Correctional nurses face challenges when treating inmates with HIV

By | 2020-04-15T16:42:03-04:00 May 19th, 2016|1 Comment

Nurses working in correctional facilities often face many obstacles when delivering nursing care to inmates: inadequate nursing staff, an overcrowded inmate population, tension between facility guards and nursing staff as to which inmates need care, and a lack of resources for nursing staff to name a few.

Even so, correctional health nurses are obligated to provide nursing care consistent with their respective state nurse practice acts and rules and the American Nurses Association’s Code of Nurses With Interpretive Statements (2015). These obligations have become increasingly difficult for correctional nurses to meet when caring for HIV inmates.

Beth Schwartzapel of the Marshall Project, reports that about “1.5% of prisoners nationwide — some 30,000 people — are infected with HIV. When the unique factors of going to jail and becoming infected with HIV overlap, the rate of HIV in prison is nationally some three times higher than in the general population” (Kaiser Health News, “Why Some Prisoners With HIV Get Better Treatment Than Others”).

Usually, she continues, inmates in state prisons receive “routine HIV testing and a well-respected funded program to link inmates to medical care on release [from prison],” but care in jails is “limited, haphazard and in many cases, non-existent.”

Schwartzapel focuses on the fact that this distressing situation is not only a correctional facility issue, but also a public health issue. Treatment protocols that are consistently adhered to can result in an individual’s HIV being well-controlled and result in a reduction in infecting others. This report has distinct ethical and legal implications for correctional health nurses.

The ANA’s Code of Ethics for Nurses provides ethical guidelines that are clearly applicable to this practice setting. Some of the mandates include:
1.    Provide care based on need, without regard for bias or prejudice (Provision 1)
2.    Take “appropriate action” when unethical situations place patient rights in jeopardy (Provision 3)
3.    Be accountable for one’s own nursing practice and take actions consistent with the obligation to protect health and provide optimal care (Provision 4)
4.    Be responsible for establishing, maintaining and improving the ethical environment of one’s work setting (Provision 6)
5.    Protect human rights, promote health diplomacy and reduce health disparities (Provision 8)
6.    Integrate principles of social justice into nursing and health policy (Provision 9)

Legally, state nurse practice acts and rules require similar guidelines. Although they vary from state to state, some examples of similarities include:
1.    Report unsafe or unethical healthcare practices or conditions to appropriate authorities
2.    Advocate for patients
3.    Practice in an ethical and professional manner
4.    Be accountable for one’s own nursing actions
5.    Maintain safe and effective nursing care

If you are practicing in correctional care, how is your facility managing inmates with HIV? How could you effect any changes needed?

For those of you who do not practice in a jail or prison setting, what suggestions would you identify to provide better care for HIV inmates?

NOTE:  Nancy Brent’s posts are designed for educational purposes and are not to be taken as specific legal or other advice.


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About the Author:

Nancy J. Brent, MS, JD, RN
Our legal information columnist Nancy J. Brent, MS, JD, RN, received her Juris Doctor from Loyola University Chicago School of Law and concentrates her solo law practice in health law and legal representation, consultation and education for healthcare professionals, school of nursing faculty and healthcare delivery facilities. Brent has conducted many seminars on legal issues in nursing and healthcare delivery across the country and has published extensively in the area of law and nursing practice. She brings more than 30 years of experience to her role of legal information columnist. Her posts are designed for educational purposes only and are not to be taken as specific legal or other advice. Individuals who need advice on a specific incident or work situation should contact a nurse attorney or attorney in their state. Visit The American Association of Nurse Attorneys website to search its attorney referral database by state.

One Comment

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    David Ade May 31, 2016 at 12:24 am - Reply

    Generally in my facility (jail) we prescribe medications that were being taken before arrest. If the patient is well known to us we will start the last HIV medications we provided. For testing we generally require symptoms or if they name a patient known to us as HIV positive we will test for HIV. It is not done routinely.

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