Correctional Nursing Questionnaire.

Eirene, ASN, RN · Nov 1, 2009

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

Nurse Ratched has been used when they disrespect or lie to me. Angel of Mercy when they are beaten just a hair of death or are gravely ill. It depends on the situation.

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

I really do not use any methods. I deliver healthcare. I ensure privacy. If they trust me- that's great. If they don't, that's fine, too. I never lie to them. I don't make promises that I can't keep.

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

Their crimes are not my business. I care for a few inmates whose crimes are very public on the news (a few serial killers, exceptionally heinous crimes). I try very hard to not let their crimes influence the way I deliver my care. I treat the inmates all the same and assume that they are all dangerous.

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

Believe it or not- most of them are very grateful for their healthcare. They are receptive to the teaching/learning process. Many of them never had healthcare before coming into corrections and view it as a luxery. Don't get me wrong- there are a few inmates who feel that medical is there to serve their every need. But a majority of them really do appreciate our help.

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

See #4.

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

My perceptions have changed drastically since becoming a correctional nurse. I now know what being a patient advocate is truly about. More often than not- we (nurses) are the ONLY advocate these inmates have in the world, even though we only advocate for their healthcare needs. We don't care what they have done- but we care about their safety. I feel empathy when a patient on death row has the flu; because he is a patient who is sick from the flu. They are a patient first and an inmate second. I believe with all of my heart that ALL people deserve healthcare.

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

For the most part- yes. However, I do not offer reassuring touch. I cannot put my hand on their shoulder when I listen to their lungs- any move like that can be misinterpreted as a sexual advance. I also use slang when it is needed to help them understand what is going on with their bodies.

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

I don't think it would be difficult- just different. I don't have to worry about press-ganey scores. I don't have to bend over backwards to make sure my patient gets dilaudid q1h. The strongest pain med I've given in prison is tylenol #3 and ultram. I can say "no" and mean "no" without worrying about hospital administrators. If one of the inmates gets loud or disrespects me- I terminate the appointment immediately and write them up for disrespect of staff. I can't do those things on the outside. I am less abused in prison than I was in the hospital.

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

The economy. I was put on-call more than I was working at the hospital.

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

NO! I thought it was very interesting when I did a rotation in nursing school- but I initially wanted to work in a critical care setting. Little did I know what corrections would offer me. I do a little of everything- including critical care until help can get there.

I love corrections. I do believe that I've found my little niche in nursing.

ellakate · Nov 1, 2009

Eirene, such a good answer! My answers are not as exciting, but caring for this population provides plenty of challenges. When I was a charge nurse a long time ago, we got a pt at change of shift directly from OR. The man had surgery for multiple cardiac knife wounds that occurred during a crime. The nurse who was to take that patient refused, because she could not care for him, knowing the history of his crime. Just what a young charge nurse needs at change of shift!

My answers --

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

Compassionate health professional

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

Outlining my role in their care. I was a radiation therapy nurse and floor nurse who cared for patients who were also incarcerated.

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

Yes I was aware. No, it did not affect day to day care.

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

Usually the same

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

Grateful for health care and that someone cares enough to help them.

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 was relieved to know that even those held against their will were helped.

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

I only have one beside manner, one size fits all.

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

Not necessary, I helped incarcerated patients who were receiving therapy in non-correctional environment.

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

Not applicable

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

No.

I hope that this can help your questionnaire. :specs:

