Caring for Those No Longer Behind Bars
There is a large population of people who have been imprisoned at some point in their lives. Though it may be easy to reject these individuals because of their past, there is great potential for their lives. However, this potential needs to be invested in by others and nurses have an ideal opportunity to do just that. This paper will cover the spirituality in the nursing care of ex-convicts. It will explore the concept of spirituality in healthcare, the health dilemmas of ex-convicts, the importance of spiritual care for ex-convicts, and explain how nurses can care for the spiritual needs of ex-convicts. The purpose of this paper is to inform nurses on the importance of the spiritual care of ex-convicts and help them in investing in the potential of this population.
Literature review
Though spirituality is not a new concept to healthcare, its importance has only recently become evident and emphasized. Because of this, there is little consistency in defining spirituality. However, there is an increase of studies being done to provide clarity to such a useful aspect of healthcare (Egan et al., 2011). A common misconception of spirituality that needs to be addressed is that spirituality and religion are synonymous. According to a study done in New Zealand, though spirituality and religion are connected and similar, religion is actually placed under the concept of spirituality. Spirituality holds different personal definitions of which most include: beliefs, values, sense of meaning and purpose, connectedness, identity, awareness, and religion. (Egan et al., 2011). The spiritual component of a person is essential because it drives how majority of people make meaning out of life and become aware of its purpose (Ivreen, 2015). Therefore, it is important that this component be addressed in the delivery of healthcare. Patients are not in their ideal circumstance when ill or injured. Their circumstance causes mental and emotional distress, which also has an impact on their physical well-being. Diagnosing and treating a patient’s spiritual needs shows competent, genuine, and holistic care. Therefore, the concept of spirituality in nursing develops the potential for a greater understanding of those being cared for (Savel & Munro, 2014).
Incarceration rates in the United States are shocking and almost unbelievable, as 25% of the population is imprisoned. These individuals face major social, economic, and health implications both in and out of prison. However, once prisoners are released these issues are heightened as they attempt to reenter society. There is a very heavy burden of disease amongst ex-convicts that is largely a result of poverty. Low income results in poor living conditions and limited access to healthcare. This living condition increases the participation in high-risk behaviors, which also increases the prevalence of infectious diseases (Tyler & Brockmann, 2017). Mental illness is another health concern of justice-involved individuals. Mental illness cannot be ignored or downplayed when caring for ex-convicts (Tyler & Brockmann, 2017). Spiritual care is especially useful when caring for those battling these illnesses. It is evident that ex-convicts have serious needs. The aversion towards this population makes it crucial that they are cared for holistically, which includes spiritual care. Simply addressing the acute physical needs of these patients does not provide sustainable health.
In a study performed to identify factors that support a successful transition to the community following incarceration, spirituality ranked on top (Parsons & Warner-Robbins, 2002). During this study, a sample of women were asked about their experience after being released from prison. The factors that enabled a successful reentry into the community included: a belief in God, drug rehabilitation, support groups, family, employment, and nurse-chaplain visits during and after imprisonment (Parsons & Warner-Robbins, 2002). Though every patient should have their spiritual needs cared for, evidence shows it is essential when caring for ex-convicts. Tending to these spiritual needs impacts a patient’s life as a whole and therefore invests in their potential.
Application to Nursing Practice
Considering the large population of justice-involved individuals, the chances of caring for this population are high. Therefore, a nurse must be educated on how to care for these specific individuals in a holistic manner. Spiritual nursing care shows the nurse’s awareness of the transcendent dimension of life that affects a patient’s reality (Savel & Munro, 2014). The roles of a nurse go beyond just physical caregiving and also impact the crucial underlying needs. An important aspect of caring for ex-convicts is being the patient’s advocate. With limited financial resources, limited social support, and strict probation/parole requirements, former inmates are under high stress. Because of this, health care is a low priority even if the need is dire (Tyler & Brockmann, 2017). Unfortunately, there are stigmas throughout the healthcare system that also lower the quality of care that ex-convicts receive. As a nurse, one has the responsibility to inform patients of their human and legal rights. It is up to the nurse to protect these rights and ensure that one’s patients are receiving quality healthcare (Potter, Perry, Stockert, Hall, & Ostendorf, 2017).
