Corrections Vs. Psych Institution for the Criminally Insane

Posted

I've been doing my psych rotation at a state run facility for the criminally insane. It's been very interesting, to say the least. But all I can think about is ... how safe is it to work there? Is working at a regular prison safer?

For instance, one patient attacked an MD, broke his jaw and, despite the fact that the doctor has had multiple operations, he's still on disability after two years. There are 20 units at this facility and, there's a couple of particularly notorious units where many patients can still legally refuse their meds. A couple of years ago, there was a riot where the patients took over the nurses station and several staff members were beaten.

Apparently there was no time to call the few corrections officers who are stationed at the facility and, since there are so few of them, I'm not sure how much help they would be anyway. There's also been some scandals with psych techs who have had sex with patients, and this has happened on more than one occassion.

I'm just wondering if a regular prison would be safer. I've talked to some nurses who've worked both areas and they tell me that in a regular prison, most of the inmates are shackled when they treat them, unless the inmate is a low level offender. They also tell me there are correction officers everywhere, and that an officer is present pretty much every time you deal with an inmate.

As one nurse put it: if anybody gets out of line at a regular prison, they "go down" ... so to speak. At the psych facility, everybody walks around with a lot of freedom, they're not shackled and you don't always have the option to use force unless you repeatedly document it or, if things get really out of hand which, by then, could be too late if you're injured.

A prison sounds a lot safer to me but, I was wondering if other corrections nurses could confirm or comment on this.

:typing

Aurora

Aurora

62 Posts

Let me guess --- Atascadero?

mommy2boys

mommy2boys

161 Posts

My DH is a correctional officer and he said that it is much safer to work in a prison. When you have any contact w/ an inmate 90% of the time you have an officer w/ you. The 10% of the time that you are alone the inmates are low risk and an officer is w/i ear shot.

He hasn't worked in a psych instition so he can't speak from experience, but he does know that you will have more one-on-one interactions. He says that the inmates are just as dangerous (if not more) as an inmate in prison.

If you want to work in an institution you should take some classes on defensive tactics (to protect youself in need be) and make sure the inmates know that you are not intimidated by them. He says that some inmates will feed off your reactions to them. If you act scared, they will use that against you to get what they want. If you act confident, they will not be as likely to start things with you.

This is a very personal choice, it is something that you need to think through. Where every you work you need to take some extra classes on how to deal with inmates and how to keep yourself safe. Remember, these people are in jail/prison for a reason, so it is important to keep your eyes and ears open when dealing with inmates.

JMO

Erin

Sheri257

Sheri257

3,905 Posts

If you want to work in an institution you should take some classes on defensive tactics (to protect youself in need be) and make sure the inmates know that you are not intimidated by them. He says that some inmates will feed off your reactions to them. If you act scared, they will use that against you to get what they want. If you act confident, they will not be as likely to start things with you.

This is a very personal choice, it is something that you need to think through. Where every you work you need to take some extra classes on how to deal with inmates and how to keep yourself safe. Remember, these people are in jail/prison for a reason, so it is important to keep your eyes and ears open when dealing with inmates.

JMO

Erin

Thanks. IF I decide to do this, I was already planning on taking several self defense courses, not just one. I want to be totally prepared if something goes wrong. And, I think it would also boost your confidence, which probably goes long way toward detering problems.

:typing

beochicken

beochicken

41 Posts

Most of the dangerous elements in hi-security psych have a lifetime of experience when it comes to dealing out damage. Although physical fitness and some classes in basic self-defense might help you in a confrontation, chances are they wont if youre mindset isnt right. If you are serious about wanting to learn self-defense that is appliccable in a psych setting i would start regular training (two times a week) in a training centre that teaches aikido, judo or ju-jitsu (A lot of the other martial arts have a tendency to be based on kicks or punches, which doesnt make your state bon very happy)

Sheri257

Sheri257

3,905 Posts

If you are serious about wanting to learn self-defense that is appliccable in a psych setting i would start regular training (two times a week) in a training centre that teaches aikido, judo or ju-jitsu (A lot of the other martial arts have a tendency to be based on kicks or punches, which doesnt make your state bon very happy)

So if you use kicks and punches in self defense, you can still get in trouble with the BON? What if you're working in a prison versus a criminal psych facility. Does that make any difference in how they view the situation?

:typing

sampaul1966

sampaul1966

12 Posts

Do nurses in the usa learn restraint techniques ? I work in a secure hospital in the uk & we do. I'd feel unsafe otherwise

jen42

jen42

127 Posts

Heck, I worked in a residential locked psych facility for teens- not criminally insane, just mental health diagnoses- and got assaulted all the time. I work in a jail for a few shifts a month, and I'd say it's safer than your basic ER. Always CO's around when inmates are out of their cells, plus they know if they mess with medical staff, they're getting sent to the hole and most likely getting their sentence extended. I've been verbally abused, and sexually harrassed to a point, but nobody's ever touched me violently. If an inmate has any history of attacking staff, or is an ultra-security, they are shackled. I guess they could conceivably bite you, but even working the psych unit, I've never had anybody try anything like that.