Vito Andolini · Nov 1, 2009

eirene, such a good answer! my answers are not as exciting, but caring for this population provides plenty of challenges. when i was a charge nurse a long time ago, we got a pt at change of shift directly from or. the man had surgery for multiple cardiac knife wounds that occurred during a crime. the nurse who was to take that patient refused, because she could not care for him, knowing the history of his crime. just what a young charge nurse needs at change of shift!
my answers --
1.using the common nursing stereotypes (battle ax, angel of mercy, etc) describe your relationship with inmates.
compassionate health professional professional nurse; courteous, not too friendly, somewhat distant, yet for real; used humor when possible,
2. what are some methods that you use to build repore rapport and trust with inmates? see above; i helped them and was nice about it; i tried to remember that there, but for the grace of god, went i.
outlining my role in their care. i was a radiation therapy nurse and floor nurse who cared for patients who were also incarcerated.
3. are you ever aware of the charges being held against your patients, if so does that effect affect the way you care for them? i usually knew their charges, it did not matter in my work with them; i was nurse, not judge, jury, or cop;
yes i was aware. no, it did not affect day to day care.
4. how do the inmates inmates' attitudes and philosophy related to healthcare compare to non-inmates?
usually the same some of them seemed to play recreational sick call, that is, used the chance to get out of their dorm, pass messages or items to other inmates, probably garnered meds to sell or trade
5. can you explain the inmate culture as it relates to healthcare? some seemed to appreciate it, also see #4; some were demanding health care as their right, which it was; most were mellow;
grateful for health care and that someone cares enough to help them.
6. how were your perceptions of nursing changed or effected affected when you began taking care of patients that were being held against their will? i learned that the only thing that got corrected in a correctional facility was the nurse's perception that she or he was there to help.
i'm being cynical. it just was true that medical care was not the top priority in jail/prison. safety always came first, then getting inmates to court, then everything else. (and "everything" included food, laundry, showers, dorm cleanliness, exercise, classes, therapies, lawyer visits, medical care, and still more activities; we were sort of low on the authority's totem pole.)
i was relieved to know that even those held against their will were helped.
7. do you believe that the bedside manner you use with inmates would be appropriate in other fields of nursing? please explain. see #1
i only have one beside manner, one size fits all.
8. would it be difficult for you to acclimate to another field of nursing? what would you have to changed? do you mean "what would i have to change about me" or "what would i have changed to"? no, not too hard to acclimate. each job, each setting is unique, all changes require some adjustment.
not necessary, i helped incarcerated patients who were receiving therapy in non-correctional environment.
9. what events led you to becoming a correctional nurse? perhaps it was a leading from god.
not applicable
10. has it been your ambition since nursing school to be a correctional nurse? no
no.
i hope that this can help your questionnaire.

i hope this helps. good luck.

shell911rn · Nov 2, 2009

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

I think inmates tend to view female nurses as sexual objects who they can manipulate to do their bidding. I have heard an inmate or two call me Nurse Ratchett, but I also heard that one time when working in a public hospital.

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

The methods I use are 1) Don't promise an inmate you will do something if you aren't going to follow through with it (i.e. look in to why they haven't received a prescription and get back to them about what you learned) 2) Keep an open mind when they are discussing their medical problems and don't make fun of them if they can't write, spell, use foul language to describe body parts, or discussing topics uncomfortable to them 3) Even though a medical problem may not be an emergency to you, the nurse, it may be to the inmate so take them seriously and reassure them & 4) Educate the inmate on how to take care of themselves and their family in the future (especially when discussing communicable diseases) to show that you do care about their health. 5) Irregardless of how the inmate treats me, I will still make sure he/she gets the medical care he/she needs or request another nurse intervene if my nurse to client relationship has bee strained. The inmates respect this because I don't withhold medical treatment as punishment.

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 have been aware of the charges held against some of my patients, but I do not allow that to affect the care I provide them. I would be just as much a criminal as they are if I did. Florence Nightingale is my role model for the nursing care I provide to inmates as she cared for people most other people were unwilling to care for (the poor and sick) and was willing to do so even though it cost her her family's wealth and support.

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

An inmates' attitude and philosophy tends to vary depending on their age, socioeconomic status prior to coming in to prison, education level, length of time in prison, prison or jail system, etc. Inmates as a whole tend to be less educated about their chronic health care problems and the medications they take and are reliant on the health care staff to maintain their health instead of being pro-active. Their attitude is that the nurses and doctors should be responsible for their health, instead of us being in partnership with them to maintain their health. When their health isn't maintained, they tend to blame us, not themselves.

