What happens when a max security inmate is unconscious in their cell?

Specialties Correctional

Published

Does a Lieutenant or Captain have to be present before the cell door is opened? When can the nurse enter?

OK tbrd, so you are not a nurse... I am so impressed with your insight and research about the correctional environment and thecultural mindset of it all. You touch on many important issuesthat I have experienced

in that environment. thank you for sharing your thinking, it rings true in my nurses' heart.:redbeathe

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Specializes in I have watched actors portray nurses.

Thank you very much for that very nice reply. I appreciate you lending support, publicly like that. That is courageous -- it demonstrates integrity and independent thought. It feels good doesn't it?:yeah:

Here's something to think about -- you are not alone. There are others reading this stuff and agreeing. They are silently going "yea... you go Tbrd!" Take solace in knowing that.

Just be careful, many feel threatened by independence. Just remember to stay true to yourself, always -- especially if and when you work in corrections.

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Specializes in I have watched actors portray nurses.
Yes they do, and I think it is extremely difficult to understand what the nurses who work in corrections face unless you have actually worked there. Looking at your profile your not a nurse and from your own admission you don't work in corrections.

I am a nurse, but have never worked in corrections, I wouldn't envy any nurse having to wait to administer first aid. However "security first, breathing second" this is not really any different to any basic first aid that is taught

Safe approach,

Airway, breathing, Circulation

In a hazardous environment this safe approach is vital, an injured rescuer is of no use.

In my opinion, this security first, is no different to a first aider at a RTC asking the question "is it safe to approach" if it's not safe, don't approach

When delivered in the correctional environment, it is not the same -- it is not intended to be the same (as a first aider at a RTC...). It is different. And, that difference makes it extremely dangerous -- dangerous to the person in immeidate need of medical care. It is a dangerous mantra to embrace in an environment where the sole medical intervention, or lackthereof, rests entirely with one self-governing, morally independent nurse.

If the practice of "security first, breathing second" was applied in the same manner, under the same circumstances as it would in any other free society crisis situation, then it would be fine, it would be a logical and sound practice to follow. Unfortunately, within the correctional environment, it is far too often used as an excuse, or a justification, for failing people in need.

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I think that violence is one of the underlying problems that does contribute to the mindset you talk about, tbrd. People react to it when they deal with it as part of their environment, work or personal. Now it's a daily reality in our world. I hope people from all perspectives can talk about it, especially those in corrections who deal with it so much. We could learn from others and perhaps be healthier and gain insight into how to cope and continue to live our lives in this increasingly threatening world. I love to hear the voices, opinions of nurses, whether it's just expressing, ventilating or anything else. Nursing has a unique perspective. I learn alot from others and often find their thoughts and opinions to be inspiring.

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Specializes in I have watched actors portray nurses.

The mindset is what it is. It comes about and thrives within corrections for various reasons. The "us vs. them" mentality that defines so many correctional environments is often perceived as necessary, as paramount to safety and security.

The Prison Rape Elimination Act of 2003 began, for the first time in a long time, to mandate a hard and careful look at correctional environments in the United States. And, this began to occur not from the inside but rather from the outside. For the most part, the Act mandated very little, if anything, in the way of actual change but instead just an initial examination phase that involved nothing more than objective research and analysis. The Bureau of Justice Statistics published some amazing reports on this topic. Among the things analyzed and discussed was this "us vs. them" mindset issue.

Please, please, please, don't take my word for any of this. Look this stuff up and read it.

Typically, the conventional wisdom has been to teach correctional staff to expect inmates to be uncooperative, destructive, aggressive, violent, and manipulative. Historically, staff have communicated these expectations by avoiding interactions with inmates, adopting a negative demeanor when they do interact with inmates, and accepting negative inmate behavior as "normal." Expect them to be manipulative. Assume they are lying. Always remain detached. Don't engage in conversation. Yes, they are "people," but don't treat them like everyday, free society people. Secure the environment before saving their lives as they are all potentially dangerous villians capable of the worst. Adopt protective mantras like "Firm, Fair and Consistent," and let those ambiguous, subjective mantras morph into whatever interpretation they can for the autonomous correctional staff individual willing to undertake the work -- the work nobody else in society wants to take. This will, after all, keep the good guys safe.

If rights are trampled a bit... well,.. that's the price. They "chose" to be inmates. They chose to behave the way they did and now must accept whatever evolves from the "us vs. them" mindset they forced us to adopt.

Recently, three Nebraska correctional officers were fired. One of them posted on Facebook:

"When you work in a prison a good day is getting to smash an inmates face into the ground... for me today was a VERY good day."

