In the past, correctional facilities staffed their health care units with individuals holding varied levels of licensure, including people who held disciplinary or probationary licenses restricted to “corrections only”. As we push to improve patient outcomes within corrections, employee licensure levels rose as well. In the free world, doctors’ offices and hospitals are staffed with LPNs who are directly overseen and supervised in-person by RNs.
Licensed Practical Nurse “LPN”
- 1 year of education, culminating in certificate or associate degree
- Provide more basic nursing care; responsible for comfort of patient
- Expected to report even minor changes in patient care to RN or doctor
Registered Nurse “RN”
- 2 or 3 years of education, usually culminating in a bachelor’s degree
- Expanded set of duties, primarily administering medication and treatments
- Generally expected to do more critical thinking on the job
In corrections, LPNs (or lower licensure, such as CMAs, CNAs, EMTs, and med techs) are sometimes preferred by county commissioners and state legislatures who have a custom of seeking less-expensive health care for inmates. Some correctional facilities operate without any RNs on staff at all. (Similarly, some county commissioners and state legislatures allow unlicensed mental health workers to care for inmates in order to save taxpayer money.) Normally, state licensing and accreditation boards would regulate this behavior; however, those entities seem to turn a blind eye to corrections.
In 2015, the lawsuit Shadrick v. Hopkins County, Ky., 805 F.3d 724 was filed. The court stated: “It is predictable that placing an LPN nurse lacking the specific tools to handle the situations she will inevitably confront in the jail setting will lead to violation of the constitutional rights of inmates.”
Correctional facilities should be staffed (and funded) according to state licensing and accreditation boards.
In 2018, Iowa’s Nursing Scope of Practice Iowa Administrative Code 655.6.3(11)d(1) was changed to state that an LPN’s role in correctional facilities is only to provide supportive and restorative care under the supervision of an RN.
*6.3(11) The licensed practical nurse may provide nursing care in a non-acute care setting. However, a registered nurse, ARNP, or physician must be present in the proximate area if the licensed practical nurse provides nursing care in the following non-acute care settings: *
*c. Correctional facilities, except: *
(1) The licensed practical nurse shall be permitted to provide supportive and restorative care in a county jail facility … The supportive and restorative care provided by the licensed practical nurse in such facilities shall be performed under the supervision of a registered nurse. However, the initial assessment shall be performed by the registered nurse, …
In recent news, a Michigan lawsuit is making that same allegation that LPNs are unqualified to work in jail. The complaint is critical of the facility and contracted health care company for having an LPN and argues that the inadequacy was obvious.
Your support in enforcing funding for properly licensed health care staff in corrections would aid public safety by improving community health and thereby reduce recidivism. You would have a direct impact on improving the provision of health care to an underserved population.
References
Birdsall, M. (2023, April 13). Reality TV figure’s lawsuit claims he was denied heart
meds during jail stay. Huron Daily Tribune. https://www.michigansthumb.com/news/article/reality-tv-s-putman-sues-claims-denied-heart-17893349.php#:~:text=In%20his%20lawsuit%2C%20Putman%2C%20who,battery%20conviction%20in%20October%202022
Casselman, B. (2013, April 25). Is nursing still an attractive career choice? The Wall
Street Journal. https://www.wsj.com/articles/BL-REB-18786
Shadrick v. Hopkins Cnty. (2015, November 6). Casetext – CoCounsel. Shadrick v. Hopkins Cnty., 805 F.3d 724 | Casetext Search + Citator
655—6.3(152) Standards of nursing practice for licensed practical nurses. (2021,
February 24). Iowa Legislature. https://www.legis.iowa.gov/docs/iac/rule/02-24-2021.655.6.3.pdf