political arena. Advocates for the imprisoned have been instrumental in changing the political arena, and their work is reflected in the aforementioned cultural and political shifts. Advocates for people in and administrators of facilities such as civil commitment programs, forensic psychiatric hospitals, and juvenile programs see the term “correctional” as offensive with its implied meaning of people requiring punishment instead of rehabilitation or treatment. For this reason, the broad specialty of forensic nursing has been their preferred Cultivating Change 11 nomenclature. This has created challenges for nurses working in these settings who find limited resources within the professional organizations for forensic nursing whose focus is primarily on victims of crime. These examples of political influence support the position that organization, thoughtfulness, and leadership are necessary to continue the advances that have been made in the protection of human rights and the provision of health care for people involuntarily placed. Social Justice Incarceration has been commonly accepted as a consequence necessary for public safety. Justice for crime victims, though critical, has been emphasized while the human dignity of those who perpetrate crime has been largely ignored. People who have committed crimes, especially violent crimes and sex crimes, are highly stigmatized for obvious reasons. Patients who experience ongoing ostracism have limited capacity for trust impacting their chances of rehabilitation and promoting further marginalization (Jacob, 2012; Lammie, Harrison, Macmahon, & Knifton, 2010; Perron & Holmes, 2011; Rose, Peter, Gallop, Angus, & Liaschenko, 2011; Willis, Levenson, & Ward, 2010). Deinstitutionalization of the mentally ill in the 1970s has unfortunately resulted in the rise of incarcerated mentally ill persons. The seriously mentally ill are often not just the perpetrators of crime, but also the victims of crime and abuse. Social justice requires special consideration of these vulnerable individuals. In addition, social justice calls for the protection of the dignity of work and the rights of workers. Workers’ rights are typically represented by labor unions. Professional organizations for forensic and correctional nurses now exist. But participation of nurses from small, rural forensic settings has been problematic. Many of these nurses have limited funds for national conferences and local opportunities for networking are rare. Cultivating Change 12 The dignity of nursing work in secure facilities has been diminished by several of the inadequacies previously described. Both the setting as well as the work itself have led to a degradation of the nurses’ integrity. Historically, nurses in forensic settings have not been appreciated for the work they do in serving an underserved population. Forensic nurses have experienced conflict with traditional health care systems. Nurses advocating for their patients who are incarcerated face difficulty finding resources such as surgeons and other specialists who are willing accept these patients. Healthcare staff in prisons have suffered physical problems, psychological problems, and negative attitudes (Garland & McCarty, 2009). Transformation is underway with increasing numbers of highly-qualified nurses entering the specialty. Yet many opportunities to advance forensic practice, education, theory, and research still exist. Creating a Plan Determining the most appropriate course of action is based on the best evidence available. Organizational culture, safety needs, and social justice are most pertinent to creating system-wide improvements in forensic nursing. There are several ways nursing can facilitate changes in these areas. One plan is to develop nursing leaders through networking. A study assessing the feasibility and desirability of networking was conducted to assess engagement in and how to effectively achieve networking in one rural Minnesota area (Ovsak, 2016). Findings from this study, in which the respondents describe a challenging patient population, the need for guidance from experienced nurses, and limited support are consistent with findings in the literature regarding forensic organizations. Organizational Culture “Culture isn’t just one aspect of the game—it is the game,” said Lou Gerstner of IBM (DiGiorgio, 2015). When a system is not working as well as it could be, someone put that Cultivating Change 13 system into place. The practice of appreciative inquiry is a way of looking at what works versus pointing out failures (Felgen, 2007) and has greater ability to gain influence (Carnegie, 2004). Research has identified aspects of forensic organizations which have limited their potential, but there are also areas of growth which can be built upon by forensic nurses. Culture impacts how nurses relationships with patients and each other. Certainly these relationships are linked to the quality of care. Studies demonstrate quality of care and rehabilitation potential has been influenced by administration’s engagement in quality-related issues and interdepartmental coordination (Jha & Epstein, 2010; Melnick, Ulaszek, Lin, & Wexler, 2008). Nursing at any level of the organization armed with knowledge and support can influence change. Transformational nursing leaders contribute to patient safety (Merrill, 2015). Safety Needs Standards of care and legal rulings have cleared the