By Jaime Shimkus

Surprise and bewilderment were the initial reactions registered by Katrina Whaley, RN, CCHP, when she learned that Mayfield Youth Development Center was to receive NCCHC’s 2004 Program of the Year Award.

“This is not special,” she recalls thinking at the time. “Doesn’t everybody do it?”

“It” refers to formal classroom education, delivered every Friday at 2 p.m., dedicated to health care subjects. This program has been in place for 17 years, initiated at Whaley’s suggestion.

At last year’s National Conference on Correctional Health Care awards ceremony, Patrick Sheridan, MD, MPA, CCHP, spoke on behalf of Mayfield. As medical director of the Kentucky Department of Juvenile Justice, he knows well the work they do.

“[Good nurses] are our eyes and our ears and our hands,” he observed. “Without good nurses we are nothing. With good nurses it is relatively easy. Katrina is such a nurse, the very best.” Sheridan also commended the work of Terry Wood, RN, the other nurse on staff, as well as the collaborative environment fostered by former superintendent Angelique Rowe.

Comprehensive Curriculum
A few months after joining the Mayfield staff nearly 18 years ago, Whaley spoke with the superintendent about the need for some “preventive maintenance” for the teenage males under her care, in particular to address their pervasive drug and alcohol problems. The superintendent fully supported the idea and provided a one-hour time slot (it runs longer if needed) in the educational program.

Whaley developed the health class from the ground up. Armed with pamphlets, she began teaching the boys about the hazards of substance abuse. The subject matter soon expanded. Apart from dental problems, most of the youth are physically healthy, with little incidence of chronic illness. But Whaley saw that they often lacked the general health education that would help them make sound lifestyle choices and maintain their good health.

Today, the “nurse’s class,” as it is called, covers prevention and self-care in a broad range of subjects, including sexually transmitted disease, birth control, smoking, asthma, oral health, personal hygiene, exercise, violence (including guns), depression, self-esteem and values.

Depending on its overall relevance, Whaley aims to present on each subject two or three times a year to introduce and reinforce different aspects before a resident is released. Substance abuse remains a pressing concern for this population, so it is addressed even more frequently.

Capturing Interest
Whaley conducts most of the classes herself, but she knows that the boys would lose interest if she lectured for an hour. Instead, she uses a variety of other media, especially videos and DVDs from her library of 140-and-growing titles. All, of course, have been evaluated to make sure they are appropriate for this age group.

These are not dull educational films, however. If there is some lesson to be learned, Whaley will use Hollywood releases, knowing that they are more likely to capture and hold attention. She recently showed the 1995 movie “Outbreak” (tagline: “This animal carries a deadly virus... and the greatest medical crisis in the world is about to happen”) to teach infectious disease concepts.

Other Mayfield staff members teach classes occasionally, as do guest speakers from the community. When the local sheriff talks to the boys about the effects of alcohol, he brings a pair of glasses that simulate the blurred vision caused by intoxication. “They all think they can handle alcohol,” Whaley says. “This is a reality check for them.”

A striking lesson on methamphetamine was delivered by a man who asked permission to share with the youth his own story: A former user, his face was horribly disfigured when he tried to kill himself while under the drug’s influence.

The Youth Center also organizes frequent off-site activities, including field trips that tie in with the educational and rehabilitative mission. Through the Youth Awareness Program, every few months a group of boys visits the state’s maximum security penitentiary for some face time with select prisoners.

Just as for the regular educational curriculum, it is mandatory for the residents to attend nurse’s class, and they do receive assignments. Not that any of them are complaining: According to NCCHC surveyors who toured the facility and spoke with the boys, the class is very popular.

Solid Services
Health education isn’t the only way in which Mayfield excels, however. As a whole, the health services delivery system is as tight as a drum.

Policies and procedures, patient care and treatment, medical records, infection control, healthy environment, staff education, interdisciplinary communication, quality improvement and more—all of the fundamentals of a solid department are well-managed.

That’s not to say that problems don’t arise, but in such a small facility, they usually are addressed quickly with a few discussions. To make sure they don’t lose sight of the big picture, staff members also hold formal meetings regularly to review reports and plan future activities.
Since Whaley and Wood are on-site weekdays only, the youth workers are, by necessity, an integral part of the health care team. The preparation they undertake is thorough.

All youth workers who have direct responsibility for juveniles are trained in the following areas: medication administration; types of action to take in potential emergency situations; signs and symptoms of an emergency; first aid administration; how to obtain emergency care; procedures for transferring patients to medical facilities or health care providers; signs and symptoms of mental illness, mental retardation, emotion disturbance, potential suicide and chemical dependency; and signs and symptoms of suspected child abuse (including sexual abuse). All staff also are trained in CPR.

Clearly the youth at Mayfield are in good hands, and thanks to Whaley they have the tools to make positive changes to nurture their health and well-being. But do these lessons and interventions have any lasting impact?

Impossible to know, Whaley says. However, a few of her guest speakers have been former Mayfield residents, and she is heartened to see that they have become productive members of society.

“You just do the best you can do and hope that you get through to them. But they have to desire to turn their lives around.”

— About the author: Jaime Shimkus is NCCHC’s publications editor. To contact her, e-mail jaimeshimkus@ncchc.org.