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

The inmate culture also varies. Some inmate's will wait until they are deathly-ill before requesting medical care while others will call for medical assistance for every fart or freckle.

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

My perception towards nursing didn't change as much as I became more of a patient advocate than I had ever been when working "outside the walls." I have had experiences that made me realize how scary it can be to be locked in a cell and at the mercy of C.O.'s to get you the medical care you need.

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

I can get away with saying things to inmates (not that I abuse this privilege, but sometimes I have to use foul language to get the point across to an inmate that I couldn't use in another setting) and being "real" with them in a way that I couldn't be when working outside the walls where it is more "customer-oriented." I often find myself playing the role of nurse and mother-figure, correcting behavior, teaching them, and providing them with advice on how to "fly right" and to take care of themselves. This bedside manner would probably be most appropriate in this setting, a psychiatric setting, and drug rehab setting. Because other settings are more customer and patient-oriented, I don't think this would be well-received.

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

One aspect of working "outside the walls" that I don't miss is the expectations of patient's family members. I don't have to deal with family members in the prison setting so I can focus on the patient. It would be difficult for me acclimate to having to contend with family again if I went to working outside the walls. I would probably work the night shift to avoid some of the issues I hated dealing with.

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

The hours, desire to work in a nontraditional setting, the benefits, retirement system, and pay led me to apply for a position as a correctional nurse.

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

It was not an ambition for me to work as a correctional nurse while in nursing school (I never considered it). I thought I would spend my career working in the emergency room. It has worked out well for me, though, as I once wanted to be a police officer. I'm now able to combine my love for nursing (including my interest in emergency nursing) with my interest in law enforcement.

NURSALICIOUS6801 · Nov 2, 2009

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.
my relationship with offenders was one built on mutual respect. i treated them the way i wanted to be treated
2. what are some methods that you use to build rapport and trust with inmates?
say what you mean and mean what you say. i didn't do favors for anyone but if they were ill, i got them taken care of
3. are you ever aware of the charges being held against your patients, if so does that effect the way you care for them?
once, i had an female offender that was in jail for allowing her children to be used in Media with animals and after i found that out, it made interacting with her tense
4. how do the inmates attitudes and philosophy related to healthcare compare to non-inmates?
some offenders tend to feel entitled to special care because they are incarcerated
5. can you explain the inmate culture as it relates to healthcare?
most offenders were gracious for receiving adequate care but some weren't
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. i had different regulations but that happens with different jobs in the free world
7. do you believe that the bedside manner you use with inmates would be appropriate in other fields of nursing? please explain.
i treat people the way i want to be treated and that usually works with people, period. incarcerated or otherwise
8. would it be difficult for you to acclimate to another field of nursing? what would you have to changed?
no. offenders are people that have been convicted. there are just as many criminals that haven't been caught and you see them every day.
9. what events led you to becoming a correctional nurse?
had a family member that was incarcerated and i wanted to see how inmates were cared for
10. has it been your ambition since nursing school to be a correctional nurse?
no. not at all. however, it was very rewarding
thank you so much for your thoughts and experiences!

correctional nursing requirs a secial kind of nurse. one that isn't going to judge the offenders and who is able to treat them fairly

egmiller · Nov 3, 2009

I'm really impressed by all of the wonderful responses! I would like to narrow my focus with a few additional questions.

1. Can you explain how you know once an inmate trusts you. What signs and behaviors of trust are most common?

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

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

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

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

Thanks again for everyones input. I appreciate all of your thoughts and considerations!

work&play · Nov 4, 2009

10. Has it been your ambition since nursing school to be a correctional nurse?
It was not an ambition for me to work as a correctional nurse while in nursing school (I never considered it). I thought I would spend my career working in the emergency room. It has worked out well for me, though, as I once wanted to be a police officer. I'm now able to combine my love for nursing (including my interest in emergency nursing) with my interest in law enforcement.

