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Comprehensive Care in Corrections: Nurses Making a Difference

If you were asked where nurses work, a youth correctional facility is probably not the first place that would come to mind. Yet for 25 years, faculty, staff, and students from the University of Utah College of Nursing (CON) have been providing care for residents in Utah’s youth detention and secure facilities. As experts in correctional health care, CON-Juvenile Justice and Youth Services (JJYS) registered nurses (RNs) and nurse practitioners (NPs) have built a practice environment that benefits residents, nurses, and correctional facility communities alike.

“People have this idea about corrections that is not necessarily the way it actually is,” says Breck Bartholomew, RN, CON graduate and nurse manager of the CON-JJYS clinics. “Most nursing students come in and are surprised at the care we can offer. They just had never considered it as a possibility as a profession.”

By law, the State of Utah must provide standard medical care for youth in correctional facilities. The partnership between the Utah Department of Health & Human Services and the CON allows Utah to go beyond basic requirements and provide exceptional physical and mental care.

“In many cases, these kids didn’t have any access to medical care before they got here,” explains Tom Rowley, DNP, a clinical associate professor of nursing and clinical director of the CON-JJYS clinics. “We’re not just filling a need that’s mandated by the federal government but also a need for socioeconomic populations who haven’t had access to care like this before.”

THE CON MODEL OF CORRECTIONAL HEALTH CARE

The CON model is built on three pillars:

ONSITE CARE FROM DEDICATED, CERTIFIED STAFF

CON-JJYS clinics are staffed by RNs, family NPs, and psychiatric- mental health NPs trained
in youth correctional health care. Unlike other models that rely on temporary nurses or offsite urgent care, CON-JJYS clinics offer consistent care from permanent staff, ensuring residents receive physical and mental health services without leaving the facility. Additionally, multiple staff members are certified by the National Commission for Correctional Health Care.

HOLISTIC, ONE-STOP CARE

Drawing on resources within University of Utah Health, the CON creates a comprehensive care environment. When the previous dental care provider resigned, the CON collaborated with the University of Utah School of Dentistry to address dental needs. The partnership brings two dentists to seven facilities, with a third dentist joining permanently. The Spencer Fox Eccles School of Medicine and University of Utah College of Health also contribute under the CON-JJYS clinics’ contract.

EVIDENCE-BASED HEALTH CARE

As the only nursing college in the United States working with a juvenile justice center, the CON leverages academic expertise to provide cutting- edge care. CON-JJYS faculty and students collaborate on quality improvement projects, addressing issues such as safety for LGBTQIA+ residents, screenings for sexually transmitted infections, and sleep treatment in correctional settings.

IMPACTS OF THE CON MODEL

The CON model has far- reaching effects for residents, students, and communities:

RESIDENTS IMPROVE THEIR QUALITY OF LIFE AND MORE

“A lot of these kids come in here with terrible demons that they’re dealing with,” Rowley explains. “As we’ve worked with them and got them to a balanced state, they feel safer mentally and physically, which makes it safer for the people around them. The goal is that, when they return to society, they can continue treatment and integrate better.”

The education and treatment provided by CON-JJYS nurses helps residents during their time in the CON-JJYS clinics and when they return to their communities.

NURSING STUDENTS GAIN VALUABLE EXPERIENCE

Nursing students working in CON-JJYS clinics encounter diverse medical conditions, such as addiction and post-traumatic stress disorder, that they might not see in community clinics.

“When you’re a student in that environment, you have an opportunity to learn how to treat the whole patient,” says Ally Cirenza, DNP, a psychiatric mental health nurse practitioner and CON graduate. “You get to think about all the aspects— psychosocial, parents, the criminal justice system—that areaffecting the patient. And then you can advocate for them.”

LESSONS SHARED WITH OTHER CORRECTIONAL HEALTH PROVIDERS

Youth in correctional facilities face unique stressors, requiring health care providers to adjust their practices. With 25 years of experience, CON-JJYS clinicians share their knowledge to improve correctional health care nationwide.

“We’re constantly improving our group and identifying different ways we can be better. One of our goals is to be recognized as a national expert in juvenile correctional medicine,” says Rowley. “As we continue to do quality improvement studies and present at national conferences, we can continue to provide more evidence-based ways to provide care for this unique population.”

IMPROVING PUBLIC HEALTH IN UTAH COMMUNITIES

The JJYS system strives to house youth near their home, so the care they receive benefits not only the individual but also the overall public health of their community.

“Helping kids physically and emotionally during their time in the CON-JJYS clinics helps the communities they go back to,” says Jennifer Clifton, DNP, a clinical professor of nursing and associate dean for the CON’s Practice and Community Collaboration. “Most of them come from underserved communities. If we do the best for them when they’re in the facilities, we’re also improving the communities they return to.”

EXPANDING ACCESS TO CARE

Previously, CON staff worked in seven facilities between Ogden and Provo. In 2024, they expanded to facilities in Logan, Richfield, Cedar City, and St. George.

“The College of Nursing, with its access to students and faculty as well as the larger medical community at the University of Utah, is uniquely able to provide care within the CON-JJYS clinics,” says Bartholomew. “None of that comes easy, but with continued efforts to improve and expand our offerings, the CON will be able to provide quality care to all of the CON-JJYS clinics throughout Utah.”