Correctional Nursing Questionnaire. - page 2

by egmiller 4,836 Views | 15 Comments

hey, i'm a student nurse from fort collins, colorado. i'm using this site to collect information about correctional nursing for a cultural presentation for my fundamentals class. i've developed a questionnaire for anyone with... Read More


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    1. Using the common nursing stereotypes (battle ax, angel of mercy, etc) describe your relationship with inmates.

    My relationship with inmates is little different than my relationship with patients when I worked in a hospital. Obviously allowances have to be made for security, and I have to be more aware of maintaining professional distance. The "touchy-feely" approach to nursing doesn't work well in this environment. Using terms of endearment with opposite-sex patients are far more likely to be misinterpreted as romantic interest when dealing with inmates, and they should be completely avoided. These people are not in prison because they have sound reasoning skills or exercise good judgment.

    I don't believe that I fit any stereotypes. I use a variety of approaches depending upon the situation. Sometimes using humor is appropriate. Sometimes being very blunt works better. It depends upon your audience. As far as how I treat inmates, I treat them with respect without coddling them. The custody mantra of "firm, fair and consistent" also has nursing applications in this environment.

    2. What are some methods that you use to build repore and trust with inmates?

    Being truthful and honest with them about their health issues goes a long way. I also try to make sure that I explain things in a way that the inmate can understand, because many of them are not well educated. Listening to them, even if you believe they are feeding you a line, also helps. For many inmates, it isn't even important to them that you believe them as long as you hear them out. Also, deliver what you promise, and don't do things for one inmate that you would not do for another.

    In a correctional environment seemingly minor details make a big difference to inmates, because they don't get much. Any interaction they have, positive or negative, is a bigger part of their day than it would be on the outside.

    3. Are you ever aware of the charges being held against your patients, if so does that effect the way you care for them?

    I make it a point not to even try to find out, because I don't want my personal feelings to affect the care I deliver. In the cases in which I cannot help but know (high-profile crime, extensive television news reporting) I block that out and concentrate on the task at hand.

    4. How do the inmates attitudes and philosophy related to healthcare compare to non-inmates?

    We have to be aware of things that don't come into play as much in hospitals. Proximity of the sharps container. Making sure the inmate doesn't see the entry code for the medication room. Never being in an examination room alone with an inmate. We also have to be ever mindful that custody is job one, and issues of security must necessarily take top priority. We must operate within the confines of that environment.

    5. Can you explain the inmate culture as it relates to healthcare?

    Many inmates try to manipulate the system to get as much out of it as they can. Exaggerating and feigning symptoms is common, and your assessment skills come into play a lot. Others, sometimes trying to appear tough to fellow inmates, will not report a problem until it is well along. You also have to do a lot of education. You cannot assume even a rudimentary knowledge of health principles, because many (perhaps most) inmates have had little or no education about how to stay healthy and when to seek medical attention.

    6. How were your perceptions of nursing changed or effected when you began taking care of patients that were being held against their will?

    Not at all. Of course, it helped that I worked in and around corrections in various capacities for many years before going into nursing.

    7. Do you believe that the bedside manner you use with inmates would be appropriate in other fields of nursing? Please explain.

    In most cases, yes. There are some times, depending upon the security level of the inmate or the situation, that I have to alter my practice to allow for security concerns. Most nurses don't do dressing changes with a custody officer standing by.

    8. Would it be difficult for you to acclimate to another field of nursing? What would you have to changed?

    I have worked in several other areas, so acclimation wouldn't be difficult. Willingness is another matter. I have no intention of leaving correctional nursing at this point.

    9. What events led you to becoming a correctional nurse?

    I was working a per diem job in a hospital at the time I signed up for the Department of Corrections' newly-created per diem nursing pool. I was just looking to pick up a few hours to supplement my income. I simultaneously got full-time offers from both the prison and the hospital. The prison's offer was for more money for less work and headaches, and I liked the job. It wasn't a difficult choice. The same hospital later offered me a nurse manager job - for less money than I was making as a line-level nurse at the prison. I politely told them "No, thanks".

    10. Has it been your ambition since nursing school to be a correctional nurse?

    I never gave it a thought. The ironic thing is that I initially went into nursing to get out of corrections.
    Last edit by Orca on Nov 5, '09
    shell911rn likes this.
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    1. Can you explain how you know once an inmate trusts you. What signs and behaviors of trust are most common?

    The more questions an inmate asks you and the more they relax and share with you about what they are feeling or experiencing is usually a good sign that they trust you.