Two of his colleagues apparently posted subsquent posts in support of this guy's good day in corrections assessment.

In my opinion they got fired not for believing this, not for even saying it, but rather for saying it (writing it) publicly. I just know, and you do as well, these guys say that sort of the thing all the time -- they believe it, some even celebrate it with happy hour bravado at the local bowling alley. They believe good days are when they get to smash another human being into the ground, just so long as it is one of the "them."

No, they weren't fired for adopting this mindset, they were fired for making it public.

It's a slippery slope. One day, the human getting smashed in to the correctional ground is an axe murdering, child molesting, no good convict deserving whatever comes his way. Soon thereafter, however, the smasher begins to slide the slippery slope toward rationalizing the irrational. Soon, the human getting smashed to the correctional ground is getting smashed because he was just disrespectful on the wrong day with the wrong correctional officer. Soon, the human getting smashed to the ground is a non-violent welfare-frauding, short term, misdemeanor convict with the audacity to question the reasoning behind getting just one roll of toilet paper for an entire week.

Soon, the human getting smashed to the ground appears to look less and less like "them" and more and more like "us." This requires some tricky mindplay to deal with.

It is a dangerous mindset that sets in. Soon, if unchecked, it leads to quiet little transgressions under the guise of "safety," "protection," "difficult work," "under-staffed," .... explanations become easier, and those whom disagree become outsiders.

They can't know, they don't work here. They don't know how different the correctional environment really is. So the thinking goes.

Resistence -- Resistence to change -- Resistence to thinking outside the box.

One commonly cited barrier to correctional overhaul and improvement -- as stated by correctional leaders across the nation -- has been resistence. It has been commonly recognized that the unwillingness of agency staff and correctional officers to change their attitudes and behaviors serves as the single biggest barrier to improving the success rate of correctional environments (reducing violence, reducing recidivism, etc.). Some line staff and supervisors are just plain uncomfortable with the idea of inmates as victims -- victims of abuse, assault, rape, extortion... etc. It's not rape, it's consenual.

Many argue that the purpose of prison is to protect society and nothing more. It is certainly not, for them (those "us"), about protecting inmates. Some even believe the hard conditions and daily potential for violence is as it should be for it is supposed to be "punishment." Still others resist change for fear it will lead to false accusations (against themselves -- the "us" in the "us vs. them" equation).

The mindset exists for many reasons. The main one, however, is that there has never been any real incentive for it to change.

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Interesting how one sided you view things in not only corrections but the medical care inmates receive. If you had personal experience in being a nurse responsible for peoples lives, or working somewhere in corrections I think your opinions would be different and more realistic. But you continue to make broad generalizations based on your clearly biased research. For now I think you are someone who has nothing but time on your hands to do a little reading and then sit back judging others on something when you have no actual qualifications to do so. It has all just turned into blah blah blah...enough said!

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Specializes in I have watched actors portray nurses.
Interesting how one sided you view things in not only corrections but the medical care inmates receive. If you had personal experience in being a nurse responsible for peoples lives, or working somewhere in corrections I think your opinions would be different and more realistic. But you continue to make broad generalizations based on your clearly biased research. For now I think you are someone who has nothing but time on your hands to do a little reading and then sit back judging others on something when you have no actual qualifications to do so. It has all just turned into blah blah blah...enough said!

I mean no disrespect to any individual nurse or correctional worker. I am certainly not judging anybody. If I have conveyed that, I appologize. I have been trying to make the point that it is the system that needs to be analyzed, evaluated, and fixed -- judged. Genuine, true oversight and accountability as it exists on so many other societal platforms -- economic, political, educational and medical -- needs to exist within the correctional system of this country.

It has become somewhat recognized by now that what happened in Abu Ghraib, for example, was just the export of what happens(ed) on a more micro, less public, correctional stage throughout individual facilities across this country. It's not me -- it's everybody these days with access to a TV, a newspaper or the Internet.

That guy out in Arizona, for example, .. that sheriff... what's his name... he paraded his work release inmates through town in their underwear.... (he may still do it, I don't know). He forces them to wear pink uniforms. He permits cross gender strip searching...blah blah blah... Is it any wonder our troops in Abu Ghraib charged with guarding foreign detainees apparently ran wild with the humiliation tactics? The main ring leader -- Charles Graner -- who ultimately received a lenghty jail sentence himself for his role in the abuse, was a PA correctional officer (in very good standing, I might add) before shipping off to Iraq.

And then there is Texas in the mid-1990s,... well... I'll let that one go for now.

