What We Do Makes a Difference
by Patricia N. Reams, MD, MPH, CCHP
An inmate who was the mother of five children expressed gratitude that the prison nurse had taken the time to teach her about aspects of child-rearing. She hoped that she would soon be released to care for her children and that she would do a better job in the future. A young man with diabetes was surprised that his blood sugars were so well controlled with consistent insulin use. He felt better and resolved to improve his self-care upon release. A middle-aged man was thankful that his hypertension had been diagnosed and treated. Chronic leg ulcers that had been present for years were starting to heal on an elderly patient who had no previous access to health care.
These are some of the stories I have collected from inmate interviews while conducting accreditation surveys for the National Commission on Correctional Health Care. Those of you who work with inmates have your own stories. In a recent issue of the Journal of Correctional Health Care, a study documented the perceived improvement in the health of soon-to-be-released prisoners. Almost all of the prisoners who had perceived poor health on intake felt that their health had improved in prison. The authors speculate that this perception will help motivate the newly released inmates to be receptive to the message about health maintenance in the future. If they had not perceived an improvement in health with routine medications and lifestyle changes, they would not be likely to maintain their health after release.
Unique Opportunities and Challenges
This is why we do what we do. Most correctional health care workers whom I meet love their jobs. Corrections facilities are places where their expertise is needed and respected. They allow for independent thinking and application of skills. They provide a unique opportunity to change peoples’ lives.
On the other hand, corrections facilities can be challenging places to work. Conflict can arise between correctional and health care staff over the inmates’ access to care, autonomy in making medical judgments and budgets for staffing and equipment. Movement through locked doors and other security measures can be frustrating. Many inmates have difficult personalities. They have no choice in their selection of providers, yet providers are required to treat them. Friends and family may not understand the allure of working in a corrections facility.
The National Commission on Correctional Health Care exists to help overcome these challenges and promote the professionalism of health care in corrections facilities. The standards spell out the means to resolve the inherent areas of conflict. Each revision of the Standards for Health Services gradually elevates the minimum requirements in order to enhance continuous improvements. Accreditation gives institutional and personal feedback. Educational programs provide networking and inspiration to busy professionals.
People who work in correctional facilities deserve commendation, especially when they convey an enthusiasm for what they do. We display with pride our Certified Correctional Health Professional credentials. This pride and enthusiasm must be conveyed to others to bring more excellent professionals into the field. In the meantime, we know that what we do makes a difference.
Patricia N. Reams, MD, MPH, CCHP, is 2014-2015 chair of the NCCHC board of directors and serves on the board as the liaison of the American Academy of Pediatrics. She also is a pediatrician at Cumberland Hospital, New Kent, VA.