By Megen Duffy, BA, BSN, RN. Her blog is Not Nurse Ratched.

Michael Coghlan/Flickr

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.

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