GINETTE FERSZT, a professor in the University of Rhode Island’s College of Nursing, was recently inducted as a fellow of the American Academy of Nursing at the organization’s 2017 Transforming Health, Driving Policy Conference in Washington, D.C. Ferszt was selected for her advocacy on behalf of incarcerated women facing health care disparities.
Can you tell us about your work with and on behalf of incarcerated women? Although I had stated that I would limit my time as a volunteer at the Rhode Island Women’s State Correctional Facility for a period of one year, that became a 16-year commitment. My work with incarcerated women began with offering a grief group at the request of the warden. There were about eight women who had experienced a major death (significant other, parent, sibling, etc.) and the warden was concerned that they did not have the staff to help address the women’s grief. I learned so much from the women in this group about how grief becomes disenfranchised in prison, so I continued this work.
I joined Phyllis Taylor, a colleague of mine doing similar work in Philadelphia, to write a grant proposal to the Robert Wood Johnson Foundation allowing us to write a pamphlet on grief in prison, which was widely distributed. Next, a new warden asked if I’d work with her social worker to see if more could be done to meet the health care needs of pregnant women in the prison. We did a needs assessment and subsequently started a group for that population. I also collaborated with Dr. Jennifer Clarke to develop standards of care for pregnant women. I wrote a grant [proposal] to develop an educational pamphlet for pregnant, incarcerated women, which I still distribute today.
Did you expect your research on the shackling of pregnant women during labor in prisons to go national? What has been the impact of that research? Dr. Clarke and I attended a think tank in D.C. related to improving health care of pregnant incarcerated women, where I was exposed to the issue of shackling. Two women who had been pregnant in state prisons described their experience, which was shocking. Dr. Clarke and I conducted a national study published in 2012 to try and determine the status of health care for pregnant women in state prisons across the country. I also felt compelled to educate nurses across the country and work with nursing and other professional organizations to address this issue in their own states.
A number of organizations, including Amnesty International and the Rebecca Project for Human Rights, were also tackling this issue. It takes groups of committed individuals and organizations to promote state legislation and make changes in correctional facilities. Even though [Amnesty] first highlighted shackling in 1999, there are still 22 states that do not have any legislation preventing it. In states that do have legislation, it is not always enforced.
How has the nursing profession changed since you were a student? The health care system has become much more complex. As science and research leads to greater discoveries, the health care system responds. For example, premature babies can now be kept alive; women with very severe co-morbidities (such as diabetes and cardiac problems) can become pregnant; people are living longer with serious multiple, chronic illnesses. Community-based care has also become more complex at home and in primary care settings.
To provide safe, competent, culturally sensitive care to varied populations in diverse settings, nurses need to have assessment, critical thinking, intervention and problem-solving skills that are very advanced. Inter-professional teams are needed to deliver care to patients today. Communication and collaborative skills are also critically important. Advanced-practice nurses, prepared at the master’s and doctoral levels, are sorely needed in primary care and critical care and in community settings.