    2. How do you ensure accurate patient education when using slang or non-standardized terminology?

    I will usually use both standard and non-standardized terminology or slang to make sure the inmate understands what I am saying and relate the two terms together. I also will have the inmate repeat back to me what I have instructed him to do if I am not sure he understands me and doesn't ask me questions.

    3. What are some reasons why a nurse would prefer providing care to an inmate rather than a non-inmate?

    I prefer providing care to an inmate rather than a non-inmate because I only have to deal with the patient, not family. Also, inmates tend to be more appreciative of the care they are receiving and the fact we are willing to take the time to explain things to them and to provide advice. They don't tend to have the unrealistic expectations that non-inmates and family have of nurses.

    4. What are some reasons why a nurse would prefer providing care to a non-inmate rather than an inmate?

    I miss the technical aspects of nursing, the resources, and the fact that I was surrounded by patient advocates "outside the walls."

    5. What are some ways in which inmates can gain the trust of their nurses?

    I don't believe this is a setting where an inmate can expect to gain the trust of a nurse. There is always going to be some doubt in my mind about the inmate's true intentions when soliciting nursing care. I am going to be suspicious of an inmate who is trying too hard to gain my trust.
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    I just wanted to thank everyone that participated in our groups questionnaire, our project kicked butt!
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    What are some ways in which inmates can gain the trust of their nurses?



    IMO this is an odd question, bordering on a red flag.
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    1. Using the common nursing stereotypes (battle ax, angel of mercy, etc) describe your relationship with inmates.
    I don't think that the common nursing stereotypes apply in prison but some of the TV and movie inspired ones crop up every oce in a while. But a relationship built on honestly seems to work for me. I also set limits for those who seem to require them and go the one step more for the patient who is being groud up by the system. I believe that most of my inmate/patients respect me and trust that I will help as I can and tell them no I can't when I can't do other tham direct them elsewhere.

    2. What are some methods that you use to build rapport and trust with inmates?
    See above.

    3. Are you ever aware of the charges being held against your patients, if so does that effect the way you care for them?
    I try VERY hard not to be aware but sometimes we do find out and then must work to make wure that that knowledge doesn't effect the care provided to that patient. Its kind of like having a bunch of kjd and one of them is naughty but a grand outing was planned so though you are upset with the one you can't let effect the plans of the many.

    4. How do the inmates attitudes and philosophy related to healthcare compare to non-inmates?
    Most of my inmate/patients are grateful for the care that they receive, some are so angry that they try to take it out on medical, and some abuse the system, while other like to cite the fact that it is their "constitutional right" to everything and anything that they have ever wanted or read or heard about to do with their real or feared disorders.

    5. Can you explain the inmate culture as it relates to healthcare?
    For many inmates the care that is available is their first encounter with the medical system and often the expectations are fashioned by the media (bless their LPPH). Other times medical care is used as a weapon by gang leaders and accessing of care can be dangerous if the gang leader has said no. Some prisoners try to frighten other peisoners with horror stories and those can be had to overcome. Manipulative inmates see medical as a feast table at times. Because of the usually lower level of education ( though not necessarily intellect) many of the things that you took for granted on the outside were known must be explained often at a periatric level.

    6. How were your perceptions of nursing changed or effected when you began taking care of patients that were being held against their will?
    Not at all. However my ability to be an advocate for my patient has been both expanded and sharply curtailed.

    7. Do you believe that the bedside manner you use with inmates would be appropriate in other fields of nursing? Please explain.
    Yes the behaviour is appropriate to many settings. The strongest inhibition that is not appropriate on the outside is compassionate touch.

    8. Would it be difficult for you to acclimate to another field of nursing? What would you have to changed?
    I worked on the outside for more than 40 years and have been on the inside only a few years so returning to outside work is not hard. I do keep my hand in in the outside a few shift a quarter.

    9. What events led you to becoming a correctional nurse?
    Family members worked for the system, in other fields, and convinced me to check it out after a traumatic event in my chosen field had me wanting to leave nursing.

    10. Has it been your ambition since nursing school to be a correctional nurse?
    No. In fact my few encounters with the systems had turned me off of ever wanting to work in or with the system.

    1. Can you explain how you know once an inmate trusts you. What signs and behaviors of trust are most common?
    They never fully trust you, as you can never trust them, especially if they are gang affiliated. However as your medical relationship begins to mature they will state to quit questioning everything that you tell them, they will begin to open up on issues that they kept hidden before, and often will seek your advise for mates who are not your immediate patients. Trust is hard in a prison, respect is probably as far as you will get.