It's not me -- it is the general public that is waking up to the need for serious overhaul in corrections. The Prison Rape Elimination Act came about because of this awakening.

7-Up quickly pulled their rape commerical once negative public backlash became apparent. Do you remember that? Understand that marketing executives for a major soda company met, discussed and determined that a commerical poking fun at the rape of U.S. citizens -- humans -- would help sell their product. Highly educated, highly paid professionals somewhere reached that conclusion. They misread the public. They pulled the commercial quickly.

Please help me understand that if I am presenting this as "one-sided," what side is it I am associatig with? I would like to believe I am on your side -- your side and every other decent correctional nurse and worker out there struggling daily to deliver decent, humane and professional service.

The correctional community itself, as reflected in the Bureau of Justice reports recently published, has recognized the need for a change, a shift, in typical correctional culture (mindsets) that permeate the typical correctional environment. The wardens and administrators have come to realize that to truly avoid huge lawsuit payouts, a more fundamental shift needs to occur on the front lines. To reduce violence, recidivism, and all the negatives that follow a rigid "us vs them" mindset, fundamental changes will need to occur.

It's not me. It's them.

Please don't take offense to what I write here in these posts. I don't really know you, nor do you really know me. The fact that I am not a nurse, nor a current correctional worker, shouldn't in any way color, or discount, the impact of the sentences I string together here.

Without going in to details, I will just tell you here and now, I am qualified to say these things. But, even if I weren't, why should that matter? The words I write stand on their own.

It's not you. It's the system. Don't own the hurt -- embrace the challenge.

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Specializes in I have watched actors portray nurses.

I know what the system can be like from the "us" side of the equation. I know about the verbal abuse, the manipulation, and the distrust. I know that feelings get hurt. No matter how "detached" one convinces him/herself that he/she is, no matter how unaffected he/she believes he/she is under the veil of professionalism, unless he/she is a walking zombie, things experienced and witnessed impact you. If you are honest with yourself, you will agree.

Here's the kicker -- that's a good thing!.

These are people you are monitoring and treating. Despite the dehuminization of the environment, these are actual people. They have children, parents, memories, hopes and dreams. Just as you are not, they are not as evil as their worst act. And, you know that as you start each new day on the job.

Placing them in the "them" category is challenging sometimes. However, when they make it easy for you to do that, then the days seems to roll a bit more smoothly. The world makes sense.

You know that those that get enhanced punishment beyond their incarceration sentence don't deserve it.

It's the system.

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tbrd's research is not biased..the points he wants to discuss are well documented from many credible sources accepted in the correctional healthcare industry. We have over a 100 years of history in the U.S. of the "mindset" tbrd describes. California's penal system,for example, the largest in the entire world, was seized by a federal court due to the unconstitutional and inhumane abuses throughout the system regarding medical and mental healthcare. It is the largest and only seizure of a US prison system, in it's entirety, in the US history of our penal systems. The US Supreme Court Rulings regarding California's prison system describe the same things that tbrd talks about. The comments and the lack of comments on this subject reflect alot......

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Specializes in CVICU, Obs/Gyn, Derm, NICU.
I know what the system can be like from the "us" side of the equation. I know about the verbal abuse, the manipulation, and the distrust. I know that feelings get hurt. No matter how "detached" one convinces him/herself that he/she is, no matter how unaffected he/she believes he/she is under the veil of professionalism, unless he/she is a walking zombie, things experienced and witnessed impact you. If you are honest with yourself, you will agree.

Here's the kicker -- that's a good thing!.

These are people you are monitoring and treating. Despite the dehuminization of the environment, these are actual people. They have children, parents, memories, hopes and dreams. Just as you are not, they are not as evil as their worst act. And, you know that as you start each new day on the job.

Placing them in the "them" category is challenging sometimes. However, when they make it easy for you to do that, then the days seems to roll a bit more smoothly. The world makes sense.

You know that those that get enhanced punishment beyond their incarceration sentence don't deserve it.

It's the system.

Wondering why you are spending so much time discussing prisoner p'ts on a nursing forum?

Having this much time on your hands ....can I ask...are you a prisoner???

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Specializes in Occupational health, Corrections, PACU.

Wondering why you are spending so much time discussing prisoner p'ts on a nursing forum?

Having this much time on your hands ....can I ask...are you a prisoner???

That's kinda what I'm thinking, too! Definitely likes the "sound of his own voice", so to speak.

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Specializes in Advanced Practice, surgery.

Guys, (and girls) please try to keep on topic

Cheers

Sharrie

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