Caring for everyone: My journey in correctional medicine

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Growing up, my father was in law enforcement, and my mother worked in Court Administrations. I often listened to their conversations about the people my dad would arrest and my mom would then process through the court system. The frustration of seeing an offender for multiple offenses can be exhausting. Surely, there must be a way to help these people? Caring for everyone, regardless of what they have done, is paramount in my line of work.

I chose to advance my career in nursing and received my educational foundation from Augsburg University in downtown Minneapolis. Their nursing program emphasizes eliminating health inequities through peaceful, just, and collaborative actions that uphold and improve human potential. One of my first professors was Katie Clarke, a true mentor to me. She listened to my concerns and assisted with helping me get into a clinical setting at the local jail with their medical agency. The jail administrator at Douglas County jail, Jackie Notch (now retired), had been a long-time role model of mine and welcomed me to assist in any way.

Making a plan

During this time, I spent many hours in downtown Minneapolis working at the Central Health Commons, an Augsburg-run health center for the homeless. I was feverishly working on a foundation of what a reentry program may look like for inmates. I had multiple conversations with previous offenders to learn about jail culture and what other facilities do to assist in helping prisoners reenter society.

This experience served as the foundation for my thesis. I worked at the Douglas County Jail to gain helpful knowledge about correctional care. To this day, I continue to volunteer my time at the facility. I started in January 2018 as a student intern and completed my Doctorate of Nurse Practice project there. During this time, I collaborated with inmates to envision what a reentry program would look like for them upon their release from jail. I focused on the top ten resources that are needed when reentering back into the community. It was modeled much like the discharge of a hospital patient. That discharge started at the time of booking.

An average day

When I arrive at the jail, I enter through two locked doors. I then proceed down a hallway and enter the locked medical unit. Once I am in the medical unit, I complete various tasks for the staff nurse. These tasks range from counting medications to filing paperwork. You might be surprised to hear that much preparation goes into caring for inmates. It isn’t going from cell to cell with a medical bag. A medical unit in jail is usually operated much like a standard clinic.

Inmates often come into jail at their sickest. They don’t usually seek medical treatment; the jail is their only stable healthcare. You need expansive knowledge of infectious disease, mental health, and drug dependency. The current jail tasks depend on the number of inmates booked for the day and the degree of illness within the jail. For example, the 70 inmates in jail could all be fine and not have any chronic diseases. You could be managing five inmates with uncontrolled diabetes, two inmates on suicide watch, and three inmates suffering from drug or alcohol withdrawals. Every day is different, and you continually have to pivot to the conditions of the jail.

Caring for everyone as equals

I think one of the hardest things in correctional care sometimes is putting aside your biases. I went into correctional care because I feel everyone deserves healthcare. Sometimes these institutions are the sole health care providers for some of the nation’s sickest people. Yet through my research, I’ve observed the quality and quantity of care provided across correctional institutions to be unclear.

Within the United States, the American Public Health Association, the American Correctional Association, and the National Commission on Correctional Health Care outline the standards for inmate care. Yet, policies and standards are still unclear. It’s also difficult to determine just what each organization is doing to maintain the quality of care across facilities.

Why keep going back?

My university days are over, and my thesis is published, but my duty to others never stops. Correctional Care is really a way to give back to my community. Several social determinants are strongly associated with poor health. In the United States, being non-white, low-income, undereducated, homeless, and uninsured are among the strongest predictors. Individuals in jails and prisons exhibit these predictors of poor health disproportionately. As a result, inmates typically share several health profile characteristics, including mental health disorders, drug dependence, infectious disease, and chronic conditions that may be affecting the greater community. This work gives me the chance to educate inmates while incarcerated on daily hygiene practices, healthy eating habits, and how to navigate the health care system in their communities.

I enjoy working side by side with the wonderful staff at Douglas County Jail. They truly do an amazing job at caring for inmates and making a difference. Inmates often say, “the people here actually care about you.”

Ashley Steen knows how important it is to care for everyone!

Ashley Steen, FNP, DNP

Thanks for reading, and remember, everyone deserves to live without illness or injury. Caring for everyone makes our society whole.

Ashley Steen, FNP, DNP

Tri-County Health Care

Meet Ashley Steen

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Meet Ashley Steen, FNP, DNP. Ashley works in ReadyCare and is no stranger to a fast-paced work environment after working in similar roles for nearly a decade. Her experience ranges from correctional medicine to dementia care.

“I was so amazed at how friendly everyone is and welcoming! I have truly walked into one big happy family. The culture is outstanding, better than any other organization I’ve been with. “– Ashley Steen

 Where it all started

Ashley received a big career push early on in life at her first job caring for people with dementia. In this home, she assisted people with their bedtime routines, which can be very challenging. Dementia behavior often made the job difficult, forcing Ashley to grasp new care techniques quickly. According to Ashley, this was the job that sparked her interest in the healthcare field.

 Care for everyone 

Ashley’s father was a police officer, and her mother worked in court corrections. She got used to hearing stories about her father arresting the same people and her mother processing them. This experience made Ashley curious about the criminal justice system, and the impact healthcare can have on repeat offenders.

“My nurse practitioner program focused on social justice and transcultural nursing.  As part of our scholarly project, we focused on a culture. I chose the culture of corrections and how we could help with recidivism. I found we are releasing people back to their communities with little to no resources,” explained Ashley. Her research led to her developing a reentry program at the local jail. This program involved interviewing inmates and gathering data. From the data collected, she came up with ten resources that people need upon being released. After this experience, Ashley kept volunteering in the medical unit at the facility. She has been doing this for three years now

 “I can read all the journals, books, attend all the conferences, but until I took the time to sit down and work in corrections and be with inmates on a daily basis, I never truly understood the disparity we serve them at times. “– Ashley Steen


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