This guest post by Mary Loos, BSN, MPH, shares her story of correctional nursing. Mary spent her correctional nursing career in the Multnomah County Health Department, providing care in the Multnomah County Jail System.
Every person who discovers Corrections Health as a career has their own story to tell about how they got there. Mine? It started with a right turn in my path to work in the Public Health arena. After earning my BSN, I decided to get RN experience for a year or two. Before I knew it, I had spent 14 years in hospital nursing, working my way up from staff nurse to hospital nursing supervisor. My clinical experience provided me with a wealth of experience in pediatrics, general and vascular surgery, post-op open heart / telemetry, quick decision-making and working with many different disciplines.
In 1985, I realized that I didn’t want to work in a hospital anymore. The first time I looked in the local newspaper for a nursing position, I saw an ad for a Nurse Manager position in our county’s Corrections Health program within the Public Health Department. My mind started making the connection right away – the public’s health includes all sectors of the population. I immediately completed an application for this position, toured facilities and had several interviews. I was hired to work with a person I soon realized was a visionary and a national leader in the Corrections Health professional arena.
At last, I was in public health! And that is the way my Program Director and I, along with our entire team carried our mission out. We grew from three facilities to six, doubling our census of patients between the years I was there. We dealt with the onset of AIDS and the corresponding issues of confidentiality and safety precautions, which was an extremely sensitive issue with custody and program staff. Our infirmaries grew along with higher complexity patients, our funding cycles went up and down, and threats of litigation motivated all staff to chart precisely and timely. Interdisciplinary challenges aside, I found working in this environment stimulating, educational, and truly worthwhile.
We established many joint public health programs within the jail facilities. Among these was our participation in a joint project with community corrections and community health, ensuring that drug-addicted pregnant women in custody were connected with community health nurses both in and out of custody. We also set up an official Food Handler Certificate program for inmates, putting them one step closer to a job on release. Corrections Health has evolved over the years into a high technology program that provides basic and complex care to a population that rotates in and out rapