An Essay on a Pregnant Inmate in a Prison
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
An Essay on a Pregnant Inmate in a Prison
John Lawrence, an educator at the state women’s correctional center, contacted Donna Williams, a women’s health care nurse practitioner and faculty member at the College of Nursing, and expressed concern for the health of an inmate, Lela Marvin.
According to Mr. Lawrence, Lela, a 19-year-old pregnant primigravida, was being seen at the state-supported hospital for antepartum care; however, she was not permitted to attend perinatal education classes. He stated that other pregnant women in the facility could benefit from perinatal education.
In fact, approximately 6.1% of female state prison inmates are pregnant when admitted to prison and could benefit from perinatal education (Snell, 1994).
Lawrence’s call was followed by a call from Herman Martin, an RN who also expressed concern for the other women’s needs for information regarding their personal hygiene. Although an RN, Mr. Martin was not knowledgeable of women’s health because his primary clinical focus was emergency and trauma care.
He indicated that many of the women were overweight, cared little about themselves, and lacked a general knowledge of how to maintain their health.
Assessment
After gaining clearance from the prison officials, Ms. Williams assessed health care information needs and started offering classes for the inmates. The immediate need was for perinatal education for women in the last weeks of pregnancy. Lela said she wanted to learn about labor because she had heard only horror stories from other women.
Ms. Williams noted that three other women were close to term and they also seemed eager to learn. She knew that students’ readiness to learn was key to the course’s success. Success of this course would be crucial to future course offerings.
The traditional perinatal education course was designed to promote healthy birth outcomes and an emotionally satisfying birth experience.
These goals are also important to pregnant women in a correctional facility; however, perinatal education would have to be modified to meet this group’s special needs.
For example, information on newborn care is not appropriate because the infant born to an inmate is usually placed with the mother’s family or in foster care.
Assessment of nonpregnant women provided opportunities for other health education classes. The next spring and each spring thereafter, junior nursing students under Ms. Williams’s guidance were assigned to develop and carry out 1-hour weekly health education and awareness sessions at the correctional facility.
Although each student expressed some initial anxiety about the experience, each evaluated it as being worthwhile.
Diagnosis
After assessment, the community health nurse developed community and aggregate diagnoses, which served as the basis for the care plan.
Individual
Inadequate preparation for childbirth related to lack of resources in prison (Lela)
Lack of family support related to separation secondary to incarceration (Lela)
Potential for feelings of loss related to separation from infant after birth (Lela)
Family
Lela’s family visits were rare; therefore, she looked for others to provide support during her pregnancy. Lela told Ms. Williams that her cellmate, Julieanna, offered to be her labor support person.
Lack of knowledge of her role as a labor support person (Julieanna).
Community
Lack of adequate health-seeking behaviors of women in the correctional facility (i.e., pregnant and nonpregnant women)
Lack of programs to promote health and prevent diseases among women prisoners
Planning
After the nursing diagnosis was validated with the individual, family, or community, the plan of care was developed. Examples of long- and short-term goals follow.
Individual
Long-Term Goal
Individual family members will have a positive birth experience (Lela).
Short-Term Goal
Family members or friends will help Lela use relaxation techniques to cope with the discomforts of labor.
Family
Long-Term Goal
The family members will be strengthened through their newly acquired knowledge and skills.
Short-Term Goal
The family members will demonstrate increased ability to perform their role as labor support people.
Community
Long-Term Goal
The health and well-being of incarcerated women (i.e., pregnant and nonpregnant) will improve.
Short-Term Goal
Health education programs will be instituted for individuals, families, and aggregates in the correctional facility.
Intervention
The community health nurse worked with the individual, family, or community to achieve mutually established goals. Intervention was aimed at empowering individuals and groups to take responsibility for themselves and to form links with others to accomplish goals.
Individual
Providing a perinatal education program for Lela was Ms. Williams’s first priority. In addition, counseling related to feelings of loss after birth might be appropriate. Referral to a counselor might be necessary, and Ms. Williams had to become familiar with available resources.
