Sherry Cameron, a medical recruiter for correctional facilities across the US, recently wrote a post for DailyNurse as the first part in this Three-part series. (For part Two, see What to Expect as a Correctional Care Nurse). Now, she’s starring in the latest DailyNurse podcast, “What is it like to be a Correctional Nurse?”
Nurses in correctional facilities work so closely with other members of the healthcare team that Sherry describes it as a “family-oriented environment.” Often looking after inmates who have never received regular medical care, these nurses perform the usual nursing tasks such as administering medications, blood sugar checks, and tending to injuries incurred in the kitchen or carpentry shop.
Also, correctional facilities offer the opportunity to experience one of the most gratifying aspects of nursing. Corrections nurses act as educators for people who have rarely had any sort of relationship with a healthcare provider. Sherry recalls, “one nurse said to me that ‘it’s a very special moment when you see a patient come to tears because someone took the time to finally talk with them and educate them about their health.’ That to me is a true nurse at heart”.
In this episode of the DailyNurse podcast, you will hear Sherry discuss the character traits that she looks for in potential correctional nurses, the concerns they have when they first consider a career as healthcare providers in a correctional facility, advice for those interested in correctional nursing, and much more.
The week of November 10-16 is National Nurse Practitioner Week, the annual recognition of the vital contributions of nurse practitioners (NPs) nationwide.
Providing Much-Needed Access to Primary Care
For over 50 years, Nurse Practitioners have been championing the needs of patients. In fact, “Patients are benefiting now more than ever from the comprehensive, patient-centered health care services NPs provide,” said Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FNAP, FAANP, president of American Association of Nurse Practitioners (AANP). “At a time when millions of patients in our country lack access to primary care providers in their own communities, Nurse Practitioners are growing the capacity of our health care workforce to meet patient demand and challenging regulatory roadblocks that prevent patients from choosing NPs as their health care provider.”
In every state, NPs assess patients, order and interpret tests, make diagnoses and provide treatment – including prescribing medications. Further, Nurse Practitioners can be found in clinics, hospitals, emergency rooms, urgent care centers, nursing homes and private practices nationwide. As clinicians that blend clinical expertise with an emphasis on disease prevention and health management, they also bring a comprehensive perspective to health care and are the health care provider of choice for millions of patients.
Serving 1.6 Billion Patient Visits a Year
“In the next decade, seniors will outnumber kids for the first time ever. Health care provider shortages are a growing concern, yet the growth of the NP role is addressing this challenge head-on. The faith patients have in NP-provided health care is evidenced by the 1.06 billion patient visits made to Nurse Practitioners annually,” said Thomas. “NP Week helps to educate patients about their choice in health care providers, and to create awareness of the many services NPs provide that enable patients to access excellent care, no matter where they live.”
To help strengthen public awareness of NPs, the American Association of Nurse Practitioners has created We Choose NPs (WeChooseNPs.org), a national multi-media public awareness campaign integrating television, radio, digital, and in-person events that reach communities nationwide. The campaign provides useful information about patient choice, the importance of finding a primary care provider and the critical roles NPs play in patient health.
The “Voice of the Nurse Practitioner”
AANP is the largest professional membership organization for NPs of all specialties, representing the interests of the more than 270,000 licensed NPs in the U.S. As The Voice of the Nurse Practitioner®, AANP provides legislative leadership at the local, state and national levels, advancing health policy; promoting excellence in practice, education and research; and establishing standards that best serve patients and other health care consumers. For more information about NPs and to locate one in your community, visit WeChooseNPs.org.
SOURCE: American Association of Nurse Practitioners
When people experience sexual assault,
they may sustain more than just physical injuries; trauma also affects short-
and long-term mental health. The medical treatment needed may require a
provider to examine parts of the body that were recently violated, which can
cause more distress. When reporting an assault, survivors often lack the
information they need about how to proceed.
Sexual assault nurse examiners
(SANEs) are trained to help survivors across this spectrum of patient care.
From providing evidence-based treatment to performing assessments to collect
forensic evidence that can be used in a criminal trial, these nurses play a
critical role in supporting survivors at the beginning of their recovery
What Is the Role of a Sexual Assault Nurse Examiner?