    2. How do you ensure accurate patient education when using slang or non-standardized terminology?
    If the inmate is using a term for something I will define the term in medicalese such as when an inmate says that his"whatever" hurts I will have him point to where his "whatever" is and then explain what it is called in medical terms. I try to explain in terms that both educate and still remain within that particular persons realm of experience and ability to understand. Just as on the outside you adjust you teaching to the individual. This mean that one seeion you can be teaching at a kindergarten level and the next session at a graduate level. As on the outside you use validation tools such as checking, repeating, and asking.

    3. What are some reasons why a nurse would prefer providing care to an inmate rather than a non-inmate?
    I'm not sure that many of us differentiate. A patient is a patient is a patient. A human is a human is a human. Prisons are small cities and the inmates are their populations. We seek the same things on the inside as we seek on the outside. The opportunity to aid another being, to utilize our training and education, and the chance to feel that good feeling that comes when we overcome the odds against. But one of the advantages of prison nursing is that all the "bad guys" wear uniforms, and unacceptable/abusive behaviour is not tolerated.

    4. What are some reasons why a nurse would prefer providing care to a non-inmate rather than an inmate?
    See above. On the otherhand the opportunity for specialization is greater on the outside, and the variety of persons is greater, including not yet captured or released criminals.

    5. What are some ways in which inmates can gain the trust of their nurses?
    Be honest both about those problems that are the topic of the appointment and those that may impact it. Be open about the fact that they have reservations about the system or the fact that they haven't had sufficient encounters with the individual to develop trust. Never try to manipulate us, once done it can seldom be taken back as an admission of manipulation is often just a change of manipulative stategy. Don't test us or, if they do, admit to it. Don't exagerate symptomatology, when you are laughing and joking with people in the holding area then as soon as you are called start limping or coughing and then claim a pain level of "oh, I know it stops at 10 but my pain has got to be at least a 12" followed immediately by actions that belie that, we will know the inmate for a player. Don't ALWAYS ask for the more expensive and overthetop treatment and testing provedures. If nursing/medical ask that you notify them for some adverse event - do so. If a testing procedure is set up for you, either decline it as scheduling or don't decline. Help us help them.

    Hope this helps. Good luck.
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    Quote from egmiller
    hey, i'm a student nurse from fort collins, colorado. i'm using this site to collect information about correctional nursing for a cultural presentation for my fundamentals class. i've developed a questionnaire for anyone with experience in correctional nursing to consider. please feel free to respond to one, all or any combination of questions which you find interesting. thank you so much for your insight!

    1. using the common nursing stereotypes (battle ax, angel of mercy, etc) describe your relationship with inmates.
    all inmates call the nurses - nurse, miss or mr

    2. what are some methods that you use to build repore and trust with inmates?
    be respectful, as they are to you, ensure that bounderies are clear and concise.

    3. are you ever aware of the charges being held against your patients, if so does that effect the way you care for them?
    nursing staff in the facility i am at has access to this information but we tend not to look at this unless the im has threated us in some way.

    4. how do the inmates attitudes and philosophy related to healthcare compare to non-inmates?
    depending on age, sex of im. the generation im all display different attitudes. the 18-25yrs age group tend be more violent and less responsible for there actions. but the health care would remain the same as non im.

    5. can you explain the inmate culture as it relates to healthcare?
    the older im are more respectful to nurses then the under 30's

    6. how were your perceptions of nursing changed or effected when you began taking care of patients that were being held against their will?
    i'm not to sure about the held against their will, a lot of the im in the corrections facility i'm at are well aware of why they are being held here, most are frequent flyers and this is there 2nd home. the answer to your question is that i am more cautious, and aware of all that i say and do.

    7. do you believe that the bedside manner you use with inmates would be appropriate in other fields of nursing? please explain.
    yes it would be helpful in mental health area, elderly care especially dimentia care.

    8. would it be difficult for you to acclimate to another field of nursing? what would you have to changed?
    no i would treat all patient with respect, the only difference would be that i would probably be more open to building rappore and relating to non im patients
    9. what events led you to becoming a correctional nurse?
    the experience that iwent into corrections with, also the fact that i am more confident in myself as a person and as a nurse.

    10. has it been your ambition since nursing school to be a correctional nurse?
    i thought that i would never go to corrections, i was always afraid of the unknown. know that i am in corrections i am glad that i applied for the position, i acccepted the position as team leader with a mind set that this is going to be a challenge as i will be out of my comfort zone and i cant judge corrections nursing by my own insecurities and because i have done hospital (medical, surgical) , community, district nursing, education including lecturing and specialty nursing i thought that i could share my nursing knowledge to the nurses within corrections.

    i hope this helps in your studies.

    thank you so much for your thoughts and experiences!
    treat all the way you like to be treated.


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