By Megen Duffy, BA, BSN, RN. Her blog is Not Nurse Ratched.
Michael Coghlan/Flickr
When I go to work, I go through a metal detector (did you know Danskos contain metal?), and all my belongings are scanned or gone through. I check out keys and a radio, and then I go through a series of sally ports to get to the medical area. I count every needle and pair of scissors I use. I never see patients without an armed guard nearby, and a good portion of my patients are cuffed and shackled. I’m on camera from the second I get out of my car.
Welcome to prison, nursing style!
“Why?” people ask me. “Couldn’t you get another job? Aren’t you scared? Didn’t you like the ER?” I worked in critical care/emergency nursing for a long time, and yes, I did like it. I brought those skills with me to corrections, where they are a lock-and-key fit. A surprising number of corrections nurses are ex-ER nurses. The same personality types work well in both settings.
Corrections nursing involves phenomenal nursing autonomy and uses many of the skills I honed in the ER:
- quick triage
- multitasking
- sorting out who is lying from who is sick
- knowing which assessments are the most important for each situation
The atmosphere tends to be quirky to chaotic and requires imagination, flexibility, and an ability to string together solutions to problems that no one has ever seen before. Particularly in jails, you never know what is going to come through the door. A jail booking area is exactly like ER triage.
I like that; I like having a job where strange things are bound to happen. I like seeing things that most people never see. I like knowing that things could get hairy at any time and that I have to be on my game all the time.
For example, one of my jobs was in an inner-city jail that brought me nose to nose with situations I’d never seen: botulism from cellside hooch (i.e., homemade liquor), resistant TB, preterm labor in women high on heroin with no prenatal care. I had to figure out which available tools could be pressed into service to remove IUDs or to form a splint that couldn’t be fashioned into a weapon.
I had to learn how to form working relationships with patients from entirely different ethnicities and socioeconomic groups than I had been around before.
I even had to learn a new language! “That sore’s been there a minute” means it’s been a really long time. “You’re just being saditty” means you’re acting all high and mighty (and not going to have any luck with whatever you’re trying to do).
What of safety? I maintain a healthy level of fear, but I feel safer in a jail than in a hospital. I got hurt frequently in the ER, but so far I haven’t been in corrections. Here I have armed guards around me all the time. In the hospital, no one had my safety in mind except for me. Inmates also generally know very well that you, the nurse, are likely the only human they will see for a long time whose only goal is to help them, and they won’t often jeopardize that. Also, after all, in corrections, you already know who the bad guys are.
Corrections nurses tend to get a bad rap, as if this is the bottom of the career elevator. I don’t understand that. It takes a certain set of skills, a fairly specific personality type, and a high tolerance for the bizarre: corrections is its very own specialty for a reason.
I’m proud to say I’m a corrections nurse. The specialty is increasingly getting some of the respect it deserves. I hope this trend continues.
I have been a correctional nurse for over 10 years. I would not have it any other way! I cannot even stand to think about working in a hospital or nursing home. Corrections is the best kept secret of nursing.
I admire those correction nurses who don’t mind working with inmates or prisoners. God bless to all the correction nurses.
I’ve been in Correctional Nursing on Evening Shift for 1+ years and can compare it to a combination of ER-Psych. I contact on-call Psych weekly for RBV’s(read back verbal orders) for Safe Cell Placement. The Inmate/patient reports Suicidal Ideation or PREA(Prison Rape). Sometimes the Patient seeks Safe Cell because of possible retaliation from opposing gang(s). Most Correctional walkup sick calls are : Chest pains from Inmates in segregation, isolation, Boils=skin infections, high blood pressure, hyperglycemia / hypoglycemia, altercations involving handmade weapons, puncture wounds, fingers crushed in electronic doors, sports injuries secondary to tackle basketball, broken bones in feet and hands/fingers. I’m now updating my resume as to seek Psych/ Behavioral Health/ Mental Health Nursing position.
This article is so TRUE and very well written by an intelligent nurse who I am proud to call my friend and co-worker
Great to see a positive article about corrections work. It is certainly not the bottom of the career bin! Everything you see in an ED or hospital ward you will see in a prison or jail. We work hard to make a difference for a sorely underserved population using evidence based guidelines and the same skills you’ll see in a hospital or doctors office.
