Prison Nursing....Is it safe?

Sheri257 · Aug 3, 2007

BE RESPECTFUL. There is a big difference between respectful and friendly. I treat all of the inmates I come in contact with as human beings without carrying on conversations with them or allowing personal information to leak out. I address all inmates by their last names (as in "Mr. Smith"), ask them how they are doing today, and thank them for their time when our sessions have ended. If an inmate I've helped in the past says "'sup man" when I walk by, I simply say, "good morning, afternoon, etc" and keep walking. I see WAAAAAY too many medical staff being downright rude to inmates when there is no need (power trip?). That type of behavior, over time, could get you "green-lighted" real quick.
To go along with the respect notion: always keep your word and 'fess up for mistakes. If you told an inmate that he would be placed in MD Line or that you would look in to his missing meds, then do it. If you forget and they call you on it, 'fess up and say that you will still look in to the matter. Again, being a truthful individual not only boosts the image of medical staff, but builds respect.

That is a great idea and sounds good but, just because you treat inmates with respect, doesn't mean they'll always do the same. Don't get me wrong ... I don't go out of my way to be rude to inmates but, some of these inmates can really try your patience. Just a few examples:

One inmate's medication was delayed because pharmacy needed clarification on the order so, I had the MD rewrite it. I had already taken care of it and the medication was going to be delivered that evening but, when I tried to explain this to the inmate, he didn't want to listen to the explanation or the fact that the medication was on the way ... he just started yelling at me so I had custody escort him out.

Another inmate complained about not receiving his medication that morning so I went to check on it. I told him I would resolve the problem but I had another inmate to attend to (one who was asthmatic and really sick). All I needed to do was get the breathing treatment started and then I would get his medication but ... instead of giving me a couple of minutes to resolve the issue, he became violent and threw a temper tantrum in the tank. I ended up having to write him up for disciplinary action.

Then you get these situations where a bunch of inmates want A&D ointment (we don't give it unless their skin is really peeling) or ... where they're trying to get stuff for free that's available in canteen. When you tell some of them no ... they have to pay for it at the canteen ... they can get downright angry and hostile.

In a lot of ways, you're dealing with children who have no impulse control which, of course, is why they're in prison to begin with. I've never overtly lost my temper in these situations but, I have to admit I sometimes get very frustrated and irritable and am sometimes short and gruff with the inmates ... especially when it's a really bad day with a lot of the above mentioned incidents.

soonahchick · Aug 9, 2007

Hello,

I spent several years working in the correctional nursing field - RN level in a state prison as well as the local county jail. First off let me say that correctional institutes will hire anyone who has a clean criminal background and no restrictions on their licenses because they are desperate for help! Second - the medical departments in the correctional institutions are breeding grounds for shady activities and a great place for incompetent nurses to hide! I am not implying by any way shape or form that all nurses who do correctional nursing are incompetent as I worked with some very capable nurses who provided excellent care, so do not misunderstand what I am saying. But, unfortunately you will most definately find a few nurses in this arena who should not be nurses period. But, because it is so difficult to get good nurses to work in this field the medical managers are reluctant to get rid of anyone and they tend to be far more lenient with mistakes than they would be in a normal medical setting. The end result.....watch out for your hard earned license because there will be times when you will think you are holding it out there with a lit match underneath it!

On the positive side - you will never ever be left alone with any prisoners. The Correctional Officers will always have your safety in their best interest and you will always have one or two with you! They are very attentive to the medical staff and rely heavily on your knowledge and expertise as a health care professional!

You must have a great deal of autonomy, street smarts and good assessment skills. The prisoners are famous for faking heart attacks, seizures, and fractured bones, but also famous for very real suicide attempts and violent fights. They will hoard medications and fight with you in med lines and always enjoy intimidating new nurses. But what you really need to be careful of are those few nurses who steal narcotics or other types of drugs because that is the real danger. Most prisons or county jails are not regulated by their State therefore they do not get surveyed and they are not held to the same standards as other facilities thus making it easier to do underhanded activities.

