within the multidisciplinary team to provide excellent care (Prison Staff Nurse, 2010).
The incarcerated population contains high levels of “mental illness, alcohol and drug dependence, victimization, traumatic injury and chronic and infectious disease” (Schoenly & Knox, 2010, para. 3). Being in prison has also been known to exacerbate pre-existing mental health conditions (Moss, 2010). The main focus of a nurse working in prison is rehabilitation for her patients and reintegration into the outside world focusing on health maintenance and promotion (Schoenly & Knox, 2012). This is an ongoing task for the nurse, as they work with inmates in for various lengths of time, until they are released and reintegrated into society.Because of the wide variety of inmate health, age, ethnicity, duration of stay and offences a prison nurse’s role is never the same day-to-day (Moak, 2010). A role that never gets boring; keeping the nurse on focused and thinking 24/7, while providing the best care possible in a difficult setting (Schoenly & Knox, 2010).ChallengesPrison nurses have a very important role to play in the healthcare and health promotion of prisoners in their care. It is crucial for nurses to understand both the challenges, goals, and issues that they will face in order to fulfill this role while nursing in this very specialized setting (Watson, Stimpson, & Hostick, 2003). The role of the nurse working within a prison setting includes goals of:
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The nursing role within prisons also can encompass assessment of self-care, past health history assessment, counseling as well as sexual health assessment. It Is because of these roles that nurses play in prisons in which they have access to personal health information as well as criminal record information that they need to fully understand that confidentially best practice is a crucial skill in the role of a prison nurse (Bennett, Perry, Lapworth, Daves, & Preece, 2010). This is where the role of the nurse in prison varies from nursing in other healthcare settings. Nurses must ensure that personal health information is kept confidentially and is only to be shared with security or other prison staff if there is a safety or medical reason to (Trossman, 2011). Nurses working in prison must understand that their role is to provide healthcare to prisoners while protecting patient confidentiality
While nursing in prisons nurses must be vigilant to the code of ethics which guides nurses because nurses in prisons are generally given more independence and therefore must focus closely follow best standards of practice and the code of ethics (Trossman, 2011). There are certain areas of legislation which are encountered daily when working in a prison nurse role. These include:- Consent
- Confidentiality
- Law and accountability
- Record keeping
- Policy and legislation related to primary care
- Using evidence to guide practice, and
- Sexual health(Bennett et al, 2010)
