NP Career Option: Correctional Health
I have spent some time behind bars. No, not from incarceration but providing health care to inmates. Correctional health was my first nurse practitioner job and it was a great learning experience. Correctional health is not for everyone and today I wanted to share my experience about this career option for nurse practitioners.
One can expect to see and treat many of the same conditions that would be treated in a primary care practice: episodic care, chronic illnesses, dermatologic conditions, sexually transmitted infections, and trauma for example. According to the CDC, the most infectious diseases encountered in correctional health are:
- Hepatitis
- HIV/AIDS
- MRSA
- Sexually Transmitted Infections
- Tuberculosis
The most chronic diseases encountered are:
- Arthritis
- Asthma
- Cancer
- Diabetes
- Heart Disease
- High Blood Pressure
- Stroke
Mental health and substance abuse and also areas commonly seen in correctional health. Dental services are usually part of the health services as well.
Typically a inmate has an initial history and physical, bloodwork, and tuberculin skin test (TST) planted upon arrival. The clinician makes their assessment, prescribes any medications as necessary and consults and arranges with the correctional staff as to whether the inmate needs care that is of higher acuity or can be put into general population. From there, inmates can follow up with the various chronic care clinics or sick call/episodic clinics as necessary.
The working conditions in correctional health are probably among the most challenging. One can expect to walk through multiple metal detectors as safety is always a primary concern and bringing belongings from the outside is not usually allowed. The facilities must be staffed 24/7, 365 days a year so shifts can also vary.
The actual employer of the health care staff varies by institution so benefits and salary depend on the employer. Some of the state correctional facilities hire the clinical staff as state/county employees with the usual benefits that state workers get (i.e. pension, health care benefits, etc). There are also agencies that contract with correctional facilities to provide health care services. The health care staff is employed by the agency. They, too, offer benefits to the health care staff that may be higher salary than the state counterparts but the benefits may not be as good.
As a new nurse practitioner, my correctional health experience was an overall good one. I got to see and treat many people with common health conditions and I learned a lot from my mentor at the facility. Ultimately, I wanted to focus more on health promotion, wellness, and proactive health which was admittedly difficult to do in correctional health.
For more information about correctional health, check out the National Commission on Correctional Health Care (NCCHC) and the CDCs website dedicated to correctional health.
