I'm in the Brig!

So...it never occurred to me that military women's health care also includes the inmate population! I know women commit crimes; it's not as if active duty women are exempt from bad behavior...but still, as an an active duty provider- am I really going to treat women in jail? Yes, particularly you Navy folk. The brig over at Miramar Marine Corps Air Corps Station is the military's only long term institution of confinement for active duty women prisoners. They can be held there for up to 10 years. If the sentence exceeds 10 years, then they are transferred to a federal prison. Most are there for murder as a result of IPV (Intimate Partner Violence). So, there I was on Friday morning...doing speculum exams...on a prisoner...in the brig. My preceptor shared with me that this experience is actually very similar to providing care for women in the deployed setting. A lot of abnormal menses [change in diet/exercise/stress; close proximity of many women living closely together (syncing of cycles)]; along with BV and candidiasis d/t changes in hygiene patterns and hygiene products. I had to do paper charting, we had to bring our own supplies- including speculums, and there is no microscopy. If it smells like BV, you treat for BV. If it looks red and inflamed w/itching to the vulva and inguinal intertriginous folds, you treat for candidiasis- you get the picture. As a military FNP, there is such a wide range of what care in austere environments means.