Forensic nursing in Correctional Facilities, comment

I have worked in a Forensic Mental Hospital. I am sure your are speaking about other correctional facilities.
In the Forensic Mental Hospital all of the patients are monitored differently that other patients with very strict rules. Only large strong young men can be the attendants because often the patients are “taken down’ But again this is because they are mentally ill criminals who have a history of hurting even killing people.
One of the forensic mentally ill patients was out in the community. A brutally mean child predator who was given large amts of Depo Provera to chemically castrate him. He could not achieve an erection but state he could not get the idea of hurting young girls out of his mind. He was readmitted to the hospital because he took a razor blade to his penis and testicles.  My job was to change the dressings once a day I had to have two strong young men with me when I was with this patient.  Even though people are locked up maybe the reasons they are criminals are not resolved.

I also applied at the State Prison. While I was waiting for my interview I saw young men hand cuffed through a bench. (i.e. one side of the hand cuff was on the patient and the other through the bench holding the prisoner on the bench)
I decided not to apply because the environment was scary. I agree with the article of Forensic nursing in Correctional facilities but feel it is a dream or fantasy to think that nursing can be like this.
These men and women are in a locked house without normal privileges; sometimes they are fighting for their life.  It is good to treat them normally but there is always the underlying ‘roar’ that they may be trying to get something more than they need. After all a large amount of criminals have sociopathic personalities
 
I work in a poor family clinic in a large city. I often have people who have gotten out of prison come to my clinic because they usually do not have money for health care.
It seems that more often then not, these patients continue their pre prison activities.  They come to us with infected needle lesions. They cry that they just cannot stop. They plead and cry for narcotics, show attitude, and sometimes are mean.
I agree we should treat them with dignity but so should show us respect also.  
I try to remember that most of them are in prison because they do not have people skills and have learned how to ‘play’ people to get what they need. How can a small clinic ‘provide nursing care that is free of bias and judgment’s when the patient (a previous criminal) has showed anger and attitude in the clinic. When I have to spend more than 15 minutes with this patient because he/she needs more help and expects it.
My company had to put a break proof piece of glass between the receptionist and the patient because one of these patients threatened the intake person. Now all the patients have to speak on a phone to the intake person.
It seems that even in a correctional facility they have rules and monitors to decrease the roots of violence. Now when the criminals are let out some of them continue the attitude and continue to cause problems.
Where does it end?

Original Post:
December 30, 2008
Forensic nursing in Correctional Facilities
This chapter started with a wonderful summary of some of the issues that forensic nurses had to contend with in correctional facilities. These nurses are not concerned about the crime that was committed because that has nothing to do with how the patient is to be treated. The same holds true for a psychiatric patient. The ED seems to be the only area where the entire story of the person is portrayed; for better or for worse. The text succinctly summarized the tasks of the correctional nurse: a. Consult and advocate on human rights issues b. Perform medicolegal examinations (not where employed) c. Teach and perform detailed, unbiased documentation d. Provide nursing care that is free of bias and judgment e. Advocate for healthcare and healthcare education f. Inspire health-care for offenders g. Assist nursing and other professionals in creating protocols with the highest ethical standards h. Assist in providing an impartial and secure environment for offenders and staff i. Develop and implement initiatives that decrease the roots of violence. References Lynch, Virginia A. and Duval, Janet Barber. (2006). Forensic Nursing. St. Louis: Elsevier Mosby

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