So - word to the wise - think twice before entering this field! Your best bet is to get some good old fashioned med surg nursing under your belt!

lauftrbstmedicine · Aug 9, 2007

i have worked at a correctionals facility before and i must tell you this...i was falsely told the facility had cameras to help with the safety issue ....well, after working there a few days a seasoned inmate nicely pointed at the camera in the corner and stated with assurrance it did not work, after he left and before the next inmate called in i stepped up on my chair and did a closer inspection of the so-called camera and found it empty of electrical engineering and the camera! when i questioned the rn and sheriffs office about being told there was cameras for security and my safety i was quickly intimidated by them and was told that the system was antique and the county could not afford to put cameras everywhere and i should stop being nosey!!!! i had been given a tour of the facility and had been shown all the security cameras in place prior to accepting the position. after this incident i went to the control room and asked to see where the "working" cameras were located...shockingly they were not in any of the areas i was expected to be with inmates...and because of the 'short staffing' of deputy-jailers i often was left alone with inmates in hallways-portal entrances/exits where i could have been hurt if the inmate had chosen to act then. i left after two accounts.....first: a day came whenever the 'shortstaffing' was known by every inmate in the facility except me...one guard for two seperate tanks....so as i made rounds i discovered i still would have noone in the nurses area with me..this was typical...usually the door is left open and the guard who is also monitoring his tank of about 100 inmates attempts to keep an eye on what is going on with me and the inmate i am with, but you see he is in a locked box a few steps down from my open door and cannot see clearly inside where i am....so this male inmate had returned from state to be a witness at another trial knew this (he had been held there before) and during confusion of yard-out, bible-study and meal time a stream of inmates would flow by my open door...this male inmate choose an oppurtunity to pop in and went unnoticed by the one guard (who could not possibly keep track of all those inmates in file) he quickly had the door shut and on top of me before i could react. he told me he had not "been with a woman for over a year and i would have to do"......i yelled out but with the thickness of the walls, the chaos and the confusion outside, and the noise from the tank and the jailer in his box----noone heard me! i reacted by instinct then and only weapon i had was my pen in hand and the knowledge of kicking a man where it hurts...i held my pen like a dagger at the guys chest and continued to call out...he continued to leer ugly remarks and move onto me....luckily...a guard returning from break from another tank coming to relieve the other guard so that guard could have a break decided to take a short cut thru this area and came in and took the inmate down. i was shooken up, frightened and relatively unharmed. a report was filed. if the camera had been working, the officer in the control room would have seen the events and sent me help but i believed god intervened on that and i was spared being raped. the second event took place at christmas time...somehow a large quantity of a controlled substanced was smuggled in and the entire tank of men were planning an evening of fun......all except one inmate who would not go along.....then they decided they could have more fun by using the 'shortstaffing'in their benefit....most of the inmates were aware that after 5pm there was only one nurse on duty for the entire jail.....their plan was to lure the nurse into the tank due to a stricken down inmate who could not safely be moved and while crazed on this drug attempt a hostage situation with me as the hostage.....the inmate that would not agree was able thank god to get out of the tank of men before he could be given a fatal overdose and have me called in to be used as a hostage. yes, the tx rangers came in and got control of the situation after it was alerted that these events were being planned by the inmate who was able to get a 'sick call' to me and alert the sherriff of the planned event. he had been drugged but luckily those inmates did not strike him down as planned. i decided then and there enough was enough and quit!!!!!!

i don't know how all jail systems work but i can say 100% that the county i was working for was corrupt and negligible in security and safety! i was never issued a walkie-talkie since the ones medical had were outdated and on a different frequency than the guards and i was never told i could carry a whistle...i was new to the correctional scene and i never saw any of the other medical team with any of those things either.....geez...was i naive!!!!!!!!

so be safe. also, i would like to agree with the above remarks: the time i worked at that facility i witnessed a handful of shady nurses...nurses that drank alcohol while on duty and stole medications and even an imposter nurse and nurses that should have never been given a license because of incompetence...thankfully an attentive rn and the few of us caught on quickly to those persons and unfortunately they were alllowed to move on (except the imposter). you have to be careful of the inmates, quiet-about yourself never tell them your full name and where you live or any personal demographics....and too many inmates can work the medical system and are good actors at faking....you have to stay on your toes and be watchful and mindful.

Notmywil · Aug 11, 2007

I've been a nurse for 21 years and I've never had more job satisfaction than since I've been working in a prison. I've done public health, labor & delivery, acute care, LTC, Hospice, specialty practice in wound care....and my final stop before retirement is corrections. I would have come to corrections sooner, but if you were older than 37, that was too old.....until they got a waiver for health care professionals. I believe the average age for nurses is still around 42-43. Regarding safety...at any hospital I've ever worked, security was inadequate. Not so in a correctional setting. In the hospital setting, you have mostly female nurses do the lifting and tugging. In male prisons, you have male inmate workers who do this. These are the same inmates who spend their free time in the rec yard doing weight lifting! What a great way to put their strength to good use! :wink2: Thankfully, I can actually concentrate on nursing--but with the dual role of corrections. Furthermore, I find the inmates as a whole appreciate the care provided to them by nurses. I came to prison expecting to provide the same quality of care I would try to give any patient, regardless of the practice setting. Respect is a huge issue in any setting, but even more so in prison. I came to the prison nurse role without judgement in mind. The courts have already done that. I have made my share of mistakes as well.....mine just haven't sent me to prison. I always ASK my inmate workers to help me and they are always pleasant to me in return. So we have a mutual respect for each other.........but I still don't forget that I work in a prison.

