Serving time: psychiatric mental health nursing in corrections

1. The opposing philosophies of custody and caring result in direct implications for nurses working in the correctional environment. Nurses constantly "walk in line" between the requirement of security, health care, and client advocacy. 2. Deinstitutionalization, increased rates of incarceration for interpersonal violence, and substance abuse related crimes have resulted in a rapidly expanding prison population. Of all offenders, 10% to 15% have a major mental illness, leading to many treatment challenges for the nurse. 3. Therapy issues with this population are complicated. Correctional nurses must have a good understanding of the therapeutic nurse-client relationship, with particular attention to therapeutic impasses, transference, and countertransference. 4. Historically, role development for nurses working in corrections has been particularly difficult. Correctional nurses must grapple with issues surrounding professional identity, professional isolation, and territoriality.