Integrating Correctional and Community Health Care: An Innovative Approach for Clinical Learning in a Baccalaureate Nursing Program

Abstract

PROBLEM.With an evolving focus on primary, community-based, and patient-centered care rather than acute, hospital-centric, diseasefocused care, and recognition of the importance of coordinating care and managing transitions across providers and settings of care, registered nurses need to be prepared from a different and broader knowledge base and skills set. A culture change among nurse educators and administrators and in nursing education is needed to prepare competent registered nurses capable of practicing from a health promotion, disease prevention, community-and population-focused construct in caring for a population of patients who are presenting health problems and conditions that persist across decades and/or lifetimes. While healthcare delivery is moving from the hospital to ambulatory and community settings, communitybased educational opportunities for nursing students are shrinking due to a variety of reasons, including but not limited to increased regulatory requirements, the presence of competing numbers of nursing schools and their increased enrollment of students, and decreasing availability of community resources capable and willing to precept students in an all-day interactive learning environment. METHODS. A detailed discussion of one college of nursings' journey to find an innovative solution and approach to the dilemma of limited and decreasing available community clinical sites to prepare senior level prelicensure baccalaureate nursing students for healthcare practice in the twenty-first century. FINDINGS. This article demonstrated how medium/maximum prisons can provide an ideal learning experience for not only technical nursing skills but more importantly for reinforcing key learning goals for community-based care, raising population-based awareness, and promoting cultural awareness and sensitivity. In addition, this college of nursing overcame the challenges of initiating and maintaining clinical placement in a prison facility, collaboratively developed strategies to insure student and faculty safety satisfying legal and administrative concerns for both the college of nursing and the prison, and developed educational postclinical assignments that solidified clinical course and

Qualitative exploration of the medical learner’s journey into correctional health care at an academic medical center and its implications for medical education

“…However, our study provides an important caveat to the previously reported positive outcomes of other studies in correctional health settings (Applebaum et al 2002;Alemagno et al 2004;Weiskopf 2005;Dhawan et al 2007;Haley et al 2009;Rich et al 2012;Filek et al 2013;Diaz et al 2014;Bouchaud and Swan 2017;Simon et al 2017;van de Mortel et al 2017;Brooker et al 2018;Candamo et al 2018). Our data suggests a more cautionary approach may be required before immersing medical trainees (or their proctors) in correctional healthcare settings.…”

A Retrospective Analysis of Nursing Students’ Clinical Experience in an All-Male Maximum Security Prison

“…The survey asked students to describe (1) what they expected of the rotation before their first day, (2) their opinions of the rotation on their last day, (3) their opinions of correctional nursing, and (4) why they would or would not recommend continuing the prison rotation as a community site option. Although 186 students completed the survey, response rates vary by question.…”

“…Prisons, as microcosms of society, provide an ideal learning experience for the nursing skill set needed for practice in the 21st century, as well as population-based care, cultural sensitivity, and interprofessional efforts to engage individuals in the management of chronic conditions. [1][2][3][4] There is beginning descriptive evidence that demonstrates that correctional health is an innovative and viable clinical resource to educate nursing students in today's changing model of health care delivery and practice.1 Existing studies describe prisonbased clinical rotations in terms of the working environment and skills gained by health professions students.1,2,4 Educational experiences in correctional settings have been received positively by health professions students,5-7 but few studies exclusively examine student evaluations of such rotations. There exists a need for more current data related to nursing students' clinical experiences in prison and their perceptions of correctional nursing.…”

Ethics Students Go to the Jail

“…Nevertheless, we found descriptions of programs that provide trainees in various clinical professions-including medicine, nursing, and occupational therapy-the opportunity to learn and practice in a correctional setting [3][4][5][6][7][8][9][10]. All attest to the enormous educational value of the experience.…”

“…For instance, they must learn to negotiate the conflicting demands inherent in caring for incarcerated persons while also respecting the need of the institution to maintain order and security through measures such as regimented medication management and restrictions on privacy [4,5,11]. Much of what trainees gain from working in correctional health care, however, is transferable to noncorrectional settings, including the learning that comes from managing a wide range of chronic conditions [2][3][4][5][6][7][8][9], providing care to a diverse and generally underserved population [2,4,[6][7][8], and negotiating relationships in which mistrust is a potential factor [4-6, 9, 12]. In this paper, we consider whether there are analogous benefits for clinical ethics students who rotate in a correctional facility.…”