Intervention Plan for Nursing Retention
Intervention Plan for Nursing Retention
As the major caregivers in correctional facilities, nurses are expected to balance the security demand of correctional facilities with the healthcare needs of individual inmates. This paper explores an evidence-based education program that aims to provide an intervention for promoting health, skills, knowledge, well-being, and the working environment for nurses working in correctional settings. Studies have revealed that proper management of work-related stress could cause a significant social change by promoting the health of the nursing staff, patient outcomes, and community health.
Intervention Plan Components
This intervention aims to increase knowledge and create awareness on adaptive strategies for correctional caregivers experiencing various challenges while caring for inmates. The field of practice for correctional nurses covers almost every aspect of public health, including medical-surgical, emergency, community nursing, mental health, occupational, and out-patient care nursing. Despite all the roles correctional nurses are expected to play, most of the nursing professionals employed in correctional facilities are Licensed Vocational Nurses (LVNs), meaning they are not professionally equipped to practice in correctional facilities. Further training and continued education are expected to strengthen them psychologically and professionally to face the challenges associated with the working environment.
Additionally, the aim is to promote resource allocation, teamwork, and good communication between healthcare professionals and correctional officers. Teamwork among the stakeholders is crucial in developing a positive healthcare environment for both patients and nursing professionals. In most cases, correctional officers work together with the nursing staff to maintain security protocols. Developing an appropriate communication strategy would promote mutual respect between the correctional officers and the nursing staff and accomplish the institutional goals and expectations.
Correctional nurses encounter various unique sets of inmate health care and personal needs. While delivering care for inmates, correctional nurses must be aware of safety measures and maintain boundaries at all times within the correctional facility. The inmate population also has a wide variation in their mental and physical needs. Correctional nurses require training and education that focuses on the following key self-care and care delivery needs to effectively prepare them for their role:
- Correctional Nursing
- Security and Safety
- Manipulation and interpersonal skills
- Legal issues
- Communication
Impact of Cultural needs and Nature of the Target population and setting on the Development of Intervention Plan Components
Correctional nursing is a very stressful job and often causes many physical and psychological problems for the nursing staff. The problems are compounded for nursing professionals who practice in hostile environments with difficult governing policies and patient populations. Normally, correctional nurses have a double responsibility of providing medical care and custody. This double responsibility is adversarial and not complementary: moreover, security in correctional facilities supersedes healthcare. Due to this role ambiguity, correctional caregivers struggle to balance their responsibility to provide quality and equitable healthcare and the strict security guideline of correctional facilities.
One of the main factors affecting the development of effective communication intervention to promote care delivery and nurse retention in correctional facilities is the nature of the tension between caring and custody. There is often a conflicting attitude among prison officers towards inmates. Correctional nurses have reported correctional officers questioning the need for quality healthcare for inmates. The attitude of correctional officers toward inmates is a major barrier in implementing interventions to promote a healthy working environment for nurses and patients.
Theoretical Foundation
Leadership has the most important role when it comes to employee retention (Clifton, 2021). Anticipating staff turnover is crucial for nurse leaders to prevent expensive costs and staff loss. Nurse turnover can stem from various issues such as leadership style, lack of cooperation among the stakeholders, long shifts, nurse manager’s treatment, and potential biases in the work environment. Amid an increasing staff shortage, organizational leaders must determine the best way to acquire and retain staff. Several interventions aim to improve patient satisfaction and well being of the nursing staff that nursing leaders can use to increase nurse retention.
One important strategy to retaining the nursing staff is through the establishment of an effective line of communication. Having an open and operational channel of communication between institutional leaders and the nursing staff is essential for the overall attitude of the organization (Sibiya, 2018). Organizational leaders need to encourage respectful and healthy communication between supervisors, nurses, administrators, and patients about how they feel. Healthy communication reduces conflict and stress among the institutional staff. In the absence of an open and clear communication channel, the staff can feel isolated as they may not be aware of whom to turn to in case of issues and concerns.
