Magazine article Corrections Today

Virginia DJJ Provides ACA Certification to Its Health Services Department

Magazine article Corrections Today

Virginia DJJ Provides ACA Certification to Its Health Services Department

Article excerpt

Every week, residents arrive at Virginia Department of Juvenile Justice (DJJ) facilities from detention centers. Commitment to a state facility is typically the last of several attempts to help redirect a young person's behavior. Unfortunately, it often represents the first time many of the residents have had regular access to health care. In addition to medically naive patients with unclear histories, correctional medical staff must deal with security constraints, physical plant issues and the weighty responsibility of care from the point of initiation through to medical compliance. Health services departments throughout corrections must deal with these same challenges: a difficult patient population in a uniquely challenging environment.

Correctional health care has been defined as a specialty in and of itself. The American Nurses Association codified the corrections specialty in the book Correctional Nursing: Scope and Standards of Practice. In 2001, the National Institute of Corrections delineated its expectations that correctional health care be practiced under industry standard regulations, such as those offered by the American Correctional Association. It is also well-known that working in an accredited facility raises morale, improves care and reduces liability. For this reason, all of the health services procedures within DJJ were rewritten to uphold ACA standards.

Few, if any, problems are ever solved by crafting policies and procedures alone. DJJ's Health Services department faced two strategic problems when it came to implementing policy into practice. First, the educational preparation for health services professionals is usually devoid of any emphasis on correctional practice. DJJ's nursing staff typically gained knowledge of correctional practices only through work experiences. The lack of correctional knowledge presented challenges in getting staff to enthusiastically engage in sound correctional health care practices rather than merely comply with written procedures. The reasoning behind a practice was too often unknown to them. Secondly, as with most clinical environments, new supervisors were often selected on the basis of clinical skills and knowledge. Management training, let alone correctional management training, was not part of their knowledge base. To overcome these challenges, Health Services offered to pay for ACA certification for all its nurses and made certification a requirement for the Health Services leadership staff.

ACA certification provided the perfect vehicle to establish a professional identity as a correctional nurse or nurse manager. Most, if not all, Health Services staff did not plan on entering correctional health care when they chose the medical field. Certification offered them a chance to officially invest in this area of their professional development. DJJ believed this choice and the associated pride of achieving certification would increase the engagement of its staff. The certification material also provided the knowledge base DJJ wanted to underpin in its nurses' clinical practice. In addition to the scope and practice of correctional nursing, DJJ staff learned about ACA standards, correctional health care operations, security concerns and correctional law. This material helped DJJ nurses understand the larger health care and corrections systems around their daily activities.

While Health Services leadership was clearly able to benefit from additional correctional health care training, they specifically needed continued development as correctional managers. …

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