Family
Teaching the family, the roles and responsibilities of a labor support person was an important intervention. In the correctional facility, interventions must ensure that Lela has a labor support person with whom to practice her relaxation techniques and to be available.
In this case, Lela’s cellmate, Julieanna, was willing to act in this role, and the nurse had to negotiate with prison officials to allow this arrangement.
Community
Specific interventions with a group of pregnant women in the correctional facility were based on the specific needs of the group. The community health nurse had to identify prison officials who were supportive of health education programs and request their input as to which women should be targeted for such programs.
Then the nurse met with targeted women to assess their level of knowledge and skills regarding women’s health. For example, the nurse surveyed what each woman perceived as learning needs (e.g., well-woman care, women’s anatomy and physiology, self-care in health promotion, health protection, and disease prevention).
Then the nurse tailored an intervention that was compatible with the community. Ms. Williams asked each nursing student to select a topic on the basis of the survey and to develop a teaching plan for presentation to female prisoners (i.e., pregnant and nonpregnant) at least once during the spring semester.
Evaluation
The community health nurse compared the actual and predicted outcomes to determine the efficacy of the plan of care and to make revisions.
Individual
For example, Lela learned necessary relaxation techniques that were useful to her in labor and helped make the birth experience positive. Follow-up of Lela’s psychosocial concerns in postpartum was also important.
Family
Evaluation of this nontraditional family would include their level of satisfaction with their role in the birth experience. Evaluation would also include learning how this interaction between family members (i.e., Lela and Julieanna) prepared them for other situations.
Community
The aggregate evaluation focuses on the community. For example, in health education programs designed for pregnant and nonpregnant women in the correctional facility, it was important to do the following:
Maintain attendance records.
Seek feedback from women, the referring nurse-educator, and prison officials regarding changes in self-care behavior regarding health.
Obtain student response to learning experience.
Make changes in health education programs on the basis of evaluation.
Levels of Prevention
The following are examples of the three levels of prevention as applied to the individual, family, and community.
Primary
Assessment and teaching perinatal education course to pregnant inmates
Assessment and teaching health education classes to nonpregnant inmates
Teaching the family, the roles and responsibilities of a labor support person
Secondary
Screening at the community level (correctional facility) of what is perceived as learning needs
Educating the family and community of the signs of postpartum depression
Tertiary
Educating HIV-positive pregnant inmates on the need for antiviral treatment and delivery by cesarean section
Educating family members and foster parents about the need for neonatal follow-up with regard to HIV status
Assessing available community resources for counseling and treatment of postpartum depression
- Visit with a women’s group in the community (e.g., business, church, sorority, Parents Without Partners, Red Hat Society) to discuss members’ health care needs and concerns. From these data, develop research questions.
- Call a family planning clinic and determine the population served (i.e., eligibility), available services, and costs.
Anita Rogers, a 16-year-old unemployed single woman, arrived at the Family Services Health Center seeking initial prenatal care at 36 weeks of gestation. She stated that for a few days she noted some brown discharge from her vagina.
She told the nurse she knew she should have begun prenatal care earlier, but when she called several health providers’ offices, the receptionists told her they were not accepting patients with Medicaid insurance. She reported that the family did not have reliable transportation.
Her father was unemployed, and her mother worked at a cafe as a waitress. Anita was sent to the hospital immediately for an ultrasound examination. The sonogram revealed twins, but one of them had died in utero. Anita was hospitalized and began to hemorrhage. She delivered a 3-lb infant.
Identify examples from everyday life that support or encourage violence against women (e.g., magazines, books, and television advertisements). Share findings with classmates.
Survey lay magazine advertisements and estimate the percentage of total pages that use a woman’s image, including aging, menopause, overweight and obesity, and sexuality, to sell products. Share these with classmates.
Discuss the need for cancer screening with female relatives; refer to the ACS guidelines.
Discuss with female relatives the need for a heart-healthy nutritional plan based on AHA guidelines.
Identify resources for mammograms and Pap smears for low-income women.
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. 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