What is it like to be a nurse in a prison?

lalarn · Aug 21, 2010

I'm not personally a prison nurse but many in my family are, and my understanding is that it depends alot on the nurse and the facility. I have family in all types of facilities from work ethic camps to supermax. What they have in common is that you are dealing with a population that have all the health problems plus many mental and infectious disease issues as seen in the outside population. As one of my cousin's put it "You can never trust one of the prisoners." While they are patients they also are a special patient population with their own issues very similiar to the mentally ill and addicted populations. But you also have to add in depending on the facility gangs and violence.

Even with all of the bad I have family and friends that have made working in healthcare in corrections their profession. And who prefer it to private sector work (they are all in state-run facilities). I have a cousin who has worked for about 20 years in the prison system and now is completely in charge of intakes and epidemiology for a large prison system where she tracks all the inmates infectious and communicable diseases. She's has told me numerous times that she would never choose to work anywhere else.

Ultimately, I think it depends on what you are most comfortable with. I have known people that burnt out quickly from prison nursing but I think it was their own lack of understanding of their job and expectations.

lkmrn123 · Aug 21, 2010

I have worked in a county jail and a federal prison (mod-maxium security). I was about 24 yo for my first job, I was a bit naive about the REAL type of people I was around, but you must have a very GOOD level of common sense... don't fall for the okey doke..... know your role is to be their nurse, not their friend or buddy. I was very fortunate to have worked with very good COs, and they have your back. Please don't go in there with a big chip like you are big and bad.. see prison is like nature...if you work in a male prision, and you are a man you WILL get challenged. If you are a female you WILL get flashed, unless you are a older, grandmotherly type. The men are men, just like men fight in professional sports, they get charged up and fight in prison. You have to know your stuff, they will think you only work in a prison because you can't get a job elsewhere, they will test your knowledge and skill. You will gain respect for treating everyone the same, can't be prejudice against black/white/hispanic/gays etc. Working in a female prison is much HARDER than a male prison, women are much more dramatic, need much more attention and overall are much more cut throat. Federal is a bit better with the type of training they provide for you, I was just hired in no training on the "culture" of prison/jail for my first job. The feds allow the inmates to do a lot more activities outside, like softball, and gym activities soo a lot more injuries. Always be aware that the person that seems the nicest may be the one to be capable of hurting you. As a female working in a prison I never felt I was going to be hit or attacked but you will have to deal with a few perverts, the male nurses were not shown genitals from the men, but a women's prison you will see breasts, clits and it all.

Of the 1500 men that were on the compound at the feds there were about 10 men or less that were sexually deviant types. I actually felt very appreciated in the prison setting, heard a lot more "thank you" and "glad you were here to help me" than one might think. Look into PHS/USPHS (Public Health) if you have a BSN. You can work at BOP or ICE, with the US Marshals and if you know can learn or already know Spanish it will help you a lot.

bossfrog · Aug 21, 2010

I would say much of it depends on the prison. I suspect the experience would be much different in a supermax prison than a minimum security facility.

fortomorrow · Aug 24, 2010

I did my preceptorship at a maximum security prison and loved it as well. No worries with being dangerous, there are officers everwhere and there is minimal risk. Felt much safer there than the psych hospital I work at. Truely hope you enjoy it if that's where you end up.

skifall · Aug 25, 2010

I've been a correctional nurse for the past 9 years after working in a major trauma hospital. My job includes working with offenders in lock down as well as offenders who live in large groups and walk around freely. I intend to stay in corrections for the duration of my carreer. There's so much to be said about corrections I don't know where to begin. But here's a start: offenders dress themselves, feed themselves and their families are out of the picture. I stay hydrated, and use the restroom when needed, and I get a routine lunch period everyday. There's pleanty of parking, and I get to live outside a major city and not deal with traffic. The work is interesting and challenging. When there's a behavioral problem I get out of the way and let the officers handle it unlike hospital nursing. In a hospital you can't hit back period, in a prison they teach you self defense and tell you to hit, kick what ever it takes. To me correctional nursing is the best kept secret. It's not an enviornment for nurses who like to pat their patients on the back and call them endearing names, it's not for everyone. But then again, you'd never find me in a L&D unit. I'm greatful I found my nitch. :nurse:

ImThatGuy, BSN, RN · Aug 27, 2010

I've been a correctional nurse for the past 9 years after working in a major trauma hospital. My job includes working with offenders in lock down as well as offenders who live in large groups and walk around freely. I intend to stay in corrections for the duration of my carreer. There's so much to be said about corrections I don't know where to begin. But here's a start: offenders dress themselves, feed themselves and their families are out of the picture. I stay hydrated, and use the restroom when needed, and I get a routine lunch period everyday. There's pleanty of parking, and I get to live outside a major city and not deal with traffic. The work is interesting and challenging. When there's a behavioral problem I get out of the way and let the officers handle it unlike hospital nursing. In a hospital you can't hit back period, in a prison they teach you self defense and tell you to hit, kick what ever it takes. To me correctional nursing is the best kept secret. It's not an enviornment for nurses who like to pat their patients on the back and call them endearing names, it's not for everyone. But then again, you'd never find me in a L&D unit. I'm greatful I found my nitch.