When a sexual assault survivor comes to a SANE-certified hospital or community health center, a sexual assault nurse examiner is the first point of care, according to Kim Day, forensic nursing director for the International Association of Forensic Nurses (IAFN). SANEs ask the patient if they would like a forensic exam, which can be completed even if the patient decides to not report their assault to law enforcement.
“Just going through the process with
someone and providing holistic patient-centered care for that patient during a
traumatic time in their life can really impact the way they leave the
hospital,” Day said.
Forensic exams are meant to document
trauma from the assault and collect evidence that could be used in a criminal
trial. This includes taking a medical history; documenting scratches, bruises,
abrasions, and other injuries on a body map diagram; taking photos of injuries;
collecting DNA swabs to be processed; and observing the patient’s behavior. In
cases where toxicology information is relevant, SANEs will also perform those
tests on a patient.
In addition to performing a forensic
exam, the main duty of a SANE is to provide holistic nursing care for the
patient. Survivors of assault may need access to testing for pregnancy, as well
as prophylactic antibiotics to prevent the contraction of diseases. Depending
on the patient’s needs, SANEs also provide referrals to see other specialists,
such as a licensed professional counselor, who can help them in their recovery
The SANE in Court: It’s Not Like “Law and Order”
Beyond working in the clinical
setting, SANEs are qualified to testify in court if a patient’s case goes to
trial. The specialized training SANEs receive prepares them to effectively
answer questions regarding evidence discovered during a forensic exam. However,
while SANEs can play a critical role in the trial process, the legal aspect of
the job is not the main focus, Day said.
“If the nurse goes into this work
thinking that they’re going to get the bad guy and put him behind bars, they
will fail at this… because that is not what we do,” she said. “The work we do
is nursing. We take care of the patients.”
This is a key factor to consider when choosing to become a SANE. Nearly 80 percent of sexual assaults are not reported to law enforcement, according to a Justice Department analysis of violent crime in 2016 (PDF, 669 KB). While performing a forensic exam and being prepared to provide evidence in court is a requirement of the job, the emotional and medical needs of a patient come first.
SANEs are trained to work within a multidisciplinary team, also known as a Sexual Assault Response Team (SART), which includes survivor advocates, members of law enforcement, and mental health providers. Together, these professionals coordinate the response to survivors of sexual assault.
What Is a Sexual Assault Response Team?
SANEs and other trained health care
providers: When an individual decides they
would like to have a sexual assault forensic exam (SAFE), health care providers
like Nurse Practitioners (NPs) or SANEs address the initial physical and
psychological needs the patient might have as a result of their assault.
Survivor advocates: Individuals who need access to information and emotional
support can work with an advocate to navigate their path to recovery. A
survivor may reach out to an advocate via a crisis center, or one may be
brought in to support someone who has decided to seek treatment at a hospital
or report their assault to the police.
Law enforcement: In cases where an individual decides to report their
assault, police officers and detectives are responsible for taking statements,
coordinating with the hospital to receive the results of the forensic exam, and
investigating the alleged assault.
Prosecutors: In cases where the survivor has chosen to report their
assault and enough evidence is present, prosecutors are tasked with making the
decision on whether to bring the case to court.
Therapists and counselors: In the aftermath of an assault, whether a case goes to trial
or not, survivors need additional support to continue their recovery process.
Mental health professionals trained in working with sexual assault survivors
may provide care at any step in the recovery process, from coping with the
immediate aftermath of an attack to navigating long-lasting trauma.
SANE education programs are designed
to train nurses to address survivors’ specific needs. After completion of this
training, SANEs become uniquely qualified to treat this vulnerable patient
group. This means that they can provide trauma-informed care to minimize the
harm of invasive exams that may trigger a patient. In doing so, they can also
equip their patients with forensic evidence that can be used if they decide to
report their assault.
One of the key challenges of
completing a sexual assault forensic exam (SAFE) is examining a patient’s
physical injuries without retraumatizing them. To help survivors feel
comfortable, SANEs ask for consent during each step of the way while providing
information on why they are doing each test.
“Consent is not just a piece of
paper with a signature on it,” Day said. “It’s a process throughout the exam.”
