Professional boundraries in Correctional Nursing

mikethemurse, BSN, RN · Jun 21, 2010

Some tips...

1. I address all IM with their last name and a Mr. or Miss before it. Just as I would in a hospital. (I work in a jail, so male and female IM) I have found you get respect by giving it.

2. Being firm, fair, and consistent, to me means that I treat all of my patients the same. You do get to know certain IM who are frequent fliers, or who have been their a while, and you therefore may have a good rapport with them, but no matter what, I always give the same care to each and every one of them.

3. They will try to manipulate you, especially before you build yourself a rep. It could be as little as giving one an extra snack bag, or allowing one to know personal information about yourself. Whatever the case may be. FIRM=No means NO!, FAIR=The same goes for all of you. CONSISTENT=It will be the same tomorrow!

3 b. That doesn't mean that I am a d*** about it, but my favorite word some nights is NO. Especially if it is a new IM that hasn't met me yet. But like I say, you build a rep pretty quickly, and after a while, they know where you stand, that you are going to follow the rules, and not to bother playing games. (most of the time)

4. I avoid any and all personal conversations. Meaning the IM have no idea where I live, if I am single or have a finance, what kind of care I drive, and etc. I also refrain from asking personal questions such as these, unless it is part of an assessment i.e. to assess the support system that an IM with psych issues has on the outside.

5. Last piece of advice, for now...See everyone, meaning if it is 0dark30, and Mr. John Doe is c/o CP again, for the third time this shift, and you are about an hour behind on your paper work, or med pass, or a million other things that need to get done. Never say no. I would rather waste 5 mins explaining what heart burn is to Mr Doe, than sitting in front of a jury explaining why I failed to act. Which brings me to another point...if you don't have mal practice insurance, get it!

Well, hope this has been helpful, That is about all I can think of for now...been up for about 24 hrs, and tonight is number three in a row, so I need to get some sleep. Welcome to this wonderful and challenging area of practice! And continue to read this blog, always an interesting conversation going on.

Mike

Orca, ADN, ASN, RN · Jun 21, 2010

All of the above is excellent advice.

deyo321 · Jun 21, 2010

FIRM=No means NO!, FAIR=The same goes for all of you. CONSISTENT=It will be the same tomorrow!

I liked this explanation. It made me smile. Thank you.

Hoozdo, ADN · Jun 22, 2010

Which brings me to another point...if you don't have mal practice insurance, get it!

Excellent advice Mike. Tell me though, I work PRN pool corrections and have

NSO insurance. They don't cover correctional nursing. What insurer do you

have?

Thanks!

angelj · Jun 23, 2010

Hi,

maybe a conceptual framework will help. You are a nurse delivering care wihtin a security environment. always address priosners as you would address any patient under your care---with dignity and respect. Adrress them formally as Mr. or Ms, but don't be afraid to just ask them by what name they wish to be called as your patient.

For every patient listen to what their complaint or needs carefully. listening skills are the most powerful as you don't waste time with a power struggle and it helps you start your assessment. A good nursing assessment, documented usually will identify the appropriate problem and intervention. Use the nursing process to assess every request and validate first what the need is and identify what teaching needs to be done. The facility health policies define what you can provide or not provide. "manipulations" are unmet needs, focusing on assessment, problem-solving and interventions that help solve the problem usually work well. stay within the boundaries of a therapeutic nursing relationship. prisoners are patients first and if you treat them with respect and provide care that is effective you will gain respect quickly. keep your interactions about them, not you. do

not talk about yourself or your colleagues and follow the institution security rules. give them the care you were licensed and educated to give, that is what counts the most. just be a nurse and be professional at all times, be yourself as a nurse. good nursing care is what they need the most and they also need education. do what your license requires you to do. you can ask them anything within the boudaries of your license. you don't have to talk to them in prison lingo; avoid it, it breaks down the boundaries. just address their health care needs to the best of your ability and stay within medical and nursing policy of the facility. This makes it alot easier and you will be fair and consistent and not have to worry so much about power struggles and manipulations. prisoners really just need nurses to be good nurses, they have no choice about who provides their health care.

They test for what they can obtain. If it is within the health care polcies to provide them with something then make sure it gets done, simply tell them if their request is outside of policy. You never have to say you care, they ALWAYS know this by your professionalism and the way you treat them. Do not violate their trust or rights under HIPPA, privacy, medical and nursing standards,etc. Do not promise what cannot be provided, do not withhold what they are entitled to, avoid judgment and remember that establishing a therapeutic relationship is at the core of every interaction. you follow security but do not become security. adopt nursing attitudes, not security attitudes. it's not your job. security and nursing are separate functions and both need to be done well.

mikethemurse, BSN, RN · Jun 23, 2010

hoozdo,

I actually talked with a rep from NSO, and they assured me that they were, for a time, not covering corrections nurses, but are as of now. I am still with them. If they have changed their minds again, please give me a heads up.

tranquilgrl · Jul 12, 2010

Excellant advice from all. Thank you for the informed education.

Boonce1 · Jul 26, 2010

They should only address you as nurse last name do not give them any of your personal information. You are to treat them with respect by addressing them by mr. lastname make sure you take care of them but it is ok to say no if they request more then what is medically associated

MacyS · May 16, 2011

I had the same NSO and heard a rumor that they were no longer accepting correctional nursing. Too many law suites. I called them and they said that they had denied correctional for a short period of time, but had begun accepting them again. I renewed.

Rob72, ASN, RN · May 18, 2011

4. I avoid any and all personal conversations. Meaning the IM have no idea where I live, if I am single or have a finance, what kind of care I drive, and etc. I also refrain from asking personal questions such as these, unless it is part of an assessment i.e. to assess the support system that an IM with psych issues has on the outside.

Cannot be emphasized strongly enough. I did a brief (6 mo) stint as a CO. I carried a work wallet- ID & cash only. If you have a secure locker, put your stuff in it before going to the units. Manipulation runs the gamut from trying to get an extra slice of pizza, to seeing what your reaction is to nekkid pictures of their GF/BF is- can you be induced to participate in internal trafficking or social compromise that opens you up to the same.

CoffeePlease · May 26, 2011

I am a new grad LVN and am interested in working in corrections. I am also a small framed female who smiles a lot. Quite a few people have told me that corrections is not something I should consider- none of them are nurses. I secretly worry that I might not be mean enough, or tough enough. I am firm and have clear boundaries. I regularly take the same self defense courses that police officers do, so I can be tough- I just don't usually lead with that tactic.

Does size matter? Does being tough matter?