I would never, ever work in a facility for the criminally insane. I would be too worried about being attacked. It takes a very special and very brave person to do it, and if that person is you, I commend you for it. And if you decide it's not for you, I commend you for making the right decision for your career, too. :)

tirzo13

tirzo13

136 Posts

Both are dangerous.

at a Psyc hospital, they "patient" may not know why he is beating or raping you.

at a prison, maybe you did not give him his narcotic because he was at visiting and its 2 hours past the cutoff. so he plans to attack you.

maybe he's pissed because the doctor DC'd his med, guess who he will attack?

you can also have psyc patients at a prison, and non insane patients at the mental health facility, though maybe they convinced someone they are crazy.

I spent some time at a state mental hospital, and now work at a prison.

in the prison you have big officers with equipment to help if the inmate is beating you.

in a state prison you have petite staff members to help you when you are getting beat, if they are even around to help.

your family will be more scared if you work at a prison but it is way safer.

nomadicV

nomadicV

17 Posts

I've worked both and agree that prison is safer. The focus is on security, in mental facilities the focus is on treatment, security is important, but not the reason for their existence. If this is indeed your overwhelming concern, however, prison is not the place for treating mental illness and the MI in prisons is quite high.

docpsychrn42

docpsychrn42, ASN, RN

Specializes in Peds and Forensic/Mental Health/Correct. Has 25 years experience. 1 Article; 21 Posts

i worked in a maximum security forensic hospital for 7 years and i am working for a prison now. i can't tell you how much better it is in the prison! i suffered many concussions, broken nails, human bites, hair pulled out, knee and back injuries etc during my 7 years at the hospital. i have been with the prison system for almost 3 years and have never even been touched my another offender. prison emphasizes sercurity and the hospital for the criminally insane emphasizes treatment. i felt that the criminally insane were treated better than your average mentally ill person off the streets! they always had the best medications, the best clothes, the best meals, parties etc. you certainly don't see that in the prison system. in the hospitals you find that your mental health staff is more concerned about the patients and their rights than you. if you try to defend yourself in a fight, you are at risk for being fired and losing your license no matter what the cause was. personally, i feel that the prison system is the best option for working with forensic clients. the security is so much more prominent and i have never felt safer. let me tell you, if a patient in the hospitals tries to kill you....they get maybe 4 hours of restraint time and a 24 hour priviliege restriction (no smoking). if a prisoner tries to kill you or even harm you in any way, they get 5 years added to their prison sentence. a huge determent to their acting out. i could tell you some horror stories of my 7 years in the hospital for the criminally insane! i am very happy where i am at and wouldn't change back for nothing. :nurse:

Michaelpro

Michaelpro

2 Posts

i worked in a maximum security forensic hospital for 7 years and i am working for a prison now. i can't tell you how much better it is in the prison! i suffered many concussions, broken nails, human bites, hair pulled out, knee and back injuries etc during my 7 years at the hospital. i have been with the prison system for almost 3 years and have never even been touched my another offender. prison emphasizes sercurity and the hospital for the criminally insane emphasizes treatment. i felt that the criminally insane were treated better than your average mentally ill person off the streets! they always had the best medications, the best clothes, the best meals, parties etc. you certainly don't see that in the prison system. in the hospitals you find that your mental health staff is more concerned about the patients and their rights than you. if you try to defend yourself in a fight, you are at risk for being fired and losing your license no matter what the cause was. personally, i feel that the prison system is the best option for working with forensic clients. the security is so much more prominent and i have never felt safer. let me tell you, if a patient in the hospitals tries to kill you....they get maybe 4 hours of restraint time and a 24 hour priviliege restriction (no smoking). if a prisoner tries to kill you or even harm you in any way, they get 5 years added to their prison sentence. a huge determent to their acting out. i could tell you some horror stories of my 7 years in the hospital for the criminally insane! i am very happy where i am at and wouldn't change back for nothing. :nurse:
:idea:the state of nc is considering the privatization of it's facilities for the criminally insane. currently a private company is considering placing such a facility in high point, nc. it is called a hospital yet has the characteristics of a prison. it is being considered a prison by residents and businesses in the area. the treatment of the criminally insane seems to be different in the institutional (hospital) setting vs. the correctional (prison) setting. are medical personnel safer in the prison setting or the hospital setting. how is the surrounding community and residents effected with either setting. does it blight the area and slow economic development. does it put residents in danger. do both settings need to be in an isolated area. for those who have worked with the criminally insane and been in these settings comment on experiences and what would be best for medical personnel working with the criminally insane and residents living in close proximity. also feelings about privatization.:cool:

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