Correctional Nursing: what are job responsibilities, jail setting,issues in providing care

Orca, ADN, ASN, RN · Apr 28, 2015

I am a DON in a state prison in the west. As far as pill call goes, it depends upon the unit as to where the distribution takes place. Our intake, segregation and mental health units are door-to-door delivery. General population units come to the pill window at the clinic.

You will see a lot of different things. In corrections I had my first exposure to gunshot wounds and snake bites. At my current facility we have one inmate with a condition that only about 5,000 people in the United States have. I could have worked an entire career in the private sector and not seen this condition once. It is not unlike working in a small town hospital. You see a lot of different things but no two days are exactly the same.

A lot of success in corrections is how you carry yourself. Be courteous and respectful and you generally get it in return. I often tell my staff that we aren't here to punish the inmates. The courts have already done that by taking away our freedom. We are here to provide health care to people who society at large had rather not deal with.

As far as the differences from hospital work, you never go into a room with an inmate alone, and you never turn your back on an inmate. There is always the possibility of assault, but more likely the inmate would take the opportunity to steal something in the room - either for his own use or to trade for something else. Never do special favors. Never bring in or take out anything for an inmate. Espeically keep your eye on sharps (needles, scalpels, etc.). Your assessment skills need to be sharp, because inmates will exaggerate or completely fabricate symptoms in order to get medication or a trip to the hospital. Stick to your written policies and procedures. If a request is reasonable and it doesn't violate policy, grant it. Any interaction you have with an inmate, positive or negative, will be a much bigger part of his day than one that you have with someone on the outside, because this is a place of regimentation and sameness. Keep any hands-on care to the minimum amount necessary to do the job. Physical comforting and terms of endearment can get you in trouble here, and it doesn't matter whether you are the same or different sex from the inmates you are providing care to.

Friends often ask me if I am afraid to go into a prison. The straight answer is no. I have never felt unsafe on the yard. Part of this is because of the way that I treat people. I treat everyone with respect (which is not to be confused with giving them everything they want). Courtesy goes a long way, especially in a place where there isn't a lot of it around. That said, the custody mantra of "fair, firm and consistent" also serves medical personnel well. There are also a lot of safety measures in place. You aren't left alone with inmates. You have custody officers around, if not in the room, at least in the immediate vicinity. If an inmate moved toward me (and in 14 years of doing this, not one has), he would be kissing linoleum in a split second. I am also pretty certain that the inmates I see every day aren't carrying firearms - something I was never sure of when walking past visitors in the back halls of a hospital late at night.

I would be happy to answer more of your questions if you like. Hopefully this has given you something to start with and something to think about.

Shuggahs · May 9, 2015

This was good info to me. Tuesday I go do security clearance for my first prison. All women! All I care is that everybody is locked up! I almost took a job at the local jail. The men were behind bars but the women could be out. Umm, no ma'am!!! I don't want to be physically tested, just let me do my job. I've always wanted correctional experience but don't want to get poop in the face....I watch too much law and order ðŸ˜

OrganizedChaos, LVN · May 9, 2015

This was good info to me. Tuesday I go do security clearance for my first prison. All women! All I care is that everybody is locked up! I almost took a job at the local jail. The men were behind bars but the women could be out. Umm, no ma'am!!! I don't want to be physically tested, just let me do my job. I've always wanted correctional experience but don't want to get poop in the face....I watch too much law and order ðŸ˜

I'd rather work with men inmates than women. Haha! I've never had anything thrown at me. The inmates usually respect medical, they usually throw stuff at C.O.'s.

Orca, ADN, ASN, RN · May 9, 2015

I have worked with both populations. My current facility houses only women. One population is not better or worse than the other but they require different approaches, and understanding the differences is key. Generally speaking, women seek medical care earlier and for more minor reasons. They want to know the "why" of whatever you are doing or plan to do. Men tend to accept what you tell them while women want more of an explanation. I can generally be more direct with males than females. The men try to tough things out, and by the time they come to you their problem is so far along that it often takes time to get ahead of it. Ideal is somewhere in the middle.

As far as everyone being locked up, that isn't always the case. On both male and female yards, I walked through groups of inmates out in the open every day. It depends upon the facility as to how controlled internal movement is, but I can pretty much promise you that you will be among inmates in an open setting, whether it is walking down the sidewalk or walking through a housing unit. Real prison isn't like what you see on television.

Television news reports don't help either. They tend to use the phrase "behind bars" to designate any kind of incarceration. Bars haven't been used in cell construction for decades. My facility has bars on the crash gates between specific areas of the prison, but the cell doors are solid steel with a window. Reporters also tend to use the term "jail" to cover both jails and prisons, when they aren't the same thing. Jails generally hold people incarcerated for one year or less, those incarcerated for misdemeanors and those awaiting criminal trials for felony offenses. Prison is where convicted felons are sent after they leave jail. I won't even get into reporters' repeated use of the term "prison guards" for correctional officers.

Old habits die hard. Sometimes not at all.

DawnJ · May 10, 2015

I think a lot depends on the size of the facility. In small jails, the nurse can be IT for the whole population for many hours at a time. You do everything. I work in a large facility and there are about 50 on the health staff and we specialize: wound care, psych, sick call, intakes, emergency/urgent care, detox, med pass.

I don't like the units where it is a dorm set up because the guys get away with more in that environment. They can make a rude comment and not be held accountable because the voice came from an area with 8 or more inmates and of course nobody knows who said what. They also take advantage of proximety to pass contraband so it can't be found easily.

In general pop with 2 person cells and dayroom time, it is fine. The guys locked in 23 hours a day get squirrely, but I'll take Seg over the dorm anyday.