In practice, the process of asking for consent may resemble the following:
will inform the patient what body part they will examine and ask permission to
do so. “I’m going to examine your neck now
to see if there are any injuries. Do I have your permission to do so?”
patient grants this permission and the SANE notices something that may require
a sample collection, the nurse will again ask for permission to collect a
specimen and explain why collecting that evidence is appropriate. “I notice a scratch that wasn’t
mentioned when I documented your health history. There may be DNA or other
materials near this wound, so I would like to swab it. Is that OK with you?”
In any instance where the patient
does not want a test performed, the SANE is directed to honor the patient’s
request. This integration of consent throughout the exam is meant to give the
patient a sense of control, a feeling that may have been lost during their
What Are the Requirements to Become a SANE?
Because SANEs work with a patient population that requires specialized care, nurses are required to meet certain expectations in order to take on this role. While some nurses go through training at the local level or through smaller programs, IAFN offers the most recognized certification for SANEs. Nurses can become certified as a SANE-A to care for adults and adolescents or a SANE-P to work in pediatrics. Some nurses elect to pursue both certifications so they can provide care to patients across all age groups.
Steps to SANE Certification
Education: To become a certified SANE, a nurse must have the minimum of a registered nursing (RN) license.
Experience: Prior to starting the certification process, a nurse must have at least two years of clinical experience working as an RN or at a higher level, such as an NP.
Training: As part of the certification process, nurses are expected to complete 300 hours of SANE clinical skills training.
Testing: The final requirement to become a certified SANE is to pass a certification examination. IAFN holds exams two times a year.
The anti-vaccination (“anti-vaxx”) movement is a global phenomenon that has received a great deal of press, but how much do we really know about it? How do educated adults come to turn against medicines that have been saving literally millions of lives since the early days of smallpox inoculations?
One partial explanation is offered by health policy reporter Stuart Lyman. In a February column for STAT, he writes, “The [pharmaceutical] industry has been engaging in bad behavior for several decades, and these self-inflicted wounds have turned much of the public against it…” After reciting a horrifying litany of pharma-company scandals the public has witnessed, he concludes, “All of this has contributed to the prominent anti-pharma themes voiced by the anti-vaxx crowd.”
Anti-Vaxx is No Longer In Its Infancy
But “the anti-vaxx crowd” shows no signs of giving up their crusade anytime soon. From their original focus on parents of autistic children, they have proceeded to target orthodox Jewish communities and recently bereaved parents. Perhaps the most influential US group behind anti-vaccine campaigns is ICAN (Informed Consent Action Network). According to the Washington Post, ICAN, founded by former daytime television producer Del Bigtree, is largely funded by New York city philanthropists Bernard and Lisa Seltz, who have contributed $3 million since joining in 2012.
Lisa Seltz now serves as ICAN president, and continues to fund the organization’s message that the government and “Big Pharma” are colluding in a massive coverup regarding the hidden dangers of vaccines. Robert F. Kennedy, Jr, a nephew of the late president, runs Children’s Health Defense, his own anti-vaxx organization, and another flush-with-cash group, The National Vaccine Information Center, is run by Barbara Loe Fisher (who claims her son’s learning disabilities were the result of a 1980 DPT shot that was followed by “convulsion, collapse and brain inflammation within hours”).
Some Quick Tips from NSO’s Georgia Reiner
Considering that these wealthy and powerful organizations are finding fertile ground in today’s conspiracy-minded culture, DailyNurse interviewed Georgia Reiner, a risk specialist for Nurses Service Organization (NSO), to request a few tips for nurses who find themselves confronted by this strange controversy.
DailyNurse: What are the
actual dangers posed by the anti-vaxx movement?
GR: It is important to state up front that the vast majority of people do vaccinate. However, the anti-vaccination movement has gained a lot of attention and helped foment outbreaks of largely preventable diseases that can be deadly. The anti-vaxx movement spreads misinformation and conspiracy theories online on social media, and by word-of-mouth in tight-knit, culturally isolated communities.
Anti-vaxx propagandists have helped to create pockets of unvaccinated people, which have contributed to public health issues like the measles outbreak seen recently in Orthodox Jewish communities in New York and New Jersey. These outbreaks of highly contagious diseases such as measles put vulnerable people, including newborn babies and people who have weakened immune systems, at great risk.
