Magazine article Corrections Today

Geriatric Nursing in Prisons Is a Growing Concern

Magazine article Corrections Today

Geriatric Nursing in Prisons Is a Growing Concern

Article excerpt

Although crime in the United States declined throughout much of the 1990s, the number of Americans in prison is at an all-time high. The combined local, state and federal prison populations more than doubled between 1985 and 1998. (1) The latest figures show that nearly 2 million people are behind bars. (2)

The increase in the number of older inmates will be a critical challenge for prison management in the coming decade. Inmates 50 and older are the fastest-growing segment of the U.S. prison population. (3) Most experts agree that age 50 is the appropriate starting point for defining an inmate as elderly because substance abuse, poor diet and lack of medical care cause premature aging. (4) By 2010, it is predicted that one-third of all U.S. inmates will be 50 or older. (5)

The economic costs of caring for an aging prison population are staggering. To incarcerate a younger offender costs approximately $22,0000 per year compared with $69,000 per year for an older inmate, (6) and the greatest contributor to the higher costs of incarcerating older offenders is medical costs. (7) State and federal governments are now spending $2.1 billion annually to house and care for inmates who are older than 55. (8) Given this situation, there is a surprising lack of research specifically on geriatric prison health care.

The health care needs of a growing and graying prison population will be increasingly difficult to meet in coming years due to a nationwide shortage of registered nurses. A diminishing pool of new talent combined with the health care demands of aging baby boomers has caused an acute nursing shortage. (9) If current trends continue, the nation will face a shortage of 500,000 nurses by 2020. (10)

The skyrocketing number of older inmates and the high cost of caring for the will tax correctional systems in many ways. Prison officials must not only recruit nurses to corrections, but also retain them once they are hired, a task made increasingly difficult as the general demand for geriatric medical specialists grows. Recruiting and retaining qualified nurses are arguably the toughest challenges facing corrections for the next decade.

The initial orientation training of newly recruited prison nurses is vital to reducing turnover and absenteeism. Prisons are dangerous places and training must focus on ensuring the personal safety of nurses and maintaining institutional security in the context of providing health care. Occasionally, specific legal issues involved in treating the protected-class population of inmates are also a concern. (11) Stress reduction training is also needed to prepare nurses for the unique challenges of working in the prison setting, and this training will reduce the risk of burnout and morale problems that can cause nurses to quit. Nurses need to be informed that the complexities and demands of prison work, in spite of their best efforts, will lead to personal anxiety and stress beyond that found in the hospital or clinical setting, where most nurses are employed.

The major sources of stress that can lead to nurse absenteeism and high turnover are examined below. These particular stressors have been shown to increase pressure and strain on nurses in ways that can lead to lower job performance, absenteeism and terminating their employment. (12) As more states open new prisons for aging offenders who will be needing long-term medical care, new orientation training should be considered to help correctional nurses cope with the stressful nature of their work, Incorporating discussion of work-related stressors into the orientation training process will prepare nurses to anticipate and respond more effectively to job demands and pressures and help lower absenteeism and turnover.

Issues That Cause Stress, Absenteeism and Turnover

Corrections Today recently published an article on correctional employee stress and strain and its consequences. …

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