Correctional nursing, sometimes called forensic nursing, is a specialized field of nursing that involves caring for the medical and mental health needs of detainees and inmates. These nurses work in a variety of settings such as jails and juvenile detention centers. In these correctional settings, nurses are the primary healthcare providers; because of the varying size of correctional facilities, there is a wide range of roles correctional nurses fill.. Some facilities are as large as small cities and include an in-house hospital with inpatient and emergency facilities. Most correctional nurses fall into four categories: Reception Screening, Chronic Care Clinicians, Medication Administration, Ambulatory Care. Intake Screening is called, "R&R Screening" for, "Reception and Release"; this is the process where nurses screen inmates entering the facility for a variety of immediate medical and mental health needs such as alcohol or drug withdrawal, suicide potential, infectious diseases, necessity for chronic medications.
Custody uses this information in order to decide which part of the facility is appropriate for housing, sometimes initiating movement to another facility if the inmate's needs cannot be met at the initial placement. The nurse performing intake screening schedules the inmate for an appointment with a healthcare provider for a detailed history and physical depending on the inmate's needs and presence of chronic diseases. Inmates with chronic health care concerns have scheduled appointments in chronic care clinics. Overseen by a physician or other mid level provider such as a nurse practitioner. Nurses here provide patient assessments and education about chronic health concerns. Medications over-the-counter ones, can be misused in a correctional environment. Most medications are be administered to patients via a medication pass or pill line process. At scheduled times during the day, inmates requiring medication either report to a nurse located centrally in a medical unit or receive their doses in a housing unit.
Inmates requiring episodic health care follow a process called Sick Call. Inmates request treatment by completing a form and are seen by a nurse. Most facilities have standardized protocols which allow administration of over-the-counter medications for simple conditions like headache, athlete’s foot, constipation without the need for communication with a medical provider. An assessment of a more serious condition, or one that falls outside the protocols, would be referred to a provider for further evaluation
Critical care nursing
Critical care nursing is the field of nursing with a focus on the utmost care of the critically ill or unstable patients following extensive injury, surgery or life threatening diseases. Critical care nurses can be found working in a wide variety of environments and specialties, such as general intensive care units, medical intensive care units, surgical intensive care units, trauma intensive care units, coronary care units, cardiothoracic intensive care units, burns unit and some trauma center emergency departments; these specialists take care of critically ill patients who require mechanical ventilation by way of endotracheal intubation and/or titratable vasoactive intravenous medications. Critical care nurses are known as ICU nurses, they treat patients who are acutely ill and unstable requiring more frequent nursing assessments and the utilization of life sustaining technology and drugs. Although many ICU patients have chronic health issues, patients are in the ICU for an acute pathology or an exacerbation of a chronic pathology.
ICU nurses apply their specialized knowledge base to care for and maintain the life support of critically ill patients who are on the verge of death. On a day-to-day basis a critical care nurse will "perform assessments of critical conditions, give intensive therapy and intervention, advocate for their patients, operate/maintain life support systems which include mechanical ventilation via endotracheal, tracheal, or nasotracheal intubation, titration of continuous vasoactive intravenous medications in order to maintain a " mean arterial pressure that ensures adequate organ and tissue perfusion. Critical care nurses in the U. S. are trained in advanced cardiac life support, many earn certification in acute and critical care nursing through the American Association of Critical–Care Nurses. Due to the unstable nature of the patient population, LPN/LVNs are utilized in a primary care role in the intensive care unit. However, with proper training and experience LPN/LVNs can play a significant role in providing exceptional bedside care for the critically ill patient.
To become a critical care nurse, one must first achieve an associate or bachelor's degree in nursing and pass the National Council Licensure Examination. Once the exam is passed someone can start working as a regular registered nurse. After getting hired into a critical care area, additional specialized training is given to the nurse. After 1750 hours of providing direct bedside care in a critical care area, a nurse can sit for the CCRN exam; the American Association of Critical Care Nurses advisory board sets and maintains standards for critical care nurses. The certification offered by this board is known as CCRN. Depending on the hospital and State, the RN will be required to take a certain amount of continuing education hours to stay up to date with the current technologies and changing techniques. Registration is a regulatory term for the process that occurs between the individual nurse and the state in which the nurse practices. All nurses in the US are registered as nurses without a specialty.
