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What to expect from correctional nursing

Author(s): Alicia Arias, DNP, APRN, NP-C, and Jana Zeller, MSN, RN

Takeaways:

  • Correctional nursing is a growing specialty that’s evolving to meet the needs of incarcerated populations in a variety of settings.
  • People who are incarcerated need compassionate nurses to address medical and mental healthcare needs and serve as advocates.
  • Nursing is built on the foundation of caring for each patient as a whole, and correctional nursing provides a unique opportunity to provide that care to a vulnerable population.

Nurses provide care and advocacy that can help

Nursing’s versatile career options include correctional nursing, a growing specialty that’s evolving to meet the needs of incarcerated populations in a variety of settings. (See U.S. corrections: Facts and figures.)

U.S. corrections: Facts and figures

According to a 2020 report by Sawyer and Wagner, the U.S. criminal justice system houses nearly 2.3 million individuals in

  • 1,833 state prisons
  • 110 federal prisons
  • 1,772 juvenile correctional facilities
  • 3,134 local jails
  • 218 immigration detention facilities
  • 80 Indian Country jails.These numbers don’t include military prisons, civil commitment centers, state psychiatric hospitals, and prisons in the U.S. territories. The authors note that the United States has the “dubious distinction of having the highest incarceration rate in the world.” Many of those who are incarcerated have healthcare needs that nurses can help meet.

Patients who are incarcerated may have significant medical and mental health conditions that weren’t treated before imprisonment, so correctional nurses must have a wide skill base that includes assessment, critical thinking, nursing process, patient education, substance use withdrawal management, communication, trauma effects, and medication administration. Nurses can have a direct impact on improving the care of this vulnerable population while also helping to decrease recidivism rates.

Working in correctional settings can provide nurses with an opportunity for increased independent practice and decision making. Within the criminal justice system, nurses have the opportunity to work in units focused on mental health, pediatrics, women’s health, hospice, immigration and customs enforcement, military, and forensic settings.

When considering a career in correctional nursing, nurses typically ask themselves these questions: Is it safe? What’s the salary? What education is required? What are the rewards and challenges?

Safety

Nursing is built on the foundation of caring for each patient as a whole, and correctional nursing provides a unique opportunity to provide that care to a vulnerable population. However, although healthcare is a mandated service and an inmate’s constitutional right, in correctional facilities, safety and security priorities frequently override nursing priorities.

Nurses will encounter a variety of safety concerns, including patients who have narcissistic and sociopathic personalities. Safety and de-escalation protocols should be guided by facility policies, procedures, and correctional staff trained in specific techniques to address situations where they need to intervene to ensure order and safety.

Nurses work alongside correctional staff and depend on that relationship to foster a safe environment. Correctional facilities should provide nurses with training on de-escalation techniques and the procedures that will ensure their safety as well as the patients they serve.

Salary

According to PayScale and Comparably, correctional nurses’ hourly wages range from $18 to $38; annual salaries can be between $54,000 and $100,000. In addition, correctional facility staff may receive hazard pay because of the working conditions. Salary may be based on education and experience.

Some facilities contract with private healthcare companies to provide staff. Job requirements and level may vary depending on a facility’s size, level of security, and whether it’s privately owned or government funded. Some government-funded positions (whether in state, county, or federal facilities) follow a step or tier model where nurses receive raises based on years of service. Nurses may work at various facilities within the organization where they’re employed.

In addition to salary, nurses should consider employer-provided benefits. If the employment opportunity is offered by the state or county department of corrections or the federal government, benefits may include retirement, health insurance, employment stability, and paid time off.

Education

Correctional nurses have a variety of experiences and education. Although they can begin with an associate degree, a bachelor of science in nursing is preferred because of the wide range of skills performed and level of critical thinking required. In addition, many facilities prefer that nurses understand the criminal justice system, so it may be helpful to obtain certification.

Nurses also should receive on-the-job training focused on correctional nursing that prepares them to work with this patient population.

Rewards

Correctional nurses are part of a multidisciplinary team that includes mental health professionals and correctional staff. This team plays an integral role in individual rehabilitation. Helping patients receive the services they need may be one of the most rewarding opportunities for nurses in this field. Nurses provide compassion in what are often harsh living environments, and patients generally appreciate the care they receive and want to learn how they can take better care of themselves and their families.

Many people who are incarcerated struggle with substance use and mental health disorders, which may have contributed to the crime they committed. Nurses who act as advocates and help patients find resources to address these issues may improve patients’ mental health and reduce recidivism. The assistance and guidance nurses provide can create a bridge from incarceration to living in the community.

Challenges

Safety must be at the forefront of all nursing care when working in correctional facilities. Nurses face many unknowns—including riots, lockdowns, verbally abusive individuals, and transmissible infectious diseases such as tuberculosis or influenza—in these working environments, creating stress for themselves and their families. (See Resources.)

Resources

Correctional nurses have access to professional organizations for guidance. The National Commission on Correctional Healthcare (ncchc.org) and the American Correctional Association (www.aca.org) set standards for healthcare in correctional facilities and offer certifications such as the Certified Correctional Health Professional and the Certified Corrections Nurse. Another resource is Correctional Nursing: Scope and Standards of Practice, 3rd Edition, published by the American Nurses Association.

Caring for a vulnerable population

Correctional nursing is a rewarding and yet challenging field. Those who choose to take on the role of being a provider to this vulnerable population must do so with the skills and knowledge to de-escalate stressful situations. However, people who are incarcerated need compassionate nurses to address medical and mental healthcare needs and serve as advocates.

Alicia Arias and Jana Zeller are assistant professors of nursing at Fort Hays State University in Hays, Kansas.

References

American Nurses Association. Correctional Nursing: Scope and Standards of Practice, 3rd Edition. Silver Spring, MD: Nursesbooks.org; 2020.

Bickford CJ, Muse MV, Shelton DA. Correctional nursing’s new professional resource. Am Nurs J. 2020;15(9):103.

Clayton E. Correctional nursing. Arizona Nurse. 2015;68(1):12.

Comparably (2020). Correctional nurse salary. comparably.com/salaries/salaries-for-correctional-nurse-in-wichita-ks

Dhaliwal KK, Hirst SP. Correctional nursing and transformational leadership. Nurs Forum. 2019;54(2):192-7.

National Commission on Correctional Health Care. Correctional nursing practice: What you need to know. ncchc.org/cnp-intro

PayScale. Average correctional nurse hourly pay. payscale.com/research/US/Job=Correctional_Nurse/Hourly_Rate

Sawyer W, Wagner P. Mass incarceration: The whole pie 2020. prisonpolicy.org/reports/pie2020.html

Williams T, Heavey E. How to meet the challenges for correctional nursing. Nursing. 2014;44(1):51-4.reduce recidivism.

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