Correctional nursing care is available to all inmates held in a correctional institution such as a jail or prison. The American Nursing Association (ANA) defines Correctional Nursing as “the protection, promotion and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, advocacy, and delivery of health care to individuals, families, communities, and populations under the jurisdiction of the criminal justice system.”
The field of correctional nursing allows employees to practice nursing in a variety of nursing specialties. Triage, wound care, chronic health education (such as diabetes, hypertension, cholesterol, asthma), substance abuse withdrawal monitoring and treatment, chest pain, psychiatric nursing, emergency response, therapeutic communication and infectious diseases (such as TB, HIV, STD’s) are all encountered in this setting.
Medical sections in correctional facilities have policies, procedures and protocols that are used as guidelines in the care of patient/inmates. To thrive as a correctional nurse, you must focus on who you are (a nurse) and not who they are (an offender) in order not to form any biases. If at all possible, one should avoid looking at their patient’s charges. Some information cannot be avoided. For instance, when on a maximum security unit, one automatically knows that the patients on that unit committed violent crimes. While information pertinent to patient care may be accessed, not looking at the charges allows one to remain objective so you can focus on medical care.
As a correctional nurse, it is important to understand one’s scope as well as limitations. If a patient’s medical condition warrants emergent care, the situation poses a potential risk for everyone involved. For instance, pregnant women, dialysis patients and patients with a shoulder injury cannot be cuffed in the back. If a nurse is not aware of potential physical risks, or does not intervene on behalf of a patient needing emergency care, it could result in harm to the nurse or the patient.
Obtaining advantages are one of the main priorities of the inmate population and nurses, due to the nature of the profession, are often a target. An inmate, who is successful in manipulating and deceiving you, can lead to frustration and cynicism. It is very well known that inmates use healthcare as a way out of the facility through the use of manipulation, deception and embellishments. Health issues will sometimes bring special treatments such as a low bunk, special shoes and evening snacks. These “perks” bring status for the inmate while medical and psychiatric housing brings safety.
Therefore, a correctional nurse should always remain “objectively caring” and maintain professional boundaries at all times.
- Professional attire should be worn at all times. Dressing should be modest in order not to draw any attention.
- Therapeutic touch as taught in nursing school and encouraged in other areas of nursing is discouraged in correctional nursing.
- There should be no special treatment to a particular inmate; one has to be firm but respectful, consistent and professional at all times. Taking an excerpt from L. Schoenly The Correctional Nurse Manifesto, the old saying ‘good fences make good neighbors’, can be applied to correctional nurses, where good fences make good nurses.
The corrections environment can be challenging for most nurses, but most get used to it. Personal, staff and patient safety is of the utmost importance when working in a correctional facility. There are three levels of security, determined by how the inmate/patient is classified; minimum, medium, or maximum. No matter what the level of security you are working in is, Correctional nurses must always be alert of their personal safety at all times. It is important to work with correctional officers to avoid injury from their patients, similar to psychiatric nursing. Correctional Officers are always close by when nursing care is rendered.
Team work is crucial in correctional nursing. From assessment, to treatment, safety and crossing boundaries, correctional nurses need to work together. There is an underlying pact between nurses that help us thrive in this environment. Burn out can be high, but with the right support and attitude, correctional nursing can be very rewarding. One may be manipulated and lied to, one may be tested, one may be insulted, but more importantly, one will be appreciated by most. At the end of the day, the nurse will know he or she has made a difference. Correctional nursing, the best career you never knew you could have!