The CCRN is an example of a post registration specialty certification in critical care. There are variants of critical care certification test that the AACN offers to allow nurses to certify in progressive care, cardiac medicine and cardiac surgery. In addition, Clinical Nurse Specialists can certify in adult and pediatric acute and critical care. In November 2007, the AACN Certification Corporation launched the ACNPC, an advanced practice certification examination for Acute Care Nurse Practitioners. None of these certifications confer any additional practice privileges, as nursing practice is regulated by the individual's state board of nursing; these certifications are not required to work in an intensive care unit, but are encouraged by employers, as the tests for these certifications tend to be difficult to pass and require an extensive knowledge of both pathophysiology and critical care medical and nursing practices. The certification, while difficult to obtain, is looked upon by many in the field as demonstrating expertise in the field of critical care nursing, demonstrating the individual's nurse's desire to advance their knowledge base and skill set, thereby allowing them to better care for their patients.
Intensive care nurses are required to be comfortable with a wide variety of technology and its uses in the critical care setting. This technology includes such equipment as hemodynamic and cardiac monitoring systems, mechanical ventilator therapy, intra-aortic balloon pumps, ventricular assist devices, continuous renal replacement equipment, extracorporeal membrane oxygenation circuits and many other advanced life support devices; the training for the use of this equipment is provided through a network of in-hospital inservices, manufacturer training, many hours of education time with experienced operators. Annual continuing education is required by most states in the U. S. and by many employers to ensure that all skills are kept up to date. Many intensive care unit management teams will send their nurses to conferences to ensure that the staff is kept up to the current state of this changing technology. In Australia there is no compulsory prerequisite for critical care nurses to have postgraduate qualifications.
However, the Australian minimum standard recommends that critical care nurses should obtain postgraduate qualifications. Critical care nurses must have a bachelor of nursing, be registered with the Nursing and Midwifery Board of Australia, meet the NMBA’s standards in order to work as a critical care nurse in Australia. Critical care nurses work in a variety of differ
A nursing school is a type of educational institution, or part thereof, providing education and training to become a qualified nurse. The nature of nursing education and nursing qualifications varies across the world. Since the mid 20th century nursing education in many countries has undergone many enhancements. Florence Nightingale was one of the pioneers in establishing the idea of nursing schools from her base at St Thomas' Hospital, London in 1860 when she opened the'Nightingale Training School for Nurses', now part of King's College London, her intention was to train nurses to a qualified and specialized level, with the key aim of learning to develop observation skills and sensitivity to patient needs allow them to work in hospital posts across the United Kingdom and abroad. Her influence flourished and nursing is now a course taught at a number of British universities. Apart from the nursing school of King's College London, the direct descendant of Nightingale's school, the University of Manchester was one of the first English institutions to offer the course at degree level.
A new building for the Manchester Medical School was opened in the early 1970s and degree courses in nursing were established about the same time. Nursing education at the university expanded in 1996 when a new School of Nursing and Midwifery was created by transferring the Manchester College of Midwifery and Nursing into the university's Faculty of Medicine and Nursing. Entry level courses, sought by most universities, are five Standard Grades/GCSEs, including English, maths and a science, two Highers/A-Levels. Mature students, over the age of twenty-one, have the option of entering upon completion of a college access course, experience in jobs such as being a health/nursing assistant are worthy for consideration into the course. Nursing is a three-year course in the UK, with students choosing the branch they want to study from day One e.g. adult, mental health, learning disability, or combinations of two. The course consists of a balance between course work in classes and practical placements in a health care setting.
The first year is foundation, where students learn basic health care. Newly qualified nurses have to register with the Nursing and Midwifery Council in order to apply for jobs and practice; the history of nursing education had a long and varied role in the United States. Before the late 1800s little formal education was available to train nursing students. Education was based on an apprenticeship with a senior nurse who taught bedside care within a hospital or clinic setting. Over time this model changed dramatically. A short chronology of Schools of Nursing in the United States is: In 1873, the Bellevue Hospital School of Nursing, of New York City, was founded, it was the first school of nursing in the United States to be founded on the principles of nursing established by Florence Nightingale. The School operated at Bellevue Hospital until its closure in 1969. 1883: The Medical University of South Carolina College of Nursing has been traced to its beginning in 1883 when the South Carolina Training School for Nurses was established at the request of Roper Hospital in Charleston, SC.
