Opinion: I’m A Correctional Nurse. What Goes On Behind Walls Is Putting Lives At Risk
In different health care settings there’s a continuing argument about how to best determine the nurse staffing level and the conventional method for determining the staffing ratios have always been left to the facility’s management, whom should have much more equipped knowledge and experience. However, what if the facility is being managed by individuals without experience or a medical license? A concern that often arises in medical department within a correctional facility is the lack of oversight by an individual with knowledge and previous experience, which overall affects the department and its staffing ratios.
A challenge often found within a correctional system is the continued understaffing of the medical department that leads to poor health outcomes of inmates and detainees, at times leaving the unit with two or three nurses to care for hundreds of patients.
Over the years, external stakeholders as well as facilities’ staff has raised the alarm on the ongoing issue that there are nearly not enough employees to oversee the growing number of those in custody while the correctional system continues to expand.
At the federal level, the medical treatment and rehabilitation of inmates and detainees are overseen by the Bureau of Prisons (BOP), that is overall responsible for the millions of individuals under custody. Correctional facilities are audited annually and the medical department must adhere to the guidelines and policies according to the National Commission on Correctional Health Care and the American Correctional Association.
While some of these correctional institutions are public, most are owned and operated by private companies. Privately own or for-profit charge the government depending on its contract.
Most of these institutions just like any corporation, exist to generate profits, which may often have conflicts with the medical ethics and treatment of those who are incarcerated, such as determining medical staffing ratios, often overlooking at the critical need to recruit employees.
Staffing ratios are not regulated by either the American Correctional Association or the National Commission on Correctional Health Care, and are left open for the correctional facility and determine based on inmate and detainee population. However, correctional facilities will argue that guidelines and policies are determined and followed accordingly under the American Correctional Association simultaneously under the National Commission on Correctional Health Care.
As someone who previously worked in a correctional facility, I experienced and witnessed the concern for the lack of medical staffing in the correctional system, often leading to delayed medical care and lack of oversight of medical conditions such as wound care treatment and medication management. My recent litigation was filed and in motion to address ongoing concerns and seek to compel changes that has been requested to improve the system issue surrounding health care treatment for detainees and inmates and the continued understaffing of correctional facilities.
Advocates for improving correctional health care have voiced out concerns regarding the lack of staffing regulations leading to deficiency in health treatments and deaths through many years, but very little have been done to acknowledged and amend the issue.
If our legal justice system in America will continue to rely on private entities for prison, then the National Commission on Correctional Health Care and the American Correctional Association guideline should be amended and improved, to have tougher regulations to include staffing ratios.
There has been a long-standing request to make changes in the medical treatment of inmates and detainees that are often reflected from the available medical staffing for many years. And the need for staffing regulations in correctional institutions is high due to the increasing numbers of inmate deaths and substandard health outcomes that are often overlooked and not addressed. If this demand is continuously ignored, then our legal and medical system is failing our country but also our patients.
Oliva is a graduate student at Duke University finishing her doctoral degree with a registered nurse licensure that previously worked as a assistant health administrator for CoreCivic in San Diego.
