Nursing in jails and prisons: An integrative literature review

Background and issues: In 2008, the Pew Center on the States reported that prison growth had led to 1 in every 100 US adults being incarcerated. This burgeoning population experiences well documented health risks and disparities including substance abuse disorders, severe mental illness, communicable disease, and chronic physical conditions. Delivering healthcare in jails and prisons is notoriously complex. It is also difficult to staff these institutions with qualified healthcare providers for a variety of reasons including greater opportunities in the “free world” with better salaries and resources. Nurses constitute the largest segment of this jail/prison healthcare workforce, and research indicates they play a critical role in prisoner access to healthcare. Description: The purpose of this integrative review is: to conduct a rigorous examination of historical and contemporary literature related to nurses practicing in jails/prisons; and to identify the most salient research findings and issues confronting this segment of the public health nursing workforce. The review utilizes established healthcare databases and other pertinent documents such as statements from correctional healthcare accrediting organizations. Lessons learned: Findings indicate a well documented tension between caring for prisoner patients/clients and the priorities of custody; variable interactions between custody and nursing personnel; and problems encountered in the management health problems in complex jail/prison environments. Recommendations: The results of this integrative review indicate a need for attention to the issues facing the jail/prison nursing workforce and research into the relationship between the characteristics of this nursing workforce and prisoner/patient outcomes.