Over half of those who have been incarcerated have not completed high school. This often correlates with a deficit of knowledge relating to personal health (Tyler & Brockmann, 2017). A nurse must acknowledge this need and educate the patient. One may need explanation on basic health concepts, self-hygiene, nutrition, and exercise. Because most justice-involved individuals come from broken families, the nurse must not judge a patient for not knowing what may seem like elementary concepts of health. This teaching can be done in a formal or informal manner, whichever the patient is most receptive to (Potter et al., 2017).
Lastly, a major and important role of a nurse is effective communication. Since spiritual needs cannot be treated physically, it takes nonverbal and verbal communication to care for these needs. Formally imprisoned individuals need spiritual support from their healthcare team, family, and friends. It is the nurse who must take the time to inquire about the patient’s spiritual condition. These patients desire and need to be heard and encouraged. The nurse can care for these needs with intentional discussions, a gentle touch, prayer, and empathy. The nurse must communicate the spiritual distress to other healthcare professionals caring for these patients. Holistic care is better achieved when the whole healthcare team is informed and engaged. Communication for a nurse also applies to the patient’s family and/or support system (Potter et al., 2017). Without clear communication to these individuals, the patient’s needs may not be heard or tended to outside of one’s own care. The nurse has the responsibility to communicate and plan goals for after discharge. Not only should the nurse work with the patient on forming these plans, but he or she must also provide resources for these patients to achieve such goals. Needed resources may include: financial advising, rehabilitation, local support groups or churches, housing options, affordable counseling, or a local healthcare specialist. It may be beneficial to include education and job opportunities as well. Without clear communication that addresses the patient’s spiritual needs, it is impossible to advocate, comfort, support, or care effectively (Potter et al., 2017).
Conclusion
Because the importance of spirituality in patient care is recently being acknowledged and emphasized, there are a lot of studies being done to improve this aspect of healthcare. A recommendation for further study would be to implement spiritual care while one is imprisoned and evaluate its impact on spirituality after being released. This could be compared to spiritual care that only beings after imprisonment and would provide evidence for or against the importance of earlier spiritual care.
Spiritually in the care of patients holds a great significance. Including spirituality shows competency and high-quality healthcare. For previously imprisoned individuals, spiritual distress is common for a multitude of reasons. This population has an influx of factors that are against them when attempting to reenter society. Therefore, the potential that they have to contribute to the community is often overlooked and diminished. However, nurses have an ideal opportunity to become informed and involved in the spiritual care of this population that they are bound to encounter. Like every patient, ex-convicts deserve to be cared for in a holistic, high-quality manner. It is evident that the complex needs of this population can only be met if spirituality is included in a nurse’s care.
References
Egan, R., MacLeod, R., Jaye, C., McGee, R., Baxter, J., & Herbison, P. (2011). What is spirituality? Evidence from a New Zealand hospice study. Mortality, 16(4), 307-324. doi:10.1080/13576275.2011.613267
Ivreen, R. (2015). Spirituality: The Meaning as Experienced by Nurses Enrolled in Graduate Nursing Programs. International Journal Of Nursing Education, 7(3), 56-60. doi:10.5958/0974-9357.2015.00134.8
Parsons, M., & Warner-Robbins, C. (2002). Factors that support women's successful transition to the community following jail/prison. Health Care For Women International, 23(1), 6-18.
Potter, P. P., Perry, A. G., Stockert, P. A., Hall, M. A., & Ostendorf, W. R. (2017). Fundamentals of Nursing (Ninth ed.). St. Louis, MO: Elsevier.
Savel, R. H., & Munro, C. L. (2014). THE IMPORTANCE OF SPIRITUALITY IN PATIENT-CENTERED CARE. American Journal Of Critical Care, 23(4), 276-278. doi:10.4037/ajcc2014328
Tyler, E. T., & Brockmann, B. (2017). Returning Home: Incarceration, Reentry, Stigma and the Perpetuation of Racial and Socioeconomic Health Inequity. Journal Of Law, Medicine & Ethics, 45(4), 545-557. doi:10.1177/1073110517750595