Nurse prescribing in the custodial setting

Prescribing medications in the custodial environment is rewarding, but intrinsically challenging. Multiple chronic and acute illnesses co-exist for a substantial proportion of the patients. Many patients have engaged poorly with health services before entering custody. Polypharmacy and neglect are common; and there is a constant threat of contraband medications entering prison, medication hoarding, and on-distribution of prescribed medications for non-prescribed purposes.