The University of North Texas Health Science Center in Fort Worth will soon offer nursing courses designed to get people thinking about a health care career in correctional facilities.
HSC's brand-new College of Nursing, which is set to accept its first students this fall, will offer an elective track in correctional health, to prepare nurses for working in jails and prisons. The classes will be part of HSC’s Master of Science in Nursing Practice Innovation program.
Jan Jowitt, a professor at HSC with years of experience nursing in correctional facilities, is designing the course. There’s a lack of awareness that working behind bars is even an option, she said, and she wants to get more nurses to consider that path.
“I believe that every individual, regardless of their circumstance, deserves access to quality health care and compassionate health care,” Jowitt said.
Students will learn about the unconventional parts of nursing in a jail or prison, like navigating security protocols, or figuring out creative health advice, she said.
In prison, patients don’t always have control over what they eat or how they exercise, so some common medical advice doesn’t apply, Jowitt said. She remembered telling people how to stay moving when in solitary confinement, to prevent blood clots.
"Doing jumping jacks and jogging in place and using the mattress as leverage, like a weight, and things like that,” she said.
Jowitt said she’s particularly concerned about what researchers have called the “aging crisis” in prisons. In 2021, 15% of people in prison were 55 or older, compared to just 3% in 1991, according to the Prison Policy Initiative.
That leads to concerns about dementia, osteoporosis, and falls, especially from bunk beds in cells, Jowitt said.
“Prisons are not designed for our older adults,” she said.
The harsh sentencing laws of the drug war in the 80s and 90s bear the most blame for the aging crisis in prisons, said Marta Nelson, the director of sentencing reform at the Vera Institute of Justice, a criminal justice reform nonprofit.
"We in the United States sentence people to longer sentences than really anywhere else in the world," Nelson said.
That means many who entered prison as young people are now old, and they need more care. The stress of incarceration has been found to accelerate aging, which can lead to more health problems earlier in life, as well as earlier deaths.
States should offer more parole opportunities to older adults and consider options like compassionate release, Nelson said.
Older people are the least likely group to be re-arrested once they leave prison, Prison Policy Initiative spokesperson Wanda Bertram said. They’re also the most expensive to care for, since their medical needs are greater.
“I think it would behoove Texas and every other state to release older people from prison and invest their savings in better programing for younger people or people who are just coming into the system," Bertram said.
While older people are behind bars, nurses “are the primary point of contact” for managing their care and accessing health services, according to a 2023 report in the Journal of Gerontological Nursing.
Through the courses at HSC, Jowitt wants to help nurses understand how to offer the best care possible behind bars, whenever someone’s health problems begin, she said.
“The health challenges prior to incarceration, during incarceration and post incarceration, they don't disappear. They're actually stacked on top of each other,” Jowitt said. “I feel it's my duty to educate our nurses in how to navigate that."
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