Due to an earthquake in 1886 which destroyed the City Hospital, the effort only lasted a few years. However, once the new hospital was built the nursing program was reestablished in 1895 as the Charleston Training School. In 1916, the Board of Commissioners of the Roper Hospital proposed the transfer of the training school to the Medical College of the State of South Carolina, whose school of medicine had been established in Charleston in 1824 and whose faculty was providing most of the nursing instruction; the proposal was accepted by both the hospital and the Medical College, in 1919 the Roper Hospital Training School for Nurses became the School of Nursing of the Medical College of the State of South Carolina. In 1969 when the Medical College was designated the Medical University of South Carolina, the School of Nursing became the College of Nursing. 1889: The Johns Hopkins School of Nursing was founded in conjunction with the creation of the Johns Hopkins Hospital. As one of the earliest hospital-based nursing schools in the United States school leaders consulted with Florence Nightingale on the program of education.
These same nurse leaders established what would be become the National League for Nursing Education and helped in establishing the American Nurses Association. In 1909, the University of Minnesota offered the first university based nursing program, it offered the first Bachelor of Science in Nursing degree and graduated the first bachelor's degree educated nurse. By 1916 13 universities and 3 colleges had developed bachelor's nursing degree programs. In 1923, the Yale School of Nursing was founded, it became the first School of Nursing to adopt the educational standards from the 1923 Goldmark Report, requested by the Rockefeller Foundation. The curriculum was based on an educational plan rather than on hospital service needs. In 1956, the Columbia University School of Nursing became the first in the United States to grant a master's degree in a clinical nursing specialty. Pre-requisites include math and other basic level courses. Basic courses in biology and physiology are required. Depending on the nursing school, credits can be taken elsewhere, transferred in, although limitations on time span between taking pre-requisites and applying to nursing programs exist around 5 years, although some schools set no parameters.
Core coursework includes anatomy, physiology and pharmacology. Additionally, a strong emphasis is placed on
Gerontological nursing is the specialty of nursing pertaining to older adults. Gerontological nurses work in collaboration with older adults, their families, communities to support healthy aging, maximum functioning, quality of life; the term gerontological nursing, which replaced the term geriatric nursing in the 1970s, is seen as being more consistent with the specialty's broader focus on health and wellness, in addition to illness. Gerontological nursing is important to meet the health needs of an aging population. Due to longer life expectancy and declining fertility rates, the proportion of the population, considered old is increasing. Between 2000 and 2050, the number of people in the world who are over age 60 is predicted increase from 605 million to 2 billion; the proportion of older adults is high and continuing to increase in more developed countries. In 2010, seniors made up 13 % and 23 % of the populations of the Japan, respectively. By 2050, these proportions will increase to 21% and 36%.
Geriatric nurses are expected to be skilled in patient care, treatment planning, mental health, rehabilitation. They take on many roles in the workplace; the main responsibility is as a caregiver. They can be advocates and educators for their patients. Gerontological nursing draws on knowledge about complex factors that affect the health of older adults. Older adults are more than younger adults to have one or more chronic health conditions, such as diabetes, cardiovascular disease, arthritis, hearing impairment, or a form of dementia such as Alzheimer's disease; as well, drug metabolism changes with aging, adding to the complexity of health needs. Gerontological nurses work in a variety of settings, including acute care hospitals, nursing homes, assisted living facilities, retirement homes, community health agencies, the patient's home; the conditions of the geriatric patient's health determines what type of facility one should reside in. Assisted living facilities are known as senior retirement homes, they provide care services depending on health conditions.
Skilled nursing, otherwise known as a nursing home, is a place where they can reside and get provided with 24/7 cares. Older adults have been referred to as "the core business of healthcare" by gerontological nursing experts. Population aging and the complexity of health care needs of some older adults means that older adults are more than younger people to use health care services. In many settings, the majority of patients are older adults. Thus, experts recommend that all nurses, not only those identified as gerontological nurses, need specialized knowledge about older adults; this position was endorsed by 55 US nursing specialty organizations. Including, GAPNA, founded in 1981, by a group of Gerontological Nurse Practitioners with the intention of offering the first continuing education conferences designed to meet the needs of advanced practice nurses providing care for older adults. GAPNA represents the interests of all advanced practice nurses who work with older adults; these advance practice nurses are active in a variety of settings across the continuum including primary, post-acute and long-term care.