Fortunately I have maturity working to my advantage. I don't smoke, don't do drugs, and didn't come to prison to find the love of my life! You may find it amusing that I mention this, but in prison, these can become even bigger issues because inmates can use these things to manipulate staff. I've worked with all kinds of personalities throughout my years of nursing, and this has helped me weather the storms as well. Every day has its new set of challenges; it is never boring working in corrections!

avalon1946 · Aug 11, 2007

prison nursing can be dangerous. i think your husband is right. why not work somewhere where you dont have to worry if a riot breaks out and your caught in it.

Sheri257 · Aug 11, 2007

Maybe I am the only one that doesn't know what this means but, can you please explain this?

At CDCR, if a telephone is off the hook for a certain period of time (I forget how long ... 30 seconds maybe?) ... an alarm goes off and custody comes running.

So, that's why it's best to deal with inmates near a telephone. If you're attacked you can at least knock the phone off the hook and help will arrive.

:typing

TrudyRN · Aug 12, 2007

I think a new nurse needs hospital experience first.

As for safety - you must always follow the rules. Do not give chicken to cats or mess up with prescriptions or be alone with inmates, even the trustees - especially the trustees.

The inmates' job is to find ways to compromise you. They largely have nothing to do but find ways to break your heart, get you to make calls for them, deliver mail or packages for them to someone outside, give them vitamins so they can sell them, get food for them from the Officers' Mess, tell them your personal matters, or otherwise get their hooks into you. DO NOT FALL FOR THIS. THEY ARE IN PRISON FOR A REASON - AND, WHILE SOME THERE MIGHT BE INNOCENT, LARGELY THEY ARE GUILTY AND YOU MUST KEEP PROFESSIONAL DISTANCE. YOUR LIFE MIGHT DEPEND ON IT.

Be courteous, help them, be nice, have a couple of laughs if possible during your work day but do not cross the line.

And, never, ever, ever, never upset the guards. Ever. They can make your life hell. If you are in a tight spot, you want them to help you quickly, not take their sweet time deciding to get up and go help you, while the inmates are raping you, abducting you, beating you, or worse. You must always be on the side of law enforcers, at least, they must think you are. It doesn't mean you have to be ugly to inmates. It does mean you might have to "not see" some things that might go on. Try hard to never embarrass or offend your boss, your peers, the guards, the inmates. Just be courteous, quiet, and do your job. It also wouldn't help to pal around outside of work with the powerful people on your job.

You must understand this - in a riot situation, in a real crisis, the officers are going to take care of themselves and their own before they help the inmates who are not involved and also before they help you and other civilians. Simple fact of life. The inmates seriously outnumber guard staff. Try to have at least some decent relationships with them and some of them might try to help you during a crisis. But honestly, in a real crisis, you're pretty much on your own and you can pretty much kiss your life goodbye. That's a sad fact but true, as I see it. The officers must protect themselves and other officers first and there just aren't that many of them, even if they bring in local police, sheriff, marshals or even the state militia/national guard for backup. They will try to help you but you are not their first priority and that's just the truth.

BTW, the officers don't just shoot at anyone standing or wearing a certain color. They are trained in how to handle these things. Not saying they might not go berserk or make a mistake but that would be the exception, I would think.

Prisons are filled with mentally ill persons and with criminals. The inmates are not there for doing something a boy or girl scout would do.

Also, in a prison, you will have people for years and years, maybe life sentences or Death Row. You must find a way to get along with them, which is not always easy.

Get some hospital experience, get some Psych experience, work in an outpatient clinic that sees STD, OB, all the specialties, ENT, Derm, diabetics, HTN, lots of variety. Most prison work is probably ambulatory, although some prisons do surgery, have inpatients, chemo, AIDS, maybe vents - probably not ICU.

Best wishes to you.

