Correctional nursing role..nurse or police?

SoloWytch · Jan 1, 2008

No, I don't think it's necessary to give up caring about your patients. It is, however, necessary to always remember that you have to keep more of a "distance" in your caring. (Not sure I'm going to be able to explain what I mean here...)

You have to have definite limits, and maintain them at all times. You have to make sure you apply the same rules and standards to everyone. (They will try to get you to make exceptions for them.)

Do you have to be rude? No, but you have to be firm, and they'll think it's rudeness. For instance, we're not allowed to give any kind of medication unless they have an order for it, and that includes motrin, tylenol, etc. One of the inmates who is new to my med pass (and hasn't learned yet! *L*) kept asking me for a motrin. I explained that without an order, I couldn't give it to him. "The other nurses did." (I love that line! If I had a penny for every time I've heard it in the last year I could retire!) Repeated the explanation. He swore and stalked off. Next med pass, same inmate, same scenario. Next med pass, it started again. I explained we'd already had this conversation, the answer wasn't going to change, and told him that that was the end of the conversation. Rude? No. Firm, setting and maintaining limits, and not letting him win the power game.

And they will run games on you. You'll probably fall for some, but you'll learn, either by trial and error or by guidance from more experienced nurses. (I've been very lucky in that regard.)

They will make you mad; they will make you laugh. You will like some and you will want to slap others upside the head. Keep in mind that they are there for a reason. Keep in mind that they are human beings.

It can be a balancing act, and some days you don't hold it all together like you think you should. When you lose it, just take a deep breath, try to shake it off, and go on to the next, trying not to let it affect you. (Hmmm... sounds like nursing in general there, doesn't it?)

Anyhow, I still think this is the most fun job there is, so don't let the burned out nurses from your clinical rotation put you off. (It does sound like they were burned out. I get like that when I work too many days in a row.)

RocknRollYogaRn · Jan 1, 2008

Not all nurses act like that.

Please don't put us all in the same boat.

There are a lot of miserable people, however, that work corrections including custody and medical staff. I have been in corrections for a little over 4 years now and the biggest complaint I have is the staff not the inmates, but I still say it's better than working in the hospital.

Eirene, ASN, RN · Jan 1, 2008

i precepted at a max-security prison here in ohio. i loved it! the nurses were exceptional-- i learned more in assessment abilities than anywhere else i had precepted.

the nurses had a wicked sense of humor and were hilarious. they treated the inmates with respect (except for the ones in the "hole"-- they were some bad boys!). safety is the #1 goal for corrections and you can't place your hand on shoulders, etc. because the inmate may think of this as some kind of affection (from what i was taught).

the nurses i worked with had been there ranging from 4 years to 25 years. i plan on getting into corrections one day.

anyway, i think it all depends on the personalities of the nurses and if they're burnt out or not. my experience was that they were much more pleasant that most of the ones i've encountered on a med-surg floor!

good luck in the rest of your schooling,

dani

ArizonaMark · Jan 2, 2008

Well, I have been in corrections for just a little while now. I presently work in a jail that houses up to 2K inmates.

I have seen the poor treatment, the humiliation and the lack of respect doled out by all staff including nurses. I am NOT one of them. I don't give a rat's a$$ what these people have or haven't done. I am there to treat them medically, professionally and without judgement. Is that easy, no. But every day I try.

Imagine, you've been arrested for the first time in your life. Perhaps you have a good job, family, community ties on the outside. Now you are faced with perhaps the biggest loss of your life, the loss of who you are, who you were. That's what many, not all, but many of these people face.

Is it not enough how much these people will suffer for the alleged crimes they may have commited (may have as I work in a jail, thus they have not been convicted)? As a nurse, I may be one of the few persons who actually gives a damn about how they are doing, are they well, will I actually believe them when they say they are sick.

I have seen good people in this business and I have seen bad. I choose good, and my patients, er, inmates are by and far grateful!