GAPNA an organization for advanced practice nurses seeking continuing education in gerontological care as well as networking and peer support from experienced clinicians. The last few decades have brought in more interest in older people. More people than before are surviving to their senior years which makes the demand for more working nurses in gerontology. Viewing aging as a natural process develops more positive attitudes towards working with older adults; the terms Gerontology and Geriatrics are used interchangeably, but there are differences between the two. Gerontology is the study of the social, psychological and biological aspects of ageing. Geriatrics, or geriatric medicine, is a specialty. Gerontological Nurses need to know how to care for illnesses that affect the aging, the other factors affect aging, how these impact people. Although nurses published articles about care of older adults as early as 1904, the specialty of gerontological nursing emerged beginning in the 1950s, with the publication of the first gerontological nursing textbook.
Pioneers in the field of gerontological nursing include Vera McIver, Doris Schwartz, Mary Opal Walanin. A geriatric nursing specialty group was formed by the American Nurses Association in 1966, with the name changed to the Gerontological Nursing Division in 1976. In the US, the National Gerontological Nursing Association was founded in 1984 and in 1985 the Canadian Gerontological Nursing Association was founded. Standards of practice for gerontological nursing were published by the American Nurses Association in 1971. In the US, certification for geriatric nurse practitioners and clinical specialists were available in 1984; the specialty has advanced since the 1990s through large scale education and practice development initiatives funded by the John A. Hartford Foundation, including the Hartford Institute for Geriatric Nursing at New York University. Significant efforts to enhance nursing education have been made in the last decade. In 2010, the American Association of Colleges of Nursing and the Hartford Institute for Geriatric Nursing published the Recommended Baccalaureate Competences and Curricular Guidelines for the Nursing Care of Older Adults.
Between 2007 and 2009 the Geriatric Nursing Education Consortium created teaching tools and trained educators in the US to impr
Coronary care unit
A coronary care unit or cardiac intensive care unit is a hospital ward specialized in the care of patients with heart attacks, unstable angina, cardiac dysrhythmia and various other cardiac conditions that require continuous monitoring and treatment. The main feature of coronary care is the availability of telemetry or the continuous monitoring of the cardiac rhythm by electrocardiography; this allows early intervention with medication, cardioversion or defibrillation, improving the prognosis. As arrhythmias are common in this group, patients with myocardial infarction or unstable angina are admitted to the coronary care unit. For other indications, such as atrial fibrillation, a specific indication is necessary, while for others, such as heart block, coronary care unit admission is standard. In the United States, cardiac conditions accounted for eight of the eighteen conditions and procedures with high ICU utilization in 2011. In the United States, coronary care units are subsets of intensive care units dedicated to the care of critically ill cardiac patients.
These units are present in hospitals that engage in cardiothoracic surgery. Invasive monitoring such as with pulmonary artery catheters is common, as are supportive modalities such as mechanical ventilation and intra-aortic balloon pumps. Certain hospitals, such as Johns Hopkins, maintain mixed units consisting of both acute care units for the critically ill, intermediate care units for patients who are not critical. Acute coronary care units called "critical coronary care units", are equivalent to intensive care in the level of service provided. Patients with acute myocardial infarction, cardiogenic shock, or post-operative "open-heart" patients abide here. Subacute coronary care units called progressive care units, intermediate coronary care units, or stepdown units, provide a level of care intermediate to that of the intensive care unit and that of the general medical floor; these units serve patients who require cardiac telemetry, such as those with unstable angina. Coronary care units developed in the 1960s when it became clear that close monitoring by specially trained staff, cardiopulmonary resuscitation and medical measures could reduce the mortality from complications of cardiovascular disease.
