Correctional Nurses: Always on Guard

Stasi-Gefängnis HohenschönhausenPersonal safety is a growing concern in all nursing specialties. Patient violence can take place in the emergency room, on inpatient psychiatric units, and dementia wards. Correctional nurses are no strangers to the need for personal safety. We have visible proof all around us that our patients may turn violent. Officers often escort nurses around the compound and many locked doors must be negotiated to gain access to deliver care. The routine nature of security operations can blunt our continuing vigilance, however. I like to consider personal safety as multi-dimensional with the very basic start being physical safety. Here are some tips in three areas of safety concern for correctional nurses.

Guard Your Body

• Be aware of your surroundings and the location of the nearest security officer.
• Travel in pairs whenever possible. Always tell others in your unit where you are going and when you expect to return.
• Observe all security procedures. Wait for clearance before entering any area, including when responding to an emergency.
• Do not leave sharps and other potential weapons out on surfaces. Keep equipment locked and maintain counts of all potential contraband items.
• Be careful to limit personal conversation or discussion of facility procedures when patients are present.

Guard Your Mind

• Our patient population can be a difficult one to care about. Patients may have cruel or violent histories. To avoid developing a judgmental attitude, do not seek out information about the crimes of your patients. Focus your mind on nursing care provision and the health care issue at hand.
• Our patients can also seek health care for secondary gain such as a privileged status, more comfortable accommodations or items to fuel the underground prison economy. Guard your mind toward manipulative behaviors while maintaining a professional nurse-patient relationship.
• Because inmate patients can try to con you or game the system, it is easy to become jaded or cynical. Guard your mind against these attitudes that decrease your ability to deliver care.

Guard Your Heart

• Regular contact with the inmate population can lead to professional boundary crossing in relationships. Some patients may seek additional ‘favors’ from nursing staff. Be firm, fair, and consistent in all patient interaction. Immediately report any such requests to your manager.
• Guard your heart toward flattery or flirtatious comments and actions by inmates. Respond firmly and initiate security procedures with the slightest indication of personal contact. You are guarding yourself from harm and protecting the patient from disciplinary action.
• Agree with your fellow nurses to watch out for each other. Comment on observations of inappropriate conversations or behavior toward patients.

Do you have additional safety tips to add to this post? Use the comments section to expand on these points.

This post originally appeared in the Essentials of Correctional Nursing blog.