CORRECTIONAL HEALTH NURSE I

DEFINITION OF CLASS:

This is entry level professional nursing performed in a correctional environment. It encompasses the entire clinical nursing process from planning and intake through discharge into the community (primary care, chronic care, case management, emergency triage, emergency services and infirmary nursing, including health promotion and disease prevention). Inmate-clients are adults of diverse cultural, socio-economic, educational and health backgrounds. Contacts include co-workers in the correctional setting, inmate-patients and all other inmates, emergency medical service (EMS) providers, deputy sheriffs, police officers, emergency room personnel, medical laboratory employees, medical suppliers, physicians, inmate family members and, at times, advocates for various inmate population segments. Contacts involve the exchange of information relating to the health needs of the inmate-patients receiving nursing care and the general inmate population as well as standards of care and medical service guidelines and procedures. Public service/assistance is provided through lengthy or detailed questioning to obtain pertinent health and background information to make a nursing diagnosis and provide nursing service or make a referral for appropriate health care service(s).

The Correctional Health Nurse I performs work under the supervision of a professional nursing supervisor who provides technical and professional guidance, but is typically not present during some portion, or all, of the shift depending on shift staffing. The employee works with relative independence in handling routine tasks and often has access on shift to the technical and practical guidance of a higher level nursing professional for initial encounters with complex and unusual cases. The employee builds skill in assessing the conditions of patients, in providing nursing care and in advising on health care needs, in full consideration of the mental, emotional, cultural, social, physical and other dimensions pertinent to individuals and groups in the correctional environment and grows progressively more independent in handling more difficult and usual cases. Work is performed consistent with such guidelines as federal, Maryland, Montgomery County and departmental regulations, policies, procedures and standards of care, sanitation and ethics (including Code of Maryland Regulations, Title 10, Subtitle 27); standards and best practices for clinical practice in correctional medicine (as promulgated by the National Commission on Correctional Health Care); and generally-accepted nursing and health care unit procedures and techniques. The Correctional Health Nurse I independently plans the work to be done and proceeds with the work, using judgment in selecting and applying the appropriate guidelines, references, and procedures to specific nursing cases. This includes routine and, after on-the-job training, complex and unusual cases that require use of different approaches or methods to make assessments and provide nursing service. Work performance is reviewed and evaluated through records, reports, conferences and observation for desired results, adherence to professional standards and established policies, contribution to the goals of the correctional health care program and other factors. The complexity of the work is derived from the need to gather and categorize information, such as client medical/social history and medical test results; ascertain their significance; and determine, implement and monitor an appropriate health treatment plan. The Correctional Health Nurse I provides a service that is part of the total service provided by the inmate health program. The Correctional Health Nurse I is responsible for making effective clinical judgments and providing self-health guidance that promote a healthy outcome for individuals and groups. There is an important health impact on individuals and the entire inmate population as the employee's judgments and guidance help safeguard group health.

The Correctional Health Nurse I works with and among inmates (including those convicted of crimes against people or the public morals) and typically works in a high security environment requiring strict adherence to security precautions. There is work with blood, urine and feces and some exposure to contagious diseases, all requiring use of such personal protection equipment as gloves and a mask. Performance of this work typically involves long periods of standing or walking. Employees in this class lift and carry or move objects weighing up to fifty pounds or more on occasion or push and pull much heavier objects at times; they usually obtain assistance when lifting or carrying more than fifty pounds.

EXAMPLES OF DUTIES: (Illustrative Only)

Conducts intake screenings of newly incarcerated inmates, as assigned.
Collects client health data - obtains initial information from the inmate-patient, the family (as needed and practical), other members of the health care team and the health record.
Analyzes the data, observes the inmate-patient's conditions, assesses nursing needs, makes nursing diagnosis, provides required nursing care and assesses the outcome.
Administers immunizations, inoculations, allergy treatments and a wide range of oral medications and hypodermic injections.
Provides client health supervision, counseling, guidance and teaching directed toward health promotion and maintenance, disease prevention, and alleviation of specific health problems, particularly those common to the correctional environment.
Helps manage the stable phase of such common chronic illnesses as diabetes and hypertension.
Assesses and treats such minor health problems as colds and perform first aid for minor burns, cuts, bruises and sprains.
Observes and records temperature, pulse, blood pressure, respiration data and effects of medication.
Takes blood, urine and feces specimens. Takes blood, urine and feces specimens. Schedules special testing and provides information to inmate-patient on testing procedures.
In emergency situations when a physician is not present or immediately available, initiates appropriate measures; for example, takes resuscitative measures in case of cardiac or respiration arrest.
Maintains records, writes reports, assures orderliness, maintains supplies and equipment and the sanitation of the unit.
Sterilizes instruments and supplies.
Refers inmate-patients and families to available health and community services and provides follow-up services.
Provides case management services and coordinates client care.
Provides one-to-one health guidance and teaching on health promotion and maintenance (including good personal hygiene), disease prevention and alleviation of specific health problems. Conducts group education classes for inmates, as assigned.
Performs related duties as required.