Nurses are responsible for most of the communication involving the healthcare system, patients, and other stakeholders. This involves communicating with patients and family members about diagnoses, medical conditions, treatment plans, and medication protocols. Promoting effective communication between the nursing staff and other healthcare stakeholders is essential for developing a healthy work environment for nurses (Sibiya, 2018).
Additionally, due to ever-changing working environments, organizational leaders need to provide training and ongoing education to their employees to cope with the changes. Promoting training and ongoing education make employees feel valued and part of organizational success. Most successful organizations provide career and professional development opportunities to their employees. Due to the unique nature of correctional facilities and inmates, correctional nurses need to receive training and ongoing education on emergency care, security and safety, correctional nursing, and legal issue. This would enable them to adapt easily to the work environment and effectively provide for the individual need of their patients.
Stakeholder, Policy, and Regulation
Healthcare independence is an important aspect of good healthcare and health care professionals, especially in prisons where the interaction between inmates and nurses is not based on choice and where the punitive correctional setting often challenges the quality of care. It is common in correctional facilities for nurses to have a conflict between their main duty to provide care for the ailing inmates and the secondary mandate to observe rules of prison management, which considers prisoners not as primary patients but as objects of surveillance, punishment, and rehabilitation. There are various structural, ethical, and organizational barriers in correctional facilities. These include dual loyalty for nurses, provision of equitable healthcare in a unique healthcare setting; challenges concerning timely access to patients and administration of medication despite the strict security and safety regulations; and the clinical independence of nurses to ensure that provision of quality medication.
Correctional nurses are usually required to report to correctional officers instead of nursing leaders and healthcare officials in the facility (Dhaliwal & Hirst, 2019, April). This hierarchical, military-like chain of command can cause serious interference by correctional officers on nursing professionals. It may require them to report patient confidential medical information to the prison administration when necessary to make a custodial judgment. Nurses are sometimes called upon to participate in custodial issues, including disciplinary matters (to determine if inmates are clinically fit for punishment), conducting body cavity searches, solitary confinement, or taking fluid body samples to test illicit drug use even when one has no medical signs for such actions. Generally, correctional facilities lack knowledge and awareness of health care principles, including knowledge of the need for clinical independence. Yet, there are no educational and training programs in healthcare ethics, care coordination, and communication available for correctional facility administrators.
Lack of clinical independence is one of the major causes of frustration and stress among correctional nurses, contributing to more than 30% of nursing turnover (Smith et al., 2021). Comprehensive education and training of correctional officers and administrators in health care principles to create awareness of the need for clinical independence are critical. Additionally, institutional administrators need to facilitate regular workshops with correctional officers and medical staff to promote acceptance of health care ethics and develop administrative and organizational goals at the institutional level that encourage quality medication.
Ethical and Legal Implication
Establishing an open and functional channel of communication between the stakeholders and using health care information technologies has been identified as an effective way of getting feedback, accessing patient records, and promoting an efficient and healthy work environment for nurses and patients. However, information exchange and the use of healthcare technologies must follow HIPPA requirements concerning the use of patient information (Shenoy & Appel, 2017). Nurses are often compelled to report patient health conditions to custody staff, especially those related to mental health and infectious diseases. Nurses may field like they are in a minefield of an ethical dilemma. It is important to educate custodial staff on the importance of patients’ information confidentiality and clinical independence to help avoid possible conflicts with nurses.
Reference
Clifton, J. M. (2021). Leadership in Correctional Nursing: The First Step. Journal of Correctional Health Care.
Dhaliwal, K. K., & Hirst, S. P. (2019, April). Correctional nursing and transformational leadership. Nursing forum (Vol. 54, No. 2, pp. 192-197).
Shenoy, A., & Appel, J. M. (2017). Safeguarding confidentiality in electronic health records. Cambridge Quarterly on Healthcare Ethics, 26(2), 337-341
Sibiya, M. N. (2018). Effective communication in nursing. Nursing, 19.
Smith, S., Muse, M. V., & Phillips, J. M. (2021). Addressing Moral Distress in Correctional Nursing: A Call to Action. Journal of Correctional Health Care.