Communication Is Key

In addition to treatment delays, communications between outside care providers, such as oncology specialists, and prison health care teams are limited. Thus, communication between the oncology clinic and the prison care team is essential. In one recorded case, an open and frequent line of communication between the prison and off-site oncology teams resulted in recommendations for pain and symptom management were followed more closely, the patient received adequate pain control, and the likelihood of the patient arriving at appointments to receive timely care was increased.7

Some healthcare providers and prisons are embracing telemedicine as a strategy to improve communication and circumvent transportation issues. If a prison healthcare provider identifies a medical concern requiring specialist attention, the prison healthcare provider and the prisoner meet the specialist together via video conference further enhancing communication between internal and external healthcare providers. The prison provider can then perform any immediate medical needs requested by the specialist such as check vital signs or obtain a blood sample. If an office visit is still required after the video conference, then an off-site visit is scheduled. 

Some opponents and correctional healthcare advocates worry that telemedicine may add to inmates’ feelings of isolation. But prisons that have implemented telehealth contest that it gives inmate-patients a more comfortable alternative. “Lots of them don’t want to go to the outside facility. They have to get on a bus, it’s bumpy, and there are delays, and if [they’re] not feeling well, they don’t like it,” explained Dr Edward Levine, the medical director for prison care for Ohio State University Wexner Medical Center, which has been practicing telemedicine with the Ohio Department of Rehabilitation and Correction since 1995.17

Conclusion

The care of incarcerated cancer patients can be uniquely challenging for nurses, both technically and ethically, but at its core is an objective to provide compassionate and humane healthcare. Increased communications between the prison healthcare team, the patient, and off-site medical specialists is clearly the key to overcoming many of the challenges oncology nurses and their incarcerated patients face. 

In general, cancer care for incarcerated populations should be modeled after the cancer care provided to the general population, ie, a unique treatment plan based on the patient’s needs and wishes should be developed and followed. Ideally, these patients should also have access to a diverse support team including spiritual support, counseling, physical and occupational therapy, wound care, and other specialized nurses and pharmacy professionals. However, doing so is not always possible. What is possible is to establish more open lines of communication, forge professional relationships between all involved healthcare teams, and communicate respectfully with a patient who just happens to be a prison inmate. 

References

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16. Bekiempis V. Don’t get cancer if you’re in prison. Newsweek; July 22, 2015. https://www.newsweek.com/2015/07/31/dont-get-cancer-if-youre-prison-356010.html. Accessed October 17, 2018.

17. Andrews M. When inmates need a specialist, they often see the doctor by video [Treatments]. NPR; May 1, 2018. https://www.npr.org/sections/health-shots/2018/05/01/607354073/when-inmates-need-a-specialist-they-often-see-the-doctor-by-video. Accessed October 17, 2018.

This article originally appeared on ONA