MINIMUM QUALIFICATIONS:

Experience: None.
Education: Graduation from a registered education nursing program approved by the Maryland State Board of Nursing or an education program in registered nursing in any other state or country that the Board finds substantially equivalent to the program in Maryland.
Equivalency: An equivalent combination of education and experience may be substituted.
Knowledge, Skills, and Abilities:
Professional knowledge of established concepts, principles and practices of registered nursing and baseline skill in nursing care to carry out prescribed treatment for medical conditions of inmate-patients, to provide first response nursing assessment of and care for inmate-patients presenting or complaining of medical maladies and to advise on health care needs. This includes knowledge of the desired effects, side effects and compatibilities of commonly used pharmaceuticals.
Knowledge of diseases and conditions more common among the incarcerated than the general US population (including STDs, HIV, TB and poor dental health) to assess needs and provide care and treatment to individual inmates, promote health and prevent disease within the inmate population, and contribute to a healthy environment
Baseline skill in problem solving, using clinical techniques, procedures and standard medical instruments, materials and medications to care for inmate-patients having a wide range of medical conditions diagnosed by a physician for pharmacological treatment and monitoring while incarcerated or presenting a medical problem or complaining of a medical condition to make an initial assessment, identify and effect a nursing response or a referral to a general practitioner, take emergency action (such as CPR), evacuate the patient to an emergency room, etc.
Knowledge of and skill in modern disinfection, sterilization and prophylactic equipment and techniques to protect oneself and inmate-patients against infectious diseases, such as AIDS, Hepatitis B and TB.
Ability to rapidly acquire knowledge of clinical procedures and practices in a public health setting, including nursing case management and legal/administrative requirements, to take, record, use and safeguard medical histories.
Knowledge of the principles of nursing standards of practice for Registered Nurses (RNs) in Maryland and of professional ethics that govern the medical treatment that is provided to ensure provision of appropriate care and adherence to ethical practices.
Some knowledge of health education principles to promote good hygiene and preventive measures by diverse demographic groups of inmate-patients.
Skill in oral communication to exchange medical and administrative information (including facts, descriptions and ideas) verbally with a range of personal contacts. This includes ability to encourage effective verbal communication by inmate-patients and others.
Skill in written communication to read medical and administrative information (including facts, descriptions and ideas) and to write such information so that others will understand.
Willingness to perform shift work in a correctional institution.

LICENSE:

Possession of a current license to practice as a Registered Nurse (RN) in the State of Maryland issued by the Maryland State Board of Nursing to practice registered nursing is required at the time of appointment.* If the license is temporary, a regular Maryland RN license must be obtained within ninety (90) days of appointment. Obtains continuing education as required by COMAR 10.53.04 for each renewal year.

*The State of Maryland accepts as valid the current RN licensure from a candidate's primary state of residence if that state has an interstate compact with Maryland. The states having this interstate compact are Arizona, Arkansas, Delaware, Idaho, Iowa, Maine, Mississippi, Nebraska, New Mexico, North Carolina, North Dakota, South Dakota, Tennessee, Texas, Utah, Virginia, and Wisconsin. (This equivalency only applies to candidates whose primary residence is not Maryland).

PROBATIONARY PERIOD:

Individuals appointed or promoted to a bargaining unit position in this class will be required to serve a probationary period of six months. Individuals appointed to a non-bargaining unit position in this class will be required to serve a probationary period of twelve months, or if promoted to a non-bargaining unit position, will be required to serve a probationary period of six months. Performance will be carefully evaluated during the probationary period. Continuation in this class will be contingent upon successful completion of the probationary period.

MEDICAL PROTOCOL: Limited Core with Drug/Alcohol Screen

Class Established: June, 2007