Outbreaks also distract
and divert resources from other important public health issues, and cost state
and local governments millions of dollars to contain. However, nurses are in an
ideal position to counter this messaging.
DN: What are nurses doing
to counter the anti-vaccination movement?
GR: Nurses are a trusted
source of credible information and can have tremendous influence over the
decision to vaccinate. This is true even for parents who are vaccine-hesitant.
Working on healthcare’s front lines, nurses can help inform families about
vaccinations and the role they play in keeping their children healthy and
stopping the spread of disease. Nurses can also learn about questions parents
may ask about vaccines, and how to effectively address common concerns.
DN: How can nurses cope
with anti-vaxx parents?
GR: First, nurses should
assume that parents will vaccinate. Research has shown that when healthcare
providers use presumptive language, significantly more parents accept vaccines
for their child. Then, if parents are still hesitant or express concerns,
nurses should work with the treating practitioner to convey the importance of
Nurses should listen to
parents’ concerns, work to understand why they are questioning the science, and
respond respectfully. Provide parents with information about vaccines and
vaccine-preventable diseases, both verbally and in writing. Document parents’ questions
If parents still decline to vaccinate, the parents should sign a Refusal to Vaccinate form. Parents should sign a new form each time a vaccine is refused so there is a record in the child’s medical file. To minimize potential legal exposure, nurses should document all discussions, actions taken, and educational material provided.
Our Nurse of the Week is Yolanda Nelson, an alumna and nursing professor at The College of New Jersey (TCNJ) who created a proven system to keep black nursing students in school. Her program Moving Forward Together was launched as a mentorship program to help black nursing students overcome barriers to entry in the nursing profession.
The US is rapidly growing more diverse, making the care provided by nurses of color especially valuable. According to Nelson, people of color often seek medical care with providers who are of the same race or ethnic background.
The number of black nurses is low at most healthcare facilities and black students comprise a small portion of nursing students nationwide. This is largely due to barriers to entry including inadequate academic preparation in high school and a lack of diverse faculty in the field.
Nelson tells news.tcnj.edu, “As a student at TCNJ, I didn’t have any role models who looked like me. It would have helped if I had a mentor to encourage me.”
Nelson has thrived as a case manager and practicing clinician and served in leadership roles at several hospitals in New Jersey throughout her career. She has personally witnessed a lack of mentoring as another road block to increasing diversity in nursing and healthcare.
To help address this issue, Nelson launched Moving Forward Together when she joined TCNJ’s faculty in 2017. Moving Forward Together is a mentorship program that matches TCNJ’s black nursing students with working black nurse mentors, some of whom are alumni. Mentors are “someone they can lean on” in dealing with a professor, developing study skills, or finding their first job. So far, Nelson has matched 30 students with mentors and has seen six participants graduate.
To learn more about olanda Nelson, an alumna and nursing professor at The College of New Jersey who created a proven system to keep black nursing students in school, visit here.
The American Association of Colleges of Nursing (AACN) is especially grateful to the US House of Representatives for their commitment to the nursing profession. Dr. Ann Cary, Chair of the AACN Board of Directors, tells newswise.com, “These programs are vital to ensuring we have a robust and diverse nursing pipeline, especially in rural and underserved areas.”
The lead sponsor of HR 728 is Representative Dave Joyce (R-OH) and the cosponsors include Representatives Tulsi Gabbard (D-HI), Doris Matsui (D-CA), Suzanne Bonamici (D-OR), Rodney Davis (R-IL), Kathy Castor (D-FL), David McKinley (R-WV), and Lauren Underwood (D-IL).
According to Rep. Tulsi Gabbard, “There is a dire need of nurses all across this country, with rural and underserved communities most negatively impacted. Nurses are the heartbeat of our healthcare system, and this shortage is a crisis that impacts everyone. This bill will help make it easier to educate, train, and grow the number of nurses across the country. The Senate must quickly take up and pass our bipartisan bill so that we can build the 21st Century nursing workforce we need.”
To learn more about the recently passed Title VIII Nursing Workforce Reauthorization Act of 2019, visit here.