Exploring cognitive dissonance in the correctional nursing experience

OBJECTIVE

Correctional nurses navigate conflict between custody and caring. Balance is needed between healthcare and security priorities. This study explores the unique nature of nursing practice within correctional settings to inform interventions reducing stress, enhancing coping and mitigating cognitive dissonance among these nurses.

DESIGN

Qualitative, semi-structured interviews.

SAMPLE

Purposive sampling of nurses practicing in a correctional facility in the Southwestern United States.

RESULTS

Thematic analyses identified six themes describing the experiences of nurses in the correctional facility. The themes, "We have a sense of purpose," "We don't trust each other," "We want respect," "We experience unique stress," "It changes who you are," and "We try to leave it all there," describe the need for interventions providing debriefing opportunities, strengthening of relationships with corrections personnel, reflection and stress reduction to ameliorate the potential for cognitive dissonance.

CONCLUSIONS

Correctional nurses in this study perceived a strong sense of purpose and a desire for respect. They are challenged by relationships with both correctional staff and inmates and perceived a change in who they are due to practice in this challenging environment. Measurable, evidence-based stress relief interventions such as mindfulness practices, reflection interventions, physical activity, prayer and meditation are indicated to address these challenges.

Nursing in the American Justice System

Efforts to provide humane care for the mentally ill has led to growth of more suitable services in community-based settings, yet resources are insufficient to meet the needs of mentally ill who interface with the criminal justice system. The resulting collateral damage has created a pathway to prison for massive numbers of impaired individuals, and the inhumane warehousing of thousands of mentally ill people is reminiscent of a century ago. The criminal justice system was never intended to be a safety net for the public mental health system. While advances in expanding the role of the nurse in the healthcare system have shifted because of efforts by nursing's response to the 2010 Institute of Medicine report, the challenges for correctional/custody nursing have not been adequately articulated. This paper seeks to enhance awareness of Correctional Nursing through a discussion of challenges posed to nurses who work at the intersection of justice and public health in prisons, jails, detention centers and community supervision in this response to the Future of Nursing report.

Leininger's Theory of Culture Care Diversity and Universality: An Overview With a Historical Retrospective and a View Toward the Future

An historical overview of Leininger's Theory of Culture Care Diversity and Universality also known as the Culture Care Theory (CCT) and evolution of the Sunrise Enabler are presented along with descriptions of the theory purpose, goal, tenets, basic assumptions, major core constructs, and orientational definitions. Recent articles, books, and book chapters provide relevant exemplars to enhance scholarly understanding and application of theory constructs. Proposed future directions encompass using the CCT to guide research of discovery and translational research projects for evidenced-based nursing practice; develop nursing courses and curricula to prepare culturally competent nurses; guide future culturally competent administrative and leadership policies and procedures; inform public policy related to cultural diversity and underserved populations; promote grant writing initiatives to enhance cultural diversity in hiring nursing staff, supervisors, and faculty; and promote admission of nursing students from underserved and/or diverse backgrounds.

Prison Nurses' Professional Identity

In the United Kingdom, health and justice services nurses are a diverse group working across a range of contexts and settings such as police custody, sexual assault referral centers, young offenders' institutes, and prisons and probation. Recruitment and retention to the specialist field of health and justice services nursing, specifically prison nursing, is problematic in the United Kingdom. In this article, we consider the background to the current situation in prison nursing and summarize some of the existing literature and research relating to this specialty to raise, for discussion and debate, issues that are pertinent to the concept of professional identity and professionalism. Role definition, resilience and burnout, and education within prison nursing are identified in relation to the development of professional identity. It could be that professional identity is the missing link to recruitment and retention.

Cultural Humility: An Active Concept to Drive Correctional Nursing Practice

Correctional nursing practice is focused on a unique patient population: inmates who present with their own ethnicities and have an imposed culture from the prison structure. As such, culture must be considered to provide holistic care. Madeleine Leininger's Theory of Culture Care Diversity and Universality, which maintains that care is the essence of nursing (without inclusion of culture, there is no care), suggests three nursing actions: to maintain the patient's culture, make accommodations for it, and/or repattern cultural ways that may be unhealthful. Given that correctional nurses work within the context (and culture) of custody, Leininger's nursing actions may not always be feasible; however, showing an underlying attitude of cultural humility is. In this article, cultural humility, the basis of culturally competent care, is described in a manner that can drive nursing practice in corrections.

Teaching Nursing Students to Care for Patients Who Are Inmates

BACKGROUND

Inmates in federal or state correctional facilities or those who are under the custody of local law enforcement officials receive health care in acute care settings, and caring for these inmate-patients is difficult for many nurses. Nurse educators should teach nursing students that nurses care for all patients in all situations with respect for a person's inherent dignity and worth.

METHOD

Information from relevant nursing publications was synthesized to provide nurse educators with content that can be useful when teaching nursing students to care for inmate-patients in acute care settings. A case study is provided as a teaching strategy for nurse educators.

RESULTS

Respect, care, and concern are expressed differently when nurses care for inmate-patients in acute care settings.

CONCLUSION

Nurse educators are responsible to teach nursing students how professional nurses should respond to patients, especially in situations that many nurses find challenging. [J Nurs Educ. 2017;56(11):655-659.].