Correctional Nursing as a New Grad

WYOTACO · Feb 23, 2013

Not sure how much help I can be since I'm not a nurse (yet), but I spent a few years as an officer and worked closely with the nursing staff. A good start is to search the forum as well, as some of your questions may already be answered.

To make it simple, here's some pros/cons that I can think of.

Pros- Steady job, fairly regular routines (as many of your patients will probably be on a much longer term basis than would be at a hospital), and a good starting point for resume building. That's about it...

Cons- Biggest issue is that it is a very stressful job. You are not only expected to follow policies/procedures of the nursing staff which is often contracted, but you must follow those of the prison/security as well. There are also federal laws that might apply differently in a prison setting than a hospital. You are constantly under pressure by prison schedules, dealing with a lot of 'difficult' inmates, and charting/pill call/emergencies/whatever else you can think of for several hundred or more (Leavenworth has about 1,800) offenders. Often times the nursing staff is on a different rotational work schedule than security which can make things more difficult.

Also, working in a very predominately male environment leads to other issues. A prison sort of operates as its own little world, and gossip for males working there can be just as bad or worse than anywhere else outside the fence. Not to mention as being some of the few female staff, you'd most likely have males (both officers and offenders) fawning over you and seemingly tripping over each other in an effort to flirt with you. In my experience, this tends to be quite detrimental to the safety and security of the institution and in most circumstances, at no fault of the women.

That leads me to what advice I feel I should give if you do decide to choose to go into correctional nursing.

While these things may not apply to every single person, it does for most inmates, therefore you must apply this mindset to ALL of them. They are VERY manipulative and lie frequently. The basic rules apply to both security and nursing staff when dealing with offenders. Be firm, fair, and consistent. I do not care how nice and personable they seem to be, for your sake and everyone else's be vigilant and do not ever ever EVER trust them! I absolutely cannot emphasize that enough.

I know though both personal experience and know way too many staff that fall for this. It doesn't matter if the staff is male/female, officer, case worker, nurse, whatever. My own wake up call was early on when a little old diabetic man with a cane that I escorted to medical everyday once kicked off his flip-flops and RAN down the wing and began punching another inmate in the back of the head. It took me completely off-guard and for a brief second I stood there dumbfounded, thinking "He can run?" Do not become complacent and assume what they can/cannot be capable of or how they might behave or react in situations.

Again, these guys can be very manipulative. I have known several staff that have brought in drugs/contraband for or developed relationships with inmates. We had one case worker quit and when the guy was paroled, she was at the front door to pick him up! We had an officer bringing in contraband and when she was fired, her mother (in charge of laundry) brought it in for her. After the inmate's sentence was up, he moved in with the former officer.

Inmates will cheek pills, sell pills, simply not take them, fake some injury or illness, insist they need a bottom bunk or extra blankets, lie about how they got their face busted up ("I fell in the shower." "I fell into my locker." "I fell on the stairs." are some common excuses when they get into a fight and don't want to be labeled a 'rat' by other inmates), among other things.

As I said before be firm, fair, and consistent. Stay on your guard and be polite and professional. A smile on your face is not a bad thing and there is nothing wrong being nice. They should know by our actions that we realize they are human and it isn't our place to judge them, but there is a fine line to walk and for safety's sake- please do not trust them.

f1j1nurse23 · Feb 24, 2013

I started off in corrections as a new grad two years ago. I can't imagine doing anything else:) I have also take my SANE-A and scheduled to take my SANE-P this year but I don't use that at work at all. I love forensics and someday wil lget into it when the opportunity presents itself but corrections is where I want to be. The population is challenging, the job is stressful (I'm a stress junkie) and the pay is superb. I made 6 figures right out of nursing school as a new grad. That said, it is hard to leave corrections and go to floor nursing becasue of the stigma of being a correction nurse and not doing much but I work with people who have done it so if this is where you want to be i'd say go for it. I work with a huge population of diabetic clients, psych clients, alcohol and drug withdrawals, pregnant women, dialysis patients, and a lot of codes. Good luck.

