A Focused Ethnography of Correctional Nurses Who Care for Incarcerated Women with Mental Health Concerns in Canada
Creators: Angel, Cybele
Publisher: name: University of Alberta Library
Year: 2023

<p>Background: Worldwide, the number of incarcerated women has been grown by more than 50% in the past twenty years. In Canada, when women are incarcerated, they make up 15% of the provincial/territorial admissions, and 8% of federal admissions. Within the correctional system, women remain disproportionally burdened with higher prevalence rates for chronic and infectious diseases, mental health concerns and substance use. Once incarcerated, research has identified that opportunities do exist to improve the physical and mental health of women. For women who are incarcerated, their regular and consistent point of contact with healthcare is through their interactions with nursing staff as they are the principal providers of healthcare in correctional facilities. The literature notes that interventions by nurses in correctional facilities have the potential to improve the lives of women beyond incarceration, and at the heart of this potential is the nurse-patient relationship which is a core component of nursing practice. For incarcerated women to undergo an improvement in their health it was worthwhile to look at how the nurse-patient relationship was perceived and enacted, more specifically by examining the experiences of the nurses working with incarcerated women.</p>

<p>Purpose: The purpose of this study was to explore nurses’ experiences working with incarcerated women with mental health concerns to bring greater understanding to the practice of correctional healthcare professionals. </p>

<p>Method: A focused ethnography was used. Eighteen correctional nurses from three provinces participated in individual semi-structured interviews. The participants worked in federal and provincial/territorial centres, including sentenced and remand facilities. Data analysis consisted of thematic analysis. Data were managed with Quirkos, a qualitative data analysis software.</p>

<p>Results: Data analysis developed seven themes: jack of all trades; seeing beyond the clinical task; being an expert; moments of opportunity; building the patient up; complex relationships, and culturally safe correctional nursing care. Complex relationships revealed that the nurse-patient relationship should be better described as a triad that includes the correctional officer. Culturally safe care was evident throughout the themes but also developed into a separate theme.</p>

<p>Conclusion: This study revealed that nurses were drawn to working in correctional facilities because of the intersection of complex patients, healthcare and the criminal justice system. The study also found that nurses experienced the pressure to acculturate into the correctional culture from when they first were employed and throughout their correctional career. Finally, it learned that the therapeutic nurse-patient relationship includes the correctional officers and can be thought of as a triad. Limitations of the study include sample diversity. Several recommendations were identified for future research, as well as for correctional nursing clinical practice and educational institutions.</p>