Prison Nursing....Is it safe?

guerrierdelion · Sep 12, 2007

I feel very safe at my prison, but I do a lot of common sense things to increase that feeling:

Do you have any suggestions or advice in regards to making the mind set shift from hospital nursing to correctional nursing? I would assume that nursing in a correctional setting would be similar to Urgent or Outpatient Care nursing roles. Do you have any books or reference material suggestions?

Thank you in advance.

nancykday · Sep 12, 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?

I work at a max security female prison.We have a very strict code of ethics that we must follow. If you tolerate abuse of inmates in any you will be held accountable for your actions . ALL staff have held accountable to the code of ethics, no one is exempt. That doesn't mean that their are not some unethically staff members, butthey will be found out eventually and will be fired along with all staff that condoned or covered up these abuses. We have several staff members who violated the code of ethics, either sexually or physically, were prosecuted and are now doing time.

I believe these abuses are more common when the state or federal government delegates thier responsibility to for -profit prisons. Public safety is not served by handing over to corparate run prisons where the bottom line is profit.

I have nerver worked for or will never work for a private prison where unethicall behavior is tolerated in the name of profit.

Public services are not a profit making business.

nancykday · Sep 12, 2007

do you have any suggestions or advice in regards to making the mind set shift from hospital nursing to correctional nursing? i would assume that nursing in a correctional setting would be similar to urgent or outpatient care nursing roles. do you have any books or reference material suggestions?
thank you in advance.

there is an excellent book available on amazon that will get you prepared for working with inmates. it is called [color=#003399]games criminals play: how you can profit by knowing them

it will get you into the mind set of working with i/m and see hoe they are trying to play you. you as a healthcare professional must remember to be fair firm and consistant at all times. the most important word in corrections is no. you your assesment skills, don't go solely on what the i/m is telling you. learn and follow your departments p&p and trust your gut.

guerrierdelion · Sep 12, 2007

there is an excellent book available on amazon that will get you prepared for working with inmates. it is called [color=#003399]games criminals play: how you can profit by knowing them
it will get you into the mind set of working with i/m and see hoe they are trying to play you. you as a healthcare professional must remember to be fair firm and consistant at all times. the most important word in corrections is no. you your assesment skills, don't go solely on what the i/m is telling you. learn and follow your departments p&p and trust your gut.

i appreciate your prompt response to my request for information.

thank you very much for sharing.

:smiley_ab

texascowgirl · Sep 13, 2007

an even better book is Behind Prison Walls....will tell ya ALL the things ya need to know about prison life, even things like what inmates do with the little KOP things ya give em in medical (this book i found on amazon, but this is the first link i found with it so you can see which book i am talkin about)

http://www.paladin-press.com/detail.aspx?ID=1292

guerrierdelion · Sep 13, 2007

an even better book is Behind Prison Walls....will tell ya ALL the things ya need to know about prison life, even things like what inmates do with the little KOP things ya give em in medical (this book i found on amazon, but this is the first link i found with it so you can see which book i am talkin about)
http://www.paladin-press.com/detail.aspx?ID=1292

Thanks!

I already ordered this:

Games Criminals Play: How You Can Profit by Knowing Them

And will probably get the book you suggested also:

http://www.amazon.com/gp/offer-listing/1581603916/sr=/qid=/ref=olp_pg_new/102-4682275-2146559?ie=UTF8&coliid=&startIndex=0&qid=&sr=&seller=&colid=&condition=new

Should make for some fascinating and eye-opening reading.

MJaneP, NP · Sep 2, 2011

I work in a maximum facility jail and I feel safe. There is always staff, always a body alarm...

As I have said in other posts - in no other job to have security with you all the time.

chulada77, ADN, BSN, MSN, APRN · Sep 5, 2011

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.

I somewhat agree with "getting hospital experience first"....In corrections there is room for autonomy which can be good and bad. If you are the type of new nurse that needs strong leaders and guidance then corrections may not be the start for you. The physicians do expect you to weed out the crap from the true medical things and use standing protocols to address items that don't necessarily need an MDs brain.

Essentially you need to gauge your confidence level. If you feel pretty comfortable in your "nursing skin" then you'll be fine. It's just not a place that gives a ton of training or guidance like the hospitals do but it can be done by a new nurse. :nurse:

Rob72, ASN, RN · Sep 6, 2011

kanidoit, you've gotten some good thoughts, but I'll add some integrated (inside and outside) thinking.

1) Your husband has serious reservations. In one way or another, the two of you need to come to an agreement on this. If something were to happen, there is some serious "relational difficulty" in store, to say the least.

2) You'll see the IMs on the outside, sooner or later. Statistically, its fairly inconsequential, but being the 1% outlier is not fun.

3) Danger is relative. You are more suscepttible to direct physical violence on the outside (generally). You are much more susceptible to being manipulated, stalked, or set-up, as an insider. Your susceptibility will depend on your character and the image you project inside. Its not just a job, its a lifestyle.

4) All jails and prisons have different institutional "character". Some are extremely professional, some show little difference between those on either side of the bars/doors. If you can talk to someone already working there, outside of work, it would be helpful, tho' that isn't always possible.

Multicollinearity, BSN, RN · Sep 10, 2011

I prefer my correctional job to my old hospital job. I feel safe most of the time. I'm always very aware of my environment, though. Sometimes I have my finger near the alarm button on my radio just to be ready. It looks like I'm just holding the radio, but I'm not.

You've got to walk a fine line between showing respect, being firm, fair, and consistent, and being able to shout orders at a menacing inmate when the situation arises and hold your ground. You cannot appear weak. I'm a very little woman, and I've had to shout orders at a group of maximum security inmates who were swarming me in the yard. No officers around. It will depend on your facility, but at mine there may be one officer in a medical building with many rooms and up to 20 inmates. I can be in an exam room with an inmate and our one officer may be over 100 feet away, tending to signing in/signing out 20 inmates in the lobby.

I have to walk the yard alone at night without any officer around. Or there may be one officer on the yard, and he cannot see everywhere. That said, I believe it is safer than working in an ER. Patients act crazy and out of control in the ED and hospital setting and there are no officers.

I believe prisons are safer than jails, generally speaking. Jails are where they just come into custody and they may be enraged and out of control. My DON was attacked when she worked at a jail. The inmate tried to strangle her with her stethoscope; she punched him in the face and knocked him out cold (former military nurse). In prisons, inmates have settled a bit, and they have broken down into their gangs and racial groups, and each group has a leadership with a hierarchy and with enforcers. If an inmate attacked medical staff without sanction or permission from his group's leadership, there might be trouble for that inmate from his group's leadership. Of course, this does not apply if the inmate is psychotic, intoxicated, or a segregation inmate who is isolated (somewhat) from inmate leadership. Also, keep in mind my prison does not house inmates with psychiatric disorders, so my experience is limited to dealing with non-psych inmates. My facility has medium, maximum, and "super-max" yards.

You have to be able to project strength and fairness and not be intimidated by huge scary criminals. If an inmate senses any kind of weakness or fear, he will probably exploit it. It's a weird, fascinating culture.