cchezem15 · Feb 27, 2013

I got my first job at my county jail. I love it. Yeah its stressful most days, but I am gaining so much experience as a LVN its ridiculous. I deal with so many different aspects of nursing. You have to keep a mindset that most people are lying and really use your assessment skills that you learned while in school. Like the first person said, you kinda have to juggle two jobs in one - nursing and security in a sense. Always have your guard up! One thing too, if you decide to take a job in corrections, know the population of people you are going to be working with - child molesters, murders, drug dealers, etc. If you believe that your opinions are going to get in the way of providing care, do not do it. I see some people I work with constantly judge inmates and it effects the quality of care they give. These people are humans despite what they have done, and you are not the person to be passing the judgement - do what you were trained to do - give medical care.

One a good note, its definitely a different area of nursing and there is NEVER a dull moment! One second everything can be calm and then next thing you know your holding a inmates member to stop the bleeding because he decided to cut it open to place a shaped domino in there (yes, this happens A LOT) :wacky:

spearsfm · Feb 28, 2013

I graduate from LPN school in October and even though just about.everyone wants to work in nursing homes,hospitals,etc. I think correctional nursing would be interesting im always up for doing.something different and I want.to eventually become a SANE after I get my RN so the correctional background should be a plus..does any1 have.any other pointers to add to this forum?

greenmanrn · Feb 28, 2013

I've been an RN for 8 yrs and work in a Med-Surg Trauma ICU. I also work for a nursing agency part-time and go to the Virginia state prisons. I was also a correctional officer for 2.5 yrs. Nursing in the prison is not that bad. I've only been to state prisons, so, I cannot speak for the federal prison. One of the prisons I go to has a 30 bed infirmary. The infirmary is so large because they house the majority of the state prison's chronically and terminally ill inmates. At this prison, I supervise 2 LPN's. One gives all the meds to the inmates. The other does the "treatments". This means he/she does all the dressing changes, cleans all the poop, and gives all the IV treatments, whether it be starting an IV or drawing labs. Of course, I work at night, so it gets very boring and I always help the treatment nurse with whatever they have to do. I'm required to do 5 assessments a night. The pt's I have to assess have already been chosen for me. This prison also has a psyc ward where the inmates are behind closed doors. I'm responsible for giving the meds to these guys, who most of the time refuse and you have to write them up for this. The infirmary is the only place they have RN's working. LPN's work out on the units and hand meds from there. The other prison only has a clinic and a 6 bed infirmary. Here I supervise 2 LPN's. These two again, give all the meds to the inmates out on the units. I take care of the inmates who are in the 6 beds. Most of these guys are just coming back from a hospital stay or procedure and only need to be observed for a day or two.

At both prisons, I respond to emergency situations out on the units. This may be anything, and I mean anything!! Believe what others have said, these guys have nothing to do but think of ways to get out of this prison, and a medical emergency is the fastest way out, so be sharp on your assessment skills. I have seen 2 nurses that came right out nursing school into the prison, but, they were both medics prior to nursing.

I currently have an application in at the federal prison. I've only spoken with some of the officers who work here. They have told me that the nurses do not work past 2200 and you either work 6-2, 2-10, or a 9-5 shift. Have yet to run into a federal corrections nurse to confirm this information.

So, if you have very sharp assessment skills and a good street sense about you, then give it a whirl. If it doesn't work out, go to a hospital or doctor's office or a jail. Once you're licensed, the options are limitless. Good luck and feel free to ask any questions. I will answer to the best of my knowledge.

spearsfm · Mar 1, 2013

Thanks that helped a lot! I live in PA but don't really know or have spoken.to a nurse.that works at the jail/prison I.wouldnt even.know who to comtact

spearsfm · Mar 1, 2013

Oops I meant contact

tigerlogic · Mar 29, 2013

Thanks for this thread.

TalldiNY · May 23, 2013

I am an RN of now 40 yrs of active work. I worked 8 years in corrections in Michigan and then now with the end of my career within site, my back is bad, my feet as well. I have raised a family of three children as a single mom. There are only a few areas of nursing that I have not worked in during my career.

