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Correctional nursing must separate from the legitimate functions and needs of corrections personnel in order to serve the legitimate purposes of nursing. Clear identification of the boundaries between and collaboration with other disciplines and agencies must be established and en- forced without sacrificing patient care or patients' rights. We must prevent encroachment on correctional nursing practice by increas- ing awareness among correctional RNs about those aspects of nursing practice which may only be performed by regis- tered RNs. Patient Advocacy In order for RNs to survive in corrections in the current shortage, strong enforce- ment and support of their primary role as patient advocate in all arenas is needed. The environment itself requires the RN be educated as to the RN's legal role and ob- ligations, in addition to a primary role as patient advocate and caregiver. RNs must not combine custody functions that com- promise the RN role as patient advocate and competent provider of safe, therapeu- tic, and effective patient care. 1. LEGISLATIVE AND REGULATORY Prioritize issues in correctional nurs- ing that most urgently require legislative/regulatory change to assure safe, therapeutic, and effective delivery of patient care. Continue to develop, support, and monitor legislation and regulations affect- ing correctional nursing and support for the development of independent nursing practice. Monitor and lobby the budget process on budget issues that directly impact access to correctional nursing care and the patient advocacy role of the correctional RN. In coalition with other labor and out- side advocacy organizations, monitor and support universal access to healthcare ef- forts and government social responsibili- ty on extending healthcare as a right. Oppose any political process that changes the role of the correctional RN to enforcement of security personnel pur- poses that violate patients' rights. 2. STATEWIDE CORRECTIONAL NURSING ADVOCACY GROUP CNA to create a statewide Correction- al Nursing Advocacy Group composed of correctional RNs. been ventilated earlier." Eva's sister, Misty Miller, testified at her sister's funeral about the loss to her and her family: "I feel that my sister has passed the most important test of all. She was born into a difficult life, with a fierce personality and a spirit full of fire. She took everything that was thrown at her with a strong heart and mind. My sister has always been my pro- tector, my shield, my friend...it is my turn to be her protector. So, as I create my own shield and prepare to face this life with- out her, I let you all know that she will never be forgotten or disregarded... Do not forget her, because I never will." PAMELA COFFEY served time at CCWF. In the early morning hours of Dec. 2, she collapsed and died on the bathroom floor of her cell, about three hours after her cellmates had called for medical help for her. For several months prior to her death, Pamela had unsuc- cessfully sought treatment for a mass on her side. On the evening of her death, she complained of terrible abdominal pain and numbness in her legs. Her tongue was so swollen she could barely speak and her abdomen was reportedly so swollen that she appeared nine months pregnant. According to eyewit- ness testimony, a Medical Technical As- sistant (MTA)—a guard with low-level medical training—arrived on the scene but did not examine her. Rhonda Smith, who witnessed Pamela's death, told in- vestigators: "When he [the MTA] came out of the room, he was laughing. He said 'I can't understand a word she's saying - you can do more for her than I can.' I was like, 'This isn't funny.'" Pamela's condition worsened; she lost control of her bowels and began vomiting blood. Her cellmates cleaned her up, comfort- ed her, and called desperately for help. The MTA was again summoned and ar- rived about 30 minutes later. By then, Pamela was dead. Her body was left in the cell for over an hour, further trauma- tizing her cellmates, who had been forced to witness her death. The medical investigators reviewing the circumstances surrounding Pamela's death concluded that "there were signif- icant problems with Pamela's medical care that might have contributed to her death." The report notes that abnormal blood tests were not followed up in the days prior to her death and one of the investigators determined that the MTA who examined her should have sought more help. CHARISSE SHUMATE The following account is written by a former cellmate of Charisse Shumate. This night, like so many others during my incarceration in cell #19, I am startled awake by the sound of sobbing. As my eyes adjust to the dim light, I see a crumpled figure leaning against the heavy steel door of our cell trying to summon one of the graveyard- shift guards. The knocking goes on with no response from outside. Soon, all eight women in our cell are awake and bang- ing, yelling, screaming for help. Bitter experience has taught us that our room- mate, Charisse Shumate, is in sickle-cell anemia crisis and needs immediate med- ical attention or she could die. Finally, a face appears at the door. She knows her life depends on convincing the guard that she needs immediate medical attention. "Is this just another convict scam?" he is probably wondering to himself. Summon- ing up what is left of her strength, she tells him she has medical protocol papers proving what she says. He says he is "not interested in reading them." He finally agrees to call the medical department to check out her story and, much later, help arrives. Charisse is taken to the infirmary and locked in a holding cell while awaiting transportation to the outside local hos- pital - a process that can take hours. Charisse knows if she is locked away without water, for hydration, or medica- tion, she may die. So, once again, she tries to explain to the infirmary person- nel why she must have immediate med- ical help. At the hospital, it starts all over again. She has been taken to a hospital not experienced in treating sickle-cell patients and again, she must explain about her disease. All she can do now is pray she receives proper care. This story would be sad enough were it only about Charisse. Unfortunately, it is a story very similar to the stories of many, many women with chronic dis- eases and illnesses now serving their sentences at CCWF. I pray for them all. Charisse Shumate passed away on Aug. 4, 2001 after being denied a com- passionate release. C A L I F O R N I A N U R S E W W W . C A L N U R S E S . O R G M A R C H 2 0 0 6 25