ThisNurseIs · Aug 12, 2007

your work day but do not cross the line.
And, never, ever, ever, never upset the guards. Ever. They can make your life hell. If you are in a tight spot, you want them to help you quickly, not take their sweet time deciding to get up and go help you, while the inmates are raping you, abducting you, beating you, or worse. You must always be on the side of law enforcers, at least, they must think you are. It doesn't mean you have to be ugly to inmates. It does mean you might have to "not see" some things that might go on. Try hard to never embarrass or offend your boss, your peers, the guards, the inmates. Just be courteous, quiet, and do your job. It also wouldn't help to pal around outside of work with the powerful people on your job.

Everyone here has been so helpful. I started with the women's prison 2 weeks ago and the mountains of advice are worthy! I was stunned after I was hired to hear what can happen to you if you report a guard for abusing an I/M. This is what terrifies me more than anything.. I worry that if I did get wind of someone being abused, I wouldn't be able to report it, otherwise my safety would be compromised. What does anytone think of this? :madface:

VegRN · Aug 13, 2007

Everyone here has been so helpful. I started with the women's prison 2 weeks ago and the mountains of advice are worthy! I was stunned after I was hired to hear what can happen to you if you report a guard for abusing an I/M. This is what terrifies me more than anything.. I worry that if I did get wind of someone being abused, I wouldn't be able to report it, otherwise my safety would be compromised. What does anytone think of this?

Is this the standard? Nurses having to refrain from reporting an officer for abusing an inmate, in order to protect their own safety??

The facility I work at jumps when the nurses have a complaint about the officers. They do not want a lawsuit or any negative attention given to them by the media if something were to happen.

I don't think I could work at a facility where a nurse would have to look the other way when an inmate/pt is being mistreated by an officer. (3 years in at my facility). People wouldn't describe me as an "inmate lover" either, I am firm but fair. Trudy's description of this makes me truely sad.

Have other corrections nurses experienced this too?

Sheri257 · Aug 17, 2007

But honestly, in a real crisis, you're pretty much on your own and you can pretty much kiss your life goodbye. That's a sad fact but true, as I see it. The officers must protect themselves and other officers first and there just aren't that many of them, even if they bring in local police, sheriff, marshals or even the state militia/national guard for backup. They will try to help you but you are not their first priority and that's just the truth.

When I was working at a private prison where profit was the priority, not security then ... I would agree with you. But since I've been working for the California state prison system ... I've seen the exact opposite of what you're describing.

I'm constantly impressed with the officers in my facility. For one thing, they don't let a crisis develop. If there's a threat ... they put it down, and they literally put it down within seconds.

Every time I've been on a unit where an inmate gets out of hand, you don't even have a chance to see what happened most of the time because the inmate is already on the ground. The alarm goes off and literally, the second you look up ... the inmate is down.

Just the other day I was walking by the entrance where they were escorting an inmate who started to fight against the officers in the entrance hallway. The CO's literally jumped on top of this inmate to bring him to the ground, telling me to hit the alarm which ... I did.

Literally within two seconds a dozen officers came to assist.

That's how fast they are in putting down threats. And, every time we've had an alarm in medical, even if it was set off by accident, extra officers have come running to make sure we're ok. So I've never felt like nurses aren't a security priority ... actually, they go out of their way to look after us.

If there's a day where they're short on officers then, it's my facility's policy to lock down the yard ... meaning the inmates are restricted to their cells. They don't take any chances if they're short staffed. And they don't hestitate to pay officers overtime to avoid being short staffed. The OT does cost the state a lot of money but, security is the priority.

Also ... every yard is under gun coverage 24 hours a day. That means that there are snipers located on the second floor ready to shoot both inside the buildings and outside in the yards if anything like a riot starts to happen either inside or outside the buildings.

They don't hesitate to use pepper spray either. The other day a couple of inmates got into a fight in their cell and they sprayed the hell out of them ... again, the inmates were down in seconds.

So I really think it depends on where you work. I constantly impressed with the officers at my facility and I feel very safe there.

Monica RN,BSN · Aug 22, 2007

Maybe I am the only one that doesn't know what this means but, can you please explain this?

new to corrections nursing, (actually start on monday) but I am guessing this is to have immediate access to security if an emergency were to arise for some reason

correctional nurse · Aug 22, 2007

I have been in Correctional Nursing for 18 years. I have never had a safety issue. I also work in an ED and it is more dangerous there than in any jail or prison I have been in. As far as a first job, I would not recommend corrections for that. You need to have keen assessment skills and that is aquired by experience. Good Luck.