Corrections is where I find myself again here in NY. It is the easiest physical job I ever had. I think other notes in this column mention the need to follow both good nursing practice and satisfy security rules and regulations. I would suggest you read up on personality disorders.

There are a few rules to remember that I would suggest:

1) There are NO gulity people in prison. They are ALL innocent. (It's a real sad story of the justice system right?)

2) These people have 24 hours a day to figure you out. Believe me within a few weeks they will know what color underwear you have on. My usual answer to every one pushing for personal information is a smile and "You don't need to know that." or a variation of that.

3) I treat them all pleasantly (which they invariably take as a sign of weakness), but I do not tolerate "attitude" or rudeness.

4) Most of them are just looking to pump you for something. They all want drugs and a mother. Your job is not to provide either of them. To cover my own butt I do a brief physical exam on any complaints that involve sore throats, breathing difficulties, and chest pain. If they have allergy- Med D tablets, asthma- referral to the MD/FNP/PA. If it's a foot problem like atheletes foot I make them show me their feet. A great many of the things you see are complaints they would just live with if they had to pay so much as $1 for the service. A good many more are trauma from fights.

Rule of thumb on chest pains. If the inmate is under 30 it's not likely. They are likely healthy. It's more likely they are lifting to much weight in the weight pit, doing too many pushups or pull ups. Medication and advice: Ibuprofen and stop excercise for 10 days. Ther is always the possibility they want to be sent out to the hospital.It is like a vacation for these men.

5) You need to be matter of fact and fair. The CO's and the inmates will behave better.

6) You don't come to prison to meet a man. These men are capable of being whatever they think you need. They are mirrors and do not have consciences. See rule #2. There is a reason and purpose for every interaction you have with them. It's a big game and the only problem playing it is that you can end up assaulted or even dead.

7) The CO staff are the only protection you have. (Although the inmates may promise you protection and even set up a scenario where it looks like they protected you to have an edge.)Not all of the CO's are perfect, but you find that in all jobs.

8) Never go anywhere alone, or with a prisoner. Wear your PAD (personal detection device)or your radio at all times. Tell someone ( a CO) where you are going, how long you will be. Dont' cross the yard alone when prisoners are out. If you travel through the tunnels (as my Michigan prison did) be aware of movement and sounds all around you.

9) You are not going to find fulfillment or positive re-enforcement in a prison job. You have to have confidence in yourself and the ability to feel fulfilled within yourself. You are not going to be able to fix any of the problems of the people you are going to work with.

10) Most important rule! Secure your keys at all times! Wear a belt with a key slide for the best control.

However I would hardily advise any new graduate to work in a hospital, especially a med-surg unit or ER for at least 2-3 years before attempting Correctional or Forensic nursing. You need that base of dealing with the public, a heavy assignment load to hone your organizational skills and ability to react in critical situations. Things happen on the block or dorm (depending on the custody level you work in) that require you to think fast and do triage. Don't short change yourself. Prison is a completely different world.

The best thing there is is that moment when you go through those gates to go home. Practice a happy life outside of work. Don't drink to excess and try to be aware of your own stress levels.

Best of everything with your career. If you can think of anything else you would like to ask feel free.

Orca, ADN, ASN, RN · May 24, 2013

I am a correctional DON. I believe that corrections is a great job, just not a great first job. It requires a degree of independence that a new grad cannot possibly have, and for that reason my agency does not hire them. The early years of your career should be spent polishing skills, and correctional nurses do a lot of different things but not enough of any one thing to get good at it (besides assessment) if it is your only experience. I know that it's cliche, but that one year of med-surg or similar experience will serve you well down the road.

laceym · May 27, 2013

I hear what you are saying Orca in your post. The sad thing is as a New Grad the only people that have responded with a possibility for a position are the correctional jobs for me. I would love to work med/surg for a year. I loved it in school-you learn so much on that floor. I get so many rejection responses from hospitals, it's almost funny now. I just want to work as a RN, in some capacity, and actually the correctional aspect is more appealing than a hospital-that might seem weird, but just how I feel.