Providing Quality Healthcare for North Carolina’s Offender Populations

Friday, May 10, 2019 - 7:22am

Nurses Answer the Call
“4 million reasons to celebrate.”  This is the slogan for the 2019 American Nurses Association (ANA), National Nurses Week recognition. (Find out more here.) Many of those four million reasons work in correctional healthcare. Teams of dedicated medical professionals provide juvenile and adult offenders housed in NCDPS facilities with the same level of healthcare accessed by the general public. 

Though the logistics of working in a secure facility calls for a higher level of protocol and procedure, from appointment management, routine checkups, allergy control and prescription distributions – to long-term chronic care and critical, life-saving care – correctional nurses provide everything their public venue counterparts deliver. Using contracted services, offenders have access to the latest procedures medicine offers.

While the use of technology in the healthcare industry is advancing at a rapid pace, the backbone of caring for the sick or injured involves patient contact. It is still the professional individuals interacting with patients who have the greatest impact on healing and recovery when people feel their worst. The oft-used image of Florence Nightingale is cliché but accurate as nurses are the frontline of medicine.

Pre-Existing Conditions Drive Treatment Plans
Dale Floyd, RN, BSN, M Ed. is the director of health services for the Juvenile Justice section and responsible for ensuring that high standards of care are provided to the youths in our facilities. “Kids coming into our facilities have both preventive and interventive health needs – from basic checkups, immunizations/vaccines and oral hygiene, to injuries and even ongoing management of chronic illness,” she stated. “There are some who come to us who have never had regular checkups with a doctor or dentist, so we work to get a plan in place to address each issue from the start.”

Anita Myers, RN, MSN is the director of nursing for the adult correction system and she concurs: “During the intake process, the health services teams do complete (mental and physical) evaluations on individuals.” A health baseline for each person is necessary to deliver the best care and establishing medical records is a large part of what is created and maintained at the onset. “A large number of these patients have not had access to regular care and treatment on the outside,” Myers continued. “We are providing ongoing maintenance of pre-existing conditions in addition to the problems which might arise.”

Special Concerns and Chronic Healthcare
Chronic health problems can either be pre-existing, or they can develop over the course of an offender’s time in custody. “The adult populations have a high number of 40, 50 and 60-something year-olds,” Myers stated. “With that cardiac issues, seizures, strokes and other conditions are bound to arise.”

Diabetes management is one area of special concern for both adult and juvenile offenders because complications deriving from this disease can lead to other major health issues. A diagnosis of juvenile diabetes (JD) is something Floyd’s nurses are adept at understanding and treating. “Poor diet and low exercise can lead to the development of type 2 diabetes. Missed diagnosis, poor condition management and lack of compliance to treatment can compound problems from either type 1 or 2 diabetes,” Floyd said. “I am profoundly proud of the efforts our nurses have made in treatment and management of the JD program.”

Dental care is another area that is emphasized in both adult and youth health programming. Regular checkups and necessary treatments are provided. “People do not understand the larger complications which can arise from problems with teeth and gums,” Myers stated. “We are often educating patients about chronic health issues as much as we are treating them.”

Logistics of Working in a Secure Environment
Juvenile Justice provides healthcare in both long-term stay youth development centers and the short-stay juvenile detention centers. “It’s obviously easier to work to get kids into a regular plan of care management when they are in one of the YDCs, whereas it can be more difficult to treat every condition a youth may have when housed in our short-term detention facilities because the kids are with us so briefly,” Floyd said. Yet her teams make every effort to ensure each child receives the care they need. “Coordination for continued care (with outside providers) is a cornerstone of our work.” 

Youth facilities are smaller than their adult counterparts, so from a logistical standpoint, treatment for youth is often quicker and easier. To provide better, more efficient care, Juvenile Justice also uses contract services in addition to its full-time staff members. Cabarrus Health Alliance (CHA) and Coastal Horizons (CH) have both been awarded contracts to provide medical support. The CH TeleHealth Initiative provides online medical consultations, diagnosis and treatment, which has allowed youth at rural locations to be seen more regularly and efficiently.
In adult health services, a team atmosphere is employed between nursing staff and the custody teams. Correctional officers are often the first responders on scene in a medical emergency, so they are required to be certified in Basic Life-Saving (BLS) skills. They are a critical component in providing care until the medical staff can arrive and take over emergency life-saving procedures.

Each prison has an on-site medical unit providing real-time diagnosis and treatment for cases. Walking in to one, you quickly realize there is little difference between these and the hospital in your community. A high-level of security protocol is a noticeable trait, but then again, take a visit to Duke, Rex or UNC and you notice they all employ security officers and the measures to provide both public and staff safety.

Staffing Correctional Health Services
Medicine is a demanding field, as well as competitive. Finding qualified people to fill positions is difficult for most providers. Long hours, holidays, weekends and night shifts are all part of the work expectations. Hospitals around the country seek to staff their facilities, so NCDPS competes heavily to hire and keep quality, qualified nurses and other healthcare staffing needs.

“A major problem with hiring nurses to work in a correctional setting is that they don’t discuss it with students while they are in school,” Myers said. “Many don’t know it’s an option so we’ve started to engage in dialogue with nursing schools around the state, as well as offering tours to prospective health professionals.” Both Floyd and Myers want people to understand that correctional healthcare is a terrific venue to start or further a career, and many of the hesitations someone may have regarding working in a secure facility are easily quelled.

Healthcare professionals engage with people when they are sick, in pain and often feeling their worst. This week we acknowledge the professionalism and dedication to those men and women who wear the badge, NCDPS Nurse. Your unwavering commitment to ensure all offenders receive quality care is celebrated this week!

Matt Jenkins, Communications Officer