Struggling to Define Caring in Correctional Nursing

rock climbingCorrectional nurses face a daily struggle to care for their patients while delivering much-needed healthcare in a restricted environment where they may also fear for their own personal safety. How can nurses truly care for and care about their inmate patient population? This is a question many of us in the specialty grapple with as we try to elevate the professional status of correctional nursing. Caring has been described as the essence of professional nursing practice, therefore we must establish the characteristics of this concept as it is enacted in the criminal justice system.

Weiskopf studied nurses’ experience of caring for inmate patients and discovered a number of limitations in our setting .  Nurses in this study described the need to negotiate boundaries between the culture of caring and the culture of custody to establish relationship with custody staff in order to be effective. One surprising finding of the study was the extent to which the negative attitudes and behaviors of other nursing staff affected nurses who were attempting to provide compassionate nursing care.

Many nurses working behind bars feel an obligation to care and often struggle to find ways to do this in a hostile environment. Yet, developing a structure and process for caring may be the core defining characteristic of our specialty. Here are some suggested ways nurses enact caring behaviors in corrections:

  • Educating patients about their health conditions and self-care principles
  • Maintaining a nurse-patient relationship that is within the helpful zone of professional boundaries
  • Advocating for the health care needs of a patient when necessary
  • Showing compassion and respect
  • Presenting a non-judgmental manner
  • Listening to what the patient is saying
  • Helping patients through a difficult situation

Correctional nurses are confronted daily with a struggle against a tidal wave of organizational culture convinced that we should not be caring ‘too much’ for our patients. Caring for murderers, rapists, and criminals takes true grit and a more serious definition than a superficial application of a warm positive emotional response or empathetic word. We are the ‘Tough Love’ folks on the nursing caring continuum.

Consider these unusual ways that a correctional nurses cares for patients:

  • Not accepting a gift from a patient
  • Letting a patient know that you know the rules and they should not ask you to violate them
  • Asking the patient to complete a sick call request for their rash that they want treated during pill line
  • Being diligent with mouth checks during pill line

All of the examples above constitute an action or activity that is helpful for the patient; whether it avoids penalties, provides boundaries, or prevents self-harm. Caring seeks the best for the other in any situation.

Have you found it difficult to care for patients in the criminal justice system? Share your thoughts in the comments section of this post.

Photo Credit: © Alexander Zhiltsov – Fotolia.com

The foundation of this post originally appeared in the Essentials of Correctional Nursing blog