Welcome to Corrections
Medicine
Orientation for Nurses New to
Corrections
By Virginia Wingler BSN, RN

Introduction
The purpose of this orientation is to standardize the information that is conveyed to new nurses. It is also to help orient you to the facility and review basic assessments that are fundamental to each department. Safety measures will also be discussed.

Is there a difference?
Jail

Prison
 Managed by states or the federal

 Managed by counties or cities
 Short sentences (usually <12 mo)

government
 Long term (>12 mo)

 Substance withdrawal
 Acute problems

 Chronic illness

 Care is started from scratch  Come with assessments and orders from

jails

Characteristics of our Population
Nearly 1 of every 100 people in the US is

incarcerated in a jail, prison or juvenile detention facility. Our patients have high rates of mental illness,

alcohol and drug dependence, victimization, traumatic injury and chronic and infectious disease. Minorities are overrepresented among the

incarcerated.

Ethical Challenges
Our patients do not choose to be in our care.
The patients are detained to carry out criminal

sanctions.
We are legally obligated to provide medical care to those in our care.
Patient privacy can be a problem.
The ANA says “The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.”

Ethical Dilemmas in
Corrections
 The care that we provide has nothing do to with the

worth of our patients to receive the care that we are delivering.
 We do not give care only to those that meet our moral standards.
 Our nursing practice is about who we are, not about who our patients are or what they have done.
 Unlike any other specialty, correctional nurses are regularly called upon to look beyond the personal attributes, and the social and economic statuses of our patients in order to deliver nursing care to murderers, rapists, and kidnappers.
 Could anything be more challenging?

Facility
What is on each floor, what each department does. Secure perimeter
When you enter the secure perimeter, you will pass

Master Control on your Left. They monitor the all of the cameras and most of the doors throughout the building.
On the floors that house inmates, when you exit the

elevators, you will find unit control. They control the doors to the four housing units on each pod. The pods are labeled A, B, C and D.
There is a sally-port outside of each pod that you will

have to pass through to get into each pod. A sally-port is a military term that is a set of two locked doors. They are usually never both unlocked or opened at the same time.

Where is it?
– Laundry and the Kitchen
– Intake and Transportation
– Clinic, Dental, Medication Room and the Infirmary
– General population pods
– Segregation Units

Intake
Intake is the department that patients start in. Every person

that is booked by the jail is first assessed by the nursing staff. Assessments take an average of 7 minutes. Some patients

have no medical problems to report and others may have many. Every patient is treated as if they are staying in our care.

Medications are verified at the pharmacy that they use, and standing orders from our physicians continue most of those medications. Intake nurses enter codes into the computer to let Justice

Services know if they have special housing needs or diets.

Intake (Continued)
Sick call is done 3 times a day at 0730, 1700 and 2100.
Can also be initiated by a call from a CO requesting a

patient to be seen.
Multiple inmates are transported to court M-F at 0800.

Patients who need medication should see the nurse before they go.
Restraints are sometimes needed, and the corrections

officers will let us know the first time they need checked.
It is policy to check restraints every