So do you ever get to throw a lick in anywhere? lol shhhhh

skifall · Aug 27, 2010

Thankfully I haven't had to defend myself at my work place. I hope I never do. But I like the rule which supports defending myself if need be. Honestly patients in the hospital are much more out of control than in prison. I'm comparing our hugely busy Trauma center and State Psychiatric Hospital to the prison setting. Not all hospitals see the level of violence and out of control patients. We have quick and effective ways to ensure staff and offenders remain safe.

On a positive note: the nursing work we do is meaningful and interesting. Offenders come down with the same diagnosis as the general population. We learn in detail diagnostics, treatment and outcomes. Talk about continuity of care. Our prison system is closely tied with our state budget and a hot bed for political issues which adds interesting topics for discussion. You can't turn on the news without reports of community crime and wonder if you know the offenders. Hopefully you get the message that I find correctional nursing interesting, and challenging and self perserving cause I can take care of myself while at work. Good luck in your career choice. Twogr8

saprn · Sep 15, 2010

I'm near completion of my PMHNP program. I'd like to learn from those who are doing the work.I've been a psych RN 20+ years but my only experience is inpt. acute psych. Any info about working psych corrections will be appreciated.I've posted on the APRN board too. I'm using the shotgun approach:)

Thx.

tbrd450 · Sep 18, 2010

What is it like to be a nurse in a prison?

It is highly autonomous. Your patients' health is in your hands. They have no second opinion. You will not have to worry about your patients' families.

You will feel the pull of the custody culture around you. You will reside on the edge of a slippery slope -- one that has claimed many people. Slide the slope and you will change, you will become somebody you may not ultimately like. You risk losing your nursing ideals. Understand a simply formula, that is that desensitization leads to dehumanization. And, dehumanization leads to devaluing yourself.

In so doing, you will recognize the subtle signs of unwanted transition.

It is an environment with a huge power imbalance. Power is intoxicating for many people. Recognize the pitfalls should you choose to embark on this. Recognize the truth when you hear (or read) it. And, most importantly, act on truth and not narcassistic, self-serving rationalizations to the contrary.

It is an environment in which humans will get raped, extorted and abused. Recognize your workplace for what it truly is. Don't drop the soap jokes are considered funny. Recognize that such humor is really humor about the rape of human beings. Recognize that there is no place for such humor. Recognize that around every correctional corner is somebody waiting to get his/her "licks" in, so to speak.

Know yourself well beforehand, then embark on this career with a prime directive to remain true to yourself.

apoppyfield, BSN, RN · Sep 19, 2010

This is really interesting. I never realized that prison work may be "less dangerous" than some hospitals or facilities. I live close to a prison and have considered working there when I graduate from nursing school. It all depends on where I fit in. I'm not to crazy about the hospital where I'll do my clinicals, most of the nurses I know who worked there didn't stay. I did hear that in the prison environment sometimes a nurse get stuck on a night shift and they are basically locked in a room all night in case anyone needs medical care. The monotony of that scenario is something I could not tolerate. I'd rather be busy all day. Anyone have any comments on this. Is there a set time period that someone would have to work those garbage shifts?

skifall · Sep 20, 2010

Wow tdrd450 very well written. I would go onto writing books if I had your skill. While I agree in some respects with the "slippery slope" I find there are safety nets along the way which include working in teams. Don't strive to be perfect as some nurses and managers do, and think that you have to produce the highest quality of care and dewell in quilt if you don't. Don't overwork yourselves, take breaks, have pot lucks and other team building activities. I'm more concerned about a nurse that approached prison work as a lone soldier. Team work is crutial.

Our water cooler discussions focus on medical issues. We learn from each other and face unique medical and behavioral challenges together and often come up with good care planning. We help each other during busy days which means: two, three, or four codes. We don't sit around and bad mouth or talk behind backs. I wouldn't work in an evnornment which wasn't supportive. We rely heavily on our medical skills which serves to improve them not the oposite.

Correctional institutions take on unique culture within every state and within every prison. This is where you'll find "power" issues. Some prisons are harder to work than others I'm sure. I fit in where I'm at but wouldn't consider working in other states from what I've heard. Corrections is a political hot bed and often subject to state budgets which are suffering as you all know. Safety is slowly getting compermised which I feel is the biggest topic. I wouldn't want to get trapped within the walls if/when it all goes down. Like I mentioned, if I had the writing skills I would go on and elaborate more. One could write a disertation on correctional nursing.

I like the working evniornment and feel we have good leadership from balanced people at the facility I work at and feel lucky spend my career here. At the end of the day I reflect on did I take care of myself, drink enough water, have my lunch time walk and have a positive interaction with a co-worker. Good luck, and support each other.

saprn · Sep 20, 2010

I have come to this board to learn from nurses who, are or have been in the role of actively providing care in the corrections setting, specifically mental health/psych.

I'm wanting to start with the basic information please. How are the areas structured? Are prisoners with active mental health problems segregated or in general population. Do facilities use PA's,PMHNP's,LMHP, who does the psych med prescribing and monitoring. How are the pt.s in needed followed up on,how are the psych practitioners viewed by CO's co-workers etc. How does psych find out if an inmate is decompensating? What is the collaboration between psych and medical?

Thanks to all the nurses to have helped me learn all those willing to help me learn more.

Saprn