The first description of a CCU was given in 1961 to the British Thoracic Society by Dr. Desmond Julian, who founded the first CCU at the Royal Infirmary of Edinburgh in 1964. Early CCUs were located in Sydney, Kansas City and Philadelphia; the first coronary care unit in the US was opened at Bethany Medical Center in Kansas City, Kansas by Dr Hughes Day, he coined the term. Bethany Medical Center is where the first "crash carts" were developed. Studies published in 1967 revealed that those observed in a coronary care setting had better outcomes. DF Beck performed the first successful resuscitation of a physician with myocardial infarction in 1953, pioneered the use of open-chest defibrillation. Dr. Zoll introduced external defibrillation in Boston in 1956, Dr. Kouwenhoven and colleagues at Johns Hopkins highlighted the effectiveness of a combo of mouth-to-mouth, sternal compression, closed chest defibrillation in restoring cardiac function in ventricular fibrillation patients; the first diagnostic angiogram was discovered by Dr. Mason Sones in 1958, due to an accidental injection of dye directly into the coronary artery rather than into the entire circulation - something, believed to be fatal.
These developments led to an interest in intensive care for myocardial infarction. In 1967, Thomas Killip and John Kimball published a report of 250 patients with acute MI’s, who had experienced better survival rates in CCUs compared to other institutions. This, along with other reports, led to an increase in coronary care units. Now catheterization units are commonplace in large cities
Nurse education consists of the theoretical and practical training provided to nurses with the purpose to prepare them for their duties as nursing care professionals. This education is provided to nursing students by experienced nurses and other medical professionals who have qualified or experienced for educational tasks. Most countries offer nurse education courses that can be relevant to general nursing or to specialized areas including mental health nursing, pediatric nursing and post-operatory nursing. Courses leading to autonomous registration as a nurse last four years. Nurse education provides post-qualification courses in specialist subjects within nursing. During past decades, the changes in education have replaced the more focused, but ritualistic, training structure of conventional preparation. Nurse education integrates today a broader awareness of other disciplines allied to medicine involving inter-professional education, the utilization of research when making clinical and managerial decisions.
Orthodox training can be argued to have offered a more intense practical skills base, but emphasized the handmaiden relationship with the physician. This is now outmoded, the impact of nurse education is to develop a confident, inquiring graduate who contributes to the care team as an equal. In some countries, not all qualification courses have graduate status. Traditionally, from the times prior to Florence Nightingale, nursing was seen as an apprenticeship undertaken in religious institutes such as convents by young women, although there has always been a proportion of male nurses in mental health services. In 1860 Nightingale set up the first nurse training school at London. Nightingale's curriculum was base around nursing practice, with instruction focused upon the need for hygiene and task competence, her methods are reflected in her Notes on Nursing. Some other nurses at that time, notably Ethel Gordon Fenwick, were in favor of formalized nursing registration and curricula that were formally based in higher education and not within the confines of hospitals.
Nurse education in the United States is conducted within university schools, although it is unclear who offered the first degree level program. So far as known Yale School of Nursing became the first autonomous school of nursing in the United States in 1923. In November 1955, a World Health Organization study group on the education of nurses met in Brussels and made several recommendations, including that "At least one experimental school of nursing be set up in each country." In the UK, the first department of Nursing Studies at the University of Edinburgh was established in 1956, with a five-year integrated degree programme introduced in 1960. Several other universities across the UK during the 1960s. In 1974 La Trobe University commenced the first nursing course in Australia. There are multiple entry levels into nursing; this has led to confusion for the public, as well as other healthcare professionals. The earliest schools of nursing offered a Diploma in not an actual academic degree. Community colleges began offering an Associate of Science in Nursing degree, some diploma programs switched to this model.
Universities began to offer Bachelor of Science in Nursing and Bachelor of Nursing degrees, followed by Master of Science in Nursing degrees, Doctor of Nursing Practice degrees. Pre-registration nurse training and education in the UK is now via a bachelor's degree following the phasing-out of the Diploma of Higher Education in Nursing, offered at universities and colleges. To become a student nurse, individuals must apply through the University and Colleges Admissions Service to their nursing degree choices, choosing from one of the four nursing fields: Adult, Mental Health and Learning Disabilities. Requirements for entry to a pre-reg nursing degree are five GCSEs at Grade C or above, along with three A-Level subjects at Grade C or above, although the majority of universities will seek higher grades due to the competition for places. Key Skills courses are no-longer accepted as an alternative to GCSEs, however science or healthcare-based BTEC Level 3 Extended Diplomas and Access courses are most oftem accepted in lieu of A-Level qualifications.