Same as me. I made it as far as LAPD academy then I hurt my knee really bad. I never whent back. The pain just whent away a year ago.

Jailhouse nurse · Nov 4, 2009

egmiller;3949174]hey, i'm[/b] 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.
i can be all of the above , but mostly try to be fair, firm, consistent, and follow the rules.
2. what are some methods that you use to build repore and trust with inmates?
respect-give it, get it. i'm not above reminding an inmate that they need to remember the manners that i know they were taught. and once they display the appropriate behaviour, i validate it immediately - works every time.
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 am frequently either aware of their charges, or can easily access the info. if someone has a charge of "assault on a healthcare worker" i'll probably watch them a bit more carefully. if their charges are particularly heinous, murdering of a child, or ___________ fill in the blank with your least favorite crime, i'll take a moment to compose myself, and remember what my job is.
4. how do the inmates attitudes and philosophy related to healthcare compare to non-inmates?
surprisingly similiar. some care about their health, others don't seem to-until their ability to function is impaired.
5. can you explain the inmate culture as it relates to healthcare?
much of the focus is on getting "extras"...extra food, extra blanket, bottom bunk, their own shoes, opiates, tylenol, psych meds (sometimes psych meds are traded for commissary items - ok, a lot of the time!). inmates learn how to manipulate the system in order to get their needs met. many times those needs are legitimate, sometimes they are not. (i'm unsure if i have provided the info you need for this question, please do let me know if i've missed the mark.)
6. how were your perceptions of nursing changed or effected when you began taking care of patients that were being held against their will?
one of my perceptions went from "the patient's pain is whatever they say it is" to 'let's look for the objective signs of pain, and factor those into the assessment! also, i was accustomed to providing my patients with whatver they wanted, whenever they wanted it. now, i have to make sure that it's medically necessary, and appropriate.
7. do you believe that the bedside manner you use with inmates would be appropriate in other fields of nursing? please explain.
well, i imagine that asking officer jones to remove inmate smith from the clinic 'cause he's being innappropriate won't fly in the private sector, however i do think that fair, firm, and consistent is (or should be) appropriate everywhere.
8. would it be difficult for you to acclimate to another field of nursing? what would you have to changed?
returning to the private sector, where abusing the nurse appears to be quite acceptable, would be very, very difficult. i don't tolerate abuse, either of my own person, or anyone else's, well. while i'm not sure i could change the way i feel about staff abuse by patients or family members, i would certainly have to change my external response to it. and perhaps start taking antidepressants!
9. what events led you to becoming a correctional nurse?
curiosity! i applied for, and was offered a position in corrections, and have been there ever since.
10. has it been your ambition since nursing school to be a correctional nurse?
heard about it in school, thought it sounded very interesting, and eight years later, got to go for it!
thank you so much for your thoughts and experiences!

hope this has helped you. please do contact me if i can clarify anything.

best,

mary

Eirene, ASN, RN · Nov 5, 2009

Can you explain how you know once an inmate trusts you. What signs and behaviors of trust are most common?

In my practice (and I may be a bit jaded)- the inmates who say that they trust me are often manipulators. It's the downside of the profession; we care for people who are criminals. A lot of them have anti-social personaility disorders. I feel that I am trusted for the most part, though. An inmate can share very personal information about their health (for example- sexual activity in prison) with me and know they will not be judged. They will ask questions and not be embarrassed.

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

After patient teaching I'll have them explain to me what they were just taught in their own words.

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

I was always interested in community health and infectious diseases. I also wanted to care for the less fortunate. Prison provides all of this.

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

Don't make promises you can't keep. Don't lie to them. Treat them all the same. Be firm, yet fair. Always be consistent. Welcome questions. Give good feedback such as, "Mr. R- your blood sugar has been great! I can tell you are taking your diet and meds seriously." Don't be fake. Be sincere.

Orca, ADN, ASN, RN · Nov 5, 2009

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.

shell911rn · Nov 6, 2009

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.