Mark :smiletea2::loveya:

Nrsndlz1 · Jan 3, 2008

I have worked in correctional nursing for 10 years and it has been an awesome job. I've dealt with all types of personalities with both staff and inmates. I treat all my patients with respect even when I do not get it in return. Many inmates thrive on "pushing your buttons" and are highly entertained when a nurse "loses their cool". There are definite boundaries that have to be set as there are those "predators" out there. These guys/gals have a lot of time to watch the staff and figure out ways to out smart them. I love the assessment aspect of the job because their is such a wide range of diseases, acute illnesses, mental health emergencies, and add a few behavior issues in with that makes it even more challenging! I myself use humor to survive the manipulative behavior. Please do not judge all correctional nurses by a few negative interractions. It is a great field!

**nurse** · Jan 3, 2008

I will never forget my first day doing sick call at prison, where I sat next to a nurse who repeatedly told inmates, there's nothing wrong with you, find God, get out. No assessment. Scared the hell out of me!!! In report, they all sat at the table and discussed sick call slips and infirmary patients, making fun of them and concocting ways to stop them from winning the game. I couldn't believe what I was seeing.

Good thing I hung in there. I found that a great deal of that is facade. I developed a motto that went, we give great care but we don't have to be nice about it. And holy moly, there are even times when you can be nice. Gotta get your bearings and learn the ropes. There is also room for all different styles of nursing, and like every other facility in the world there are different levels of competency and integrity within the staff. I've seen every bit as horrendous stuff go on in LTC.

I think most staff in prison go through a development of their prison persona...too soft to too hard, too gullible to too cynical, and if they stay they hopefully mellow into someone fair but firm. Sometimes they do harden into pretty evil, the ones that never toughen at all usually don't last. Although we've had some sweet and gentle ones that you would never dream could survive stay and thrive, including one little old lady who RV'd half the year with her retired husband. Drove us crazy with her little old lady dithering and honey and sweetie stuff, but she DID function and could get the job done. No one took her hostage or conned her out of too much.

My daughter is a nursing student now, and she described her OR experience with exactly the same horror you have for corrections. But I can describe incredible experiences of staff giving from thier heart, giving beyond what was expected, for a patient at prison as well as LTC and dialysis. Sometimes so quietly that no one notices. Sometimes with that same not mattering look on thier face. Sometimes they are making big bad noises while going day to day giving exceptional care. In prison and the hospital and the nursing home and the ER, OR, rehab unit.

nursinunderpressure · Jan 9, 2008

I have just joined this site and I was reading the posts and was prompted to join and post a reply. When I started working in a prison I had no idea if it would be me for me or not, and we all know there are nurses that are great nurses, but correctional nursing isn't for them. I, too, watched staff scream, yell, and do things I could never see myself doing. I learned something on my own, R-E-S-P-E-C-T. I found you can be firm and still be respected. Where I work, respect is very important to our prisoners. They want you to respect them, so I made it clear to those that I had to, that if respect is wanted then it must be given. I found this works alot better than yelling, screaming, etc. Usually, when I do have a problem with a couple of them, I tell them that they have disrespected me. And, I seem to get better results than the other staff that scream, yell, etc.

loveylilly · Jan 12, 2008

I totally agree with SoloWytch....U must be firm and consistent in correctional nursing...u cant be the same caring way with them as u would in hospice,geri,etc...but u can treat them with respect and demand the same....if to caring they will mistake that for affection...i worked corrections for 6.5 years as a nurse with all boys from ages 13-21 it was a wonderful experience but you must definately be on point at all times...remember all nurses are not the same:saint:

