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Issues and Themes in Forensic Nursing
Fundamental issues have been described in the literature and are frequently subjects in the media. They include professional identity, organizational practices and patterns of interaction (Dhondea, 1995). Part of the dialog on identity is focused on the word “forensic”. Lynch et al (2006) list correctional nursing as one of the many aspects of forensic nursing; other aspects are death investigation, sexual assault examiner, nursing jurisprudence, forensic nurse examiner and legal nurse consultants. Not all nurses who work with inmates or in correctional settings are forensic nurses. Further discussion and their code of ethics can be found at the web site for forensic nurses
This and other issues identified by Maeve and Vaughn in 2001 were “maintaining patient confidentiality, using chemical restraint for security rather than medical purposes, working with under qualified personnel providing care outside their scope of practice, caring for addicted prisoners, caring for the mentally ill, caring for incarcerated mothers and their newborns, managing for the visitation rights of children whose parents are incarcerated, dealing with violence, coping with prolonged isolation and segregation of inmates and providing appropriate planning for released prisoners”. Guidance for managing each of these issues can be found throughout the Code of Ethics for Nurses in one or more of the nine principles (ANA, 2001). Nurses who work with prisoners must find a balance among the clinical, legal and public health factors found in these demanding environments. Common to their experiences are contagious diseases, acute and chronic diseases, mental health problems and other complications of overcrowding. Specific opportunities for nurses caring for inmates who are mentally ill were described by Lattanzi (2006). These include self esteem workshops, anger management, coping strategies and lifestyle management. She also listed problems associated with the nursing diagnosis “ineffective coping mechanisms related to perceptual disturbances”. “Lack of mental health programs, inadequate mental health screening and lack of continuing support” are some of them.
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