A key area of correctional nursing professional development is collaboration. In correctional health care we have collaboration responsibilities not only with other care providers but also with our correctional staff colleagues. A valuable way to collaborate with correctional peers is through the establishment of a common purpose. Health care staff and custody officers work together within the enclosed community for mutual support and similar goals.

Correctional health expert Joseph Paris, MD, PhD, CCHP-A, suggests engaging in quality improvement efforts that would benefit both disciplines as a method to encourage collaboration (see his chapter on Interaction Between Correctional Staff and Health Care Providers in the Delivery of Medical Care in Clinical Practice in Correctional Medicine, 2nd Edition, by Michael Puisis, DO). Examples of good mutual projects might be reducing med line time or responding to medical emergencies. In addition, regularly scheduled communication points such as weekly or even daily briefings increase collaboration and communication.

Collaboration is more intense than mere involvement. Whereas involvement is sharing information about what is happening, collaboration is actually working together toward a common goal. Collaboration involves mutual decision making in a two-way exchange rather than merely assigning tasks or involving in actions. Collaboration uses a consensus approach rather than one-way communication.

When it comes to medical information, patient confidentiality must always be considered. According to NCCHC standard A-08 (Communication on Patients’ Health Needs), communication with custody staff should address “significant health needs that must be considered in classification decisions in order to preserve the health and safety of that inmate, other inmates, or staff.” Provide the minimally necessary information needed to meet the safety need. For example, you might specify that a patient requires a lower bunk but not that he is epileptic, or that an inmate should not work in a job involving high temperatures, not that the inmate is mentally ill and receiving psychotropic medications. Enough rumors and assumptions make the rounds in a facility without adding to it.

Conditions that may require communication with custody to accommodate safety, housing or classification needs include chronic illness, dialysis, adolescents in adult facilities, communicable diseases, physical disability, pregnancy, frail elderly, terminal illness, mental illness, suicidality and developmental disability.

Professional development also includes consultation with other care providers. In this regard correctional nursing is similar to other practice settings, although there may be a larger group of disciplines to consider. Adherence to the team approach in all clinical processes is the ideal to strive for.

Conflicts can arise due to conflicting missions between custody and health care, as well as competing priorities among health care staff. The Department of the Navy has delineated the principles of conflict resolution as follows (see www.mediate.com/articles/navy.cfm for details):

• Think before reacting
• Listen actively
• Assure a fair process
• Attack the problem
• Accept responsibility
• Use direct communication
• Look for interests
• Focus on the future
• Options for mutual gain

Professional nursing practice requires continually upgrading knowledge, skills and abilities. Thus, other professional development areas to consider are peer review or competency evaluation of individual staff members, quality improvement efforts for clinical processes and accountability for continuing professional development such as maintaining licensure, remaining current with practice changes and proactively improving nursing skills.

Finally, professional development involves actively participating in the orientation and in-service activities for health care and custody staff. Corrections staff need to know their role in emergency medical situations, how to control infections in the facility and how to deal with common health issues like diabetes and hypertension, to name just a few.

Applying professional development principles to correctional nursing is a key component of the specialty. Those who pursue specialty certification must understand these principles and apply them in practice.

— Lorry Schoenly, PhD, RN, CCHP-RN, is a member of the CCHP-RN task force and coordinates this column. She is an independent consultant specializing in correctional health care and social media and is based in Pennsylvania. For correspondence about this column, write to editor@ncchc.org.