We miss you Megan Duffy.
Thank you for shining a light on an area of nursing so few of us know about. Love the fun facts about the danskos 😉 and perspective of safety.
Been a correctional nurse for 18 years. Working in prisons has spoiled any other job for me. Can’t work anywhere else.
Regarding how to get into corrections, it’s much like any other specialty: try and try again. If you can figure out who is hiring, it never hurts to call and say you’re interested and want to make sure your name is on their radar: to find out whom to talk to, call the facility in question, ask for medical, and ask to be transferred to the DON or HSA. One point: many new grads work in corrections, and I really wish they wouldn’t. Because you CAN get a job there doesn’t mean you SHOULD; new nurses do not have the assessment and other skills needed to avoid catastrophe. Hope this helps!
Correctional system is just another community system like any other. It is a highly misunderstood and stigmatized system due to social media creating a delusion that it’s a horrific place to be. Reports are always bad but good things do happen inside.
Like all other system, you need to be in there to learn its culture and language to know how to appreciate the beauty within. There are heaps of love, loyalty, friendship and kindness when you are”fitted” in to it.
I am a forensic mental health nurse and I have worked in medium and maximum secured hospital in Singapore and Australia respectively. Loving what I am experiencing and will never regret my choice of nursing.
RN, DipNurs, BN, GradDipTh, GDipForenMentlHlth, MNurSt, PhD student
So true, I worked in a max. The CO’s were always there as protection and with a helping hand. 95% of the inmates were respectful and grateful. Iliked the autonomy and never knowing what the day was going to bring. We all worked as a team. I retired in 2006 and did per diem until last year. Still miss my co-workers and the “prison humor”
Great article!! I love corrections!
RN Kent County Jail Grand Rapids Michigan.
I love your article
So true.
I’ve been trying to get into correctional care. Haven’t had much luck with the online process. Any tips on getting noticed?
10 yr county jail and love the job its management and co bs I hate when you work private agency. Rock on sisters n bros!
Hard to do and stick to doing what is right, not falling into a mentality to shrug things off. Loved my time in a max, probably the most gratifying job I had. Was glad I also came back into the “professional world”, it was time and I proved to myself I never lost my clinical skills.
I like your writing and hearing about your life. You go girl!
I also work as a Nurse Practitioner in corrections after working over 29 yrs in an ED. Your right, the fit is perfect. After working in an ED you cannot settle for a mundane job without a lot of good stories. I enjoy teaching the inmates about their chronic diseases and acute illnesses. They do appreciate some one to chooses to help them when many family and friends turn their backs on them. It is exciting, rewarding, and you meet people from all socioeconomic groups. They are not all ” bad”. Many have many one bad decision and many of those are related to alcohol and drugs.Many could be better served by rehab but there mare few facilities across the country. Some have had little or no bonding with a parent. Some thought they were better than others and were caught. The rich arrogant drunk driver who killed a child . Some will come to jail once , others every few months. Some come because they are homeless and cold. Many would be in housed in psychiatric settings that don’t exist anymore. So there is a vey diverse population , not boring, not pompous, not haughty. Real people who are very down on their luck temporarily. I tell them nothing’s permanent and everything in the world, inside and out is temporary. One never knows when the tides might turn. There are many evil bad people paying their way out of ja who live next door. Better the devil that you know. And our CO’s and Sheriiffs become our guardians, in case and become like family much like cops partners… I love my job and the nurses and staff I work with , hearts of gold who walk with the broken. Gods work
this is so true I worked in jcorrwctional for years and I said it over an over I am much safer in jail then I
was in any hospital. The pay for correctional nurses is better then most hospitals. .you have to be able to think outside of the box You don’t have to argue with doctors because the inmate doctor wants the same thing. Correctional nurses have to be passionate an caring and not nieve inmates are master manipulators I have been psy nurse for years ER nurse has a lot more dangers then any jcorrwctional facility.
I love hearing about other nursing jobs and love when nurses share their work world. Yes, there is a pecking order in Nursing, but this helps to dispel it. An intelligent, articulate nurse like yourself sharing goes a long way. Thanks
This article is just a glimpse of a daily correctional nurse…..