Conference workshops address a variety of topics.
For the past year and a half, the Georgia Department of Juvenile Justice has been implementing a school-based supervision model that has led to great successes for students and the department. Robert Rosenbloom, deputy commissioner for the department, introduced the model and explained to workshop attendees the core values that DJJ employees strive to demonstrate to the students on their caseloads. Dee Bell, Georgia's program coordinator, and Jeffery Alligood, district director, outlined other states' school-based supervision models and spoke briefly on how attendees could begin to implement similar programs in their agencies.
Rosenbloom defined school-based supervision as the case management of youths on court-ordered supervision by probation officers placed in local schools. One of the initial goals of Georgia's program was to have more conversational contact with youths. "We wanted to change the setting from the occasional office visit to more informal, day-to-day interactions in schools," Rosenbloom said.
The idea, he explained, was that youths would be more responsive and therefore more successful in school, if they increased interactions between probation officers and youths. Originally, the department planned to execute these goals by sending officers into schools more frequently. However, once Georgia initiated the school-based supervision they encountered another problem: DJJ was awarded funding to hire 67 new employees but had no space to house them. Fortunately for Georgia, the problem ended up being the solution.
Alligood recounted a conversation he had with a principal at a Georgia high school that would lay the groundwork for Georgia's current model. The principal observed probation officers coming in and out of his school--several probation officers had one or two students on their caseloads at the school and were making intermittent visits. The principal wondered why they did not have just one probation officer handling all the school's DJJ students. Alligood agreed, and better yet, they thought, why not have the probation officer work directly out of the school? Alligood presented these ideas to the DJJ management team, and before long the department was training selected staff to work directly in Georgia's middle and high schools. This collaboration between DJJ and the school was the first of its kind in Georgia, and the success did not go unnoticed. In April 2006, 14 schools agreed to have a DJJ officer in their buildings; by October 2007, 99 schools were requesting their own probation officer.
Ideally, a single officer handles all case management for all DJJ youths at one or two schools. Unfortunately, with 99 schools requesting officers, it is not possible to have officers at all schools. So, if a school only has a handful of DJJ students, or is located in a rural area, DJJ will assign an officer to make as many school visits as possible. According to Bell, the Georgia model calls for officers to spend 70 percent of their time at the schools, with the remainder of their time split among meetings at the department, court dates and home visits. This is facilitated by technology, Bell explained. "Officers have laptops and cellphones, so they are able to access DJJ datasystems from schools to enter in notes and casework." Georgia serves a host of youths, including intake youths, probated youths, youths returning from facilities and placements, and in-school suspension youths. Having probation officers working in schools helps not only the students they are serving but also teachers who work with DJJ students.
When a teacher is having trouble with a particular student, he or she can speak directly with that student's officer. Therefore the problem can be addressed before it escalates. In turn, officers often benefit from regular meetings with teachers, who can offer a wealth of insight into the DJJ students they teach. The department's preliminary results have shown promise, including reduction in truancy and disciplinary reports, Bell and Alligood reported. The workshop closed with Alligood discussing a sample memorandum of agreement between a juvenile justice department and a school district. He explained how individual agencies can amend the memorandum to focus on their department's specific goals. "Our goals are that youth leave out of the system more competent in academics and with pro-social values that will lead them to success," Bell said, stressing that these are the same goals that are found in all school systems.
Nursing the Mentally Ill: Training and Planning for the Future
"Sometimes we are trained in mental health, and sometimes we are placed in mental health," said Inez Tann, a registered nurse with MHM Services Inc, a provider of specialized mental health services in Vienna, Va. Presenting with Tann was Lillian Werner who trains mental health nurses for the Georgia Department of Corrections. They discussed some of the specific issues facing mental health nurses and brainstormed with workshop attendees ways to attract qualified nurses to the field. Tann addressed the intake process for mental health patients in Georgia. She reviewed with workshop participants the mental health status exam, emphasizing the importance of nurse assessment and the ability to convey accurately to doctors any behaviors that may be indicators of a mental illness. "It's not our job to diagnose," Tann said. However, nurses must make appropriate and thorough assessments that doctors in proper diagnosis. Some mental status indicators that nurses assess on intake include:
* Appearance--how the patient dresses and the state of his or her hygiene;
* Behavior--including facial expression and body movements;
* Speech--the tone of voice, rate of speech, manner in which they speak and the content of their speech;
* Orientation--whether a patient can identify the time, place and situation;
* Mood and affect--the patient's emotions, whether depressed, anxious or fearful; and
* Thought process--logical, coherent thinking patterns.