vwarelpn · Jan 12, 2008

i have been a correctional nurse for 10 years and i love it!!! I have been a nurse 33 yrs and have worked all facets of nursing. the old saying goes give respect get respect rings so true with correctional nursing. i stay firm with each inmate male or female and treat them all equally. i listen to their concerns no matter how small the complaints are. we assess our inmates when they come into our facility and they know first hand that they are to respect us as professionals and we will do what we can within reason for them. we dont tolerate disrespect nor do we disrespect the inmates. i tell them if they r yelling and being disrespectful that i will see them once they calmed down we also explain the procedures for them when they arrive at the jail so they know what to expect from the medical staff. we diagnois many illness from new diabetics to severe cases of anyuersyms. so that is why its so important to listen to them.its nice going to work when i get to work all these inmates request to see me. i let them know from the start im not afraid of them but there to listen and respect them as human beings isnt that the reason i became a nurse correctional nursing is like home health in many ways. we do assessments , help inmates with chronic problems. my motto is to keep them at thier optimal level of wellness till they go home.:paw::paw::paw::paw:

tirzo13 · Feb 3, 2008

During my school rotation we did clinical training in a California state prison.
Although my time was brief, perhaps 3 weeks, this was the impression I came away with:
The nurses at this prison, including the DON, represented everything I believe nursing is not. I had the impression most of the nurses there were correction officers with a stethoscope. They enjoying humiliating
the inmates and being generally disrespectful and rude.
They repeatedly told us ( the student nurses) what terrible human beings the inmates were, deserving of no respect, that they were predators....and I kept thinking the only terrible I could see was the attitude of the nurses.
On the other hand, I met a nurse once that worked per diem at our hospital and regularly at a county jail. I really liked her and she was a terrific nurse, although I did only work with her in our hospital setting.
I have decided to reconsider the role of nursing in corrections...
So my question/concern.....is it necessary to give up caring about your patients in order to do correctional nursing? Is it necessary to be routinely judgmental towards someone for circumstances you really know nothing about? As nurses, isn't our role there to well....be a nurse?
I came away feeling it was the nurses not the inmates that I was most concerned about ( I've left out details of situations I observed)

I tend to agree with you, though i have only worked in California prisons, not out of this state.

So perhaps we see the same things.

Sure not all are like that, just like not all officers are .......?

There is good and bad everywhere, i just seem to notice a hell alot of the bad staff at the prisons compared to any place else i have worked.

MadisonsMomRN, BSN, RN · Feb 3, 2008

No, I don't think it's necessary to give up caring about your patients. It is, however, necessary to always remember that you have to keep more of a "distance" in your caring. (Not sure I'm going to be able to explain what I mean here...)
You have to have definite limits, and maintain them at all times. You have to make sure you apply the same rules and standards to everyone. (They will try to get you to make exceptions for them.)
Do you have to be rude? No, but you have to be firm, and they'll think it's rudeness. For instance, we're not allowed to give any kind of medication unless they have an order for it, and that includes motrin, tylenol, etc. One of the inmates who is new to my med pass (and hasn't learned yet! *L*) kept asking me for a motrin. I explained that without an order, I couldn't give it to him. "The other nurses did." (I love that line! If I had a penny for every time I've heard it in the last year I could retire!) Repeated the explanation. He swore and stalked off. Next med pass, same inmate, same scenario. Next med pass, it started again. I explained we'd already had this conversation, the answer wasn't going to change, and told him that that was the end of the conversation. Rude? No. Firm, setting and maintaining limits, and not letting him win the power game.
And they will run games on you. You'll probably fall for some, but you'll learn, either by trial and error or by guidance from more experienced nurses. (I've been very lucky in that regard.)
They will make you mad; they will make you laugh. You will like some and you will want to slap others upside the head. Keep in mind that they are there for a reason. Keep in mind that they are human beings.
It can be a balancing act, and some days you don't hold it all together like you think you should. When you lose it, just take a deep breath, try to shake it off, and go on to the next, trying not to let it affect you. (Hmmm... sounds like nursing in general there, doesn't it?)
Anyhow, I still think this is the most fun job there is, so don't let the burned out nurses from your clinical rotation put you off. (It does sound like they were burned out. I get like that when I work too many days in a row.)

I totally agree. I really dislike the ones that treat them all like crap. I had issues when I first started correctional nursing I had a hard time with the security and safety.

I am definitely not like those nurses you had the joy of experiencing. We are not all like that :)