If successful following interview, the student will study a "core" first year, learning basic nursing competencies essential to all four of the above fields. It is from second year and onwards that the degree will begin to focus on the student's chosen field. Following completion of the degree, the applicant will be registered with the Nursing and Midwifery Council as a Registered Nurse in their field of practice, using the post-nominal RNA, RNC, RNMH or RNLD as appropriate to their degree qualification. There are two specific pathways individuals can take if they wish to become a nurse in Western Australia, they can decide to study at university to become a registered nurse, alternatively they can study at Technical and Further Education to become an enrolled nurse. Both pathways require a variety of entry requirements whether it be passing year 12 Maths and Human Biology along with receiving a specific Australian Tertiary Admission Rank known as a score for university or providing prior learning experiences and legal clearances for TAFE.
Either way individuals need to be aware these requirements can vary year to year and, why they are recommended to contact each university or institute to find out entry requirement
A Flight Nurse is a registered nurse who specialises in the field of providing comprehensive pre-hospital, emergency critical care, hospital care to a vast scope of patients. The care of these patients is during aeromedical evacuation or rescue operations aboard helicopters, propeller aircraft or jet aircraft. On board a rescue aircraft you would find a flight nurse accompanied by flight medics and respiratory practitioners, as well as the option of a flight physician for comprehensive emergency and critical transport teams; the inclusion of a flight physician is more seen in pediatric and neonatal transport teams. A Flight Nurse is required to complete a copious amount of every call out. Listed below is a comprehensive list of these duties and responsibilities: Flight Nurses perform as a member of an aeromedical evacuation team on helicopters and propeller or jet aircraft Responsible for planning and preparing for aeromedical evacuation missions Expedite mission and initiate emergency treatment in absence of Flight Physician Provide in-flight management and nursing care for patients Evaluate individual patient in-flight needs Liaison between medical and operational aircrews and support personnel to promote patient comfort Responsible for maintaining patient care and safety Care for patients with both medical and traumatic issues Request appropriate medications and equipment to provide care to patient Must have training in mechanical ventilation, hemodynamic support, vasoactive medications and intensive care skills Specialised clinical skills in union with knowledge, theory and expertise in hospital and pre-hospital environments are required Perform advanced medical procedures without supervision of a doctor such as intubation, ventilator management, chest tube insertion, intra-osseous line placement, central line placement, intra-aortic balloon pump management, management of pacing devices, titration of vasoactive medications, pain management, administration of anaesthetic medications for intubation, in some cases and family care National Requirements for most Flight Nurse programs include: License as a registered nurse- attainable through most Universities or Education Institutions 2–3 years of critical care experience and/or Mobile Intensive Care Unit experience.
Advanced Cardiac Life Support certificate Pediatric Advanced Life Support Certificate Additional requirements may include: Neonatal Resuscitation Program Nationally recognised trauma program such as Pre Hospital Trauma Life Support, Basic Trauma Life Support, Trauma Nurse Core Course, or Transport Nurse Advanced Trauma Course Certifications such as Critical Care certification, Certified Emergency Nurse, or Certified Flight Registered Nurse Helpful, but may not be required: EMT or EMT-P certification with field experience Certified Emergency Nurse Certified Flight Registered Nurse Critical Care Registered Nurse Civilian Flight Nurse Works for hospitals, federal and local governments, private medical evacuation firms, fire departments and other agencies. Military Flight Nurse Army Air Force Evacuation Service Member of aeromedical evacuation crew Senior medical member of aeromedical evacuation team on Continental United States Works in intra-theatre and inter-theatre flights to provide in-flight management and nursing care Plan/Prepare aeromedical evacuation missions and prepare patient care facilitation plan Australia has an estimated 20% of land recognised as desert with a rather small population density.
Providing health care to these remote, rural towns can prove to be quite laborious. Australia provides a number of organisations. Aerospace Medical Association Air Medical Services Flight Nurse Badge RAF Medical Services Respiratory therapist Royal Flying Doctor Service of Australia United States Navy Nurse Corps § Flight nurses David M Kaniecki Acnp. Operation Flight Nurse: Real-Life Medical Emergencies. David Kaniecki. ISBN 978-0-615-83996-7. Janice Hudson. Trauma Junkie: Memoirs of an Emergency Flight Nurse. Firefly Books. ISBN 978-1-77088-004-7. Air & Surface Transport Nurses Association Flightweb