With mood and affect, Tann suggested that nurses speak with correctional officers to get a better sense of inmate disposition. Security staff see patients interacting with other inmates and will be able to offer insight into their overall mood. When assessing patients, Tann also cautions nurses to be aware of behaviors that may present as psychiatric. Patients with an organic brain dysfunction, for example, could display symptoms that are easily misinterpreted as a mental illness.
Correctional nurses are responsible for myriad tasks, Tann said, pointing out that nurses working alone in small correctional facilities, "may have to do it all." Chart auditing; the drawing up and carrying out of treatment plans, which should be individualized to the inmates condition and needs; and medication management are a few of the responsibilities highlighted by Tann. When auditing charts, it is a nurse's job to make sure that lab orders are filled promptly, issues of noncompliance are followed up on, and inmates are properly educated on how and when to take their medication. With medication management, nurses work on both ends, ensuring the proper medication comes in from the pharmacy and, in turn, is administered correctly to the inmate. "No process is perfect," Tann advised. "Make sure what you ordered is what you receive."
When dealing with mentally ill patients and psychotropic medications, always take extra precaution, Tann said. She used an everyday occurrence to illustrate her point. When a facility changes pharmacies, there is a chance the new pharmacy will dispense medications that look different from the facility's previous pharmacy. If a patient is used to taking a little blue pill every day, something as slight as a change in pill color may prevent a patient from willingly taking that medication.
Medication management sparked a question from a workshop attendee about inmate dosage. Typically in correctional facilities, inmates are only given a single dose of medicine in a pill line once or twice a day. Inmates, therefore,, are never responsible for managing their own medicine. How then, an attendee asked, are inmate's expected to manage their medicine upon release? Werner explained that because inmates will hoard medicine and sell it, they cannot be given more than a single dose at a time. She said, as of now, the best thing correctional health care staff can do is set up appointments with doctors as soon as possible upon an inmate's release. Then only enough medicine to last the inmate until that first doctor's visit will be given. "What if it's five months before they can see a doctor?" the attendee asked. Werner and Tann both acknowledged that there is no easy solution to inmate medicine management, stressing that nurses must do the best they can to evaluate patients needs individually and educate accordingly.
Tann concluded with a discussion of suicide risks and prevention measures. She drew attention to a number of incidents that could spark suicide ideations among inmates including a long sentence, marital problems, significant family loss and conflicts with other inmates.
Careful screening at intake, Tann said, can go a long way toward identifying inmates at risk. "Document, document, document," Tann emphasized, reminding nurses to record questionable behavior in the appropriate place on the inmate's chart. If a nurse feels the threat of suicide is critical, Tann advocated placing that inmate in a safe cell where he or she can be appropriately monitored.
Werner briefly ran down the statistics on the mental health population in Georgia, noting that 16.5 percent of all inmates have a diagnosed mental illness. Of those, more than 75 percent are on psychotropic medication. She next discussed the numbers of mental health nurses in Georgia's facilities. The DOC budget only allocates 87 nurses to care for the 8,100 patients on Georgia's mental health caseloads. And currently, 37 percent of those positions are vacant. This prompted a comment from a nursing manager in Indiana, who said that in her facility, 55 percent of nursing positions are not filled. She added that her agency pays nurses $4 more per hour than any hospital in the area. Attendees expressed shock at the high percentage of vacant positions.
Werner opened up the floor to the audience, asking for reasons why nursing position were so difficult to fill. Several attendees felt that a lack of knowledge about the field of correctional nursing was a big reason for the recruitment difficulties. With that lack of knowledge, one attendee said, comes a sense of fear that the general public carries about correctional working conditions. Though several attendees dismissed this stigma with comments such as, "at my facility I feel very safe," they acknowledged that they too held similar misconceptions before entering the field. Adding more correctional nursing rotations into nursing school curriculums across the country was suggested as one way to stomp out the stigma and place correctional nursing on the radar of young nurses.
Stacking Your Bench: Work Force Training in Action
As the theme of this winter's conference, work force issues took center stage at the Gaylord. ACA's Workforce/Human Resource Issues Committee sponsored a special roundtable workshop titled "Developing an All Star Bench through Leadership Development and Succession Planning." The committee chair, Joyce Fogg, introduced three experts in the field, who spoke passionately about the need for corrections to focus its efforts on work force recruitment, training and retention.
Dan Ronay, director of staff development and training for the Indiana Department of Correction, described a program that his agency developed last year to train and develop leaders. His department selected 40 employees from staff nominations to participate in two days' worth of seminars and group sessions at an Indiana state park. "We wanted to make this very special and very prestigious for years to come." Participants were divided into eight teams to work on projects that revolved around major problems facing the Indiana DOC. At the end of the program, the teams presented solutions to these problems. Ronay was excited to report that four of the projects were completely adopted by the department, which ''changed policy and procedures based on the recommendations and research of the teams that were challenged to come up with answers to those issues." Also, the program brought employees from facilities throughout the state and from all areas of corrections, providing great networking opportunities for participants.
A key to successful leadership development is reinforcement and rejuvenation, Ronay said, stressing that in order for succession planning to succeed, it must be "interwoven into the culture of an organization." "The world's best companies realize that no matter what business they are in, their real business is building leaders," Ronay said, reminding attendees to view corrections as a business.
"If we don't have leaders to take care of the business, the business is not going to take care of itself." In order for an agency to succeed in leadership development, Ronay suggested following these steps:
* Invest time and money;
* Identify promising leaders early;
* Choose employees' assignments strategically;
* Make leadership development part of the culture;
* Be passionate about feedback and support; and
* Develop teams, not individuals.
Next to speak was Mel Brown, Ph.D., a former director of community corrections and current president of Mel Brown and Associates, a management and consulting firm. He likened succession planning to planning a trip, stressing that people need to know their destination, where they are, and how they are going to get there. Succession planning should focus on grooming individuals who show potential to be future leaders, Brown said. The downside is "that if you do it right, some people who work for you aren't going to be there when openings come." Brown advised attendees to be aware that some employees will get tired of waiting and to begin the development process for more future leaders than you think you will need.
The key to succession planning is developing talent. Brown gives his employees extra responsibility, affording them opportunities to exercise leadership abilities while still in subordinate positions. "I never worry about being gone from my office," Brown said. His employees are given the confidence and training to function without him there. The key to this is patience, Brown emphasized, stressing that failure in leadership development is natural and even necessary. "When your child was learning to walk you didn't run around and protect him every time he started to fall," Brown said. "Allow your people who are taking the leadership walk to do the same thing."
For Brown, "feedback is the breakfast of champions." Specific and timely evaluations should flow naturally from proper monitoring of employees, said Brown, who believes careful supervision is essential. "If you aren't checking, they don't think it's important." When employees fail to perform, it is imperative to confront them immediately. Brown emphasized that confrontation should not be considered a negative action but rather an essential part of a leader's responsibility. When an employee is not performing, it not only reduces his of her effectiveness but also the effectiveness of the leader and prevents an agency from functioning at its highest potential. Plus, said Brown, when a leader fails to confront an underperforming employee, "it robs the employee of an opportunity to improve his or her performance."
Last to speak was Leslee Hunsicker, health care administrator for ACA's Standards and Accreditation Department. She focused her remarks on the shortage of correctional health care staff, encouraging attendees to think creatively when planning for future staffing needs. Hunsicker encouraged health care leaders to be proactive in recruiting staff and advocated approaching succession planning in an organized, ongoing manner. "Accept the reality that the shortage is not just today's problem."
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|Title Annotation:||Workshop Coverage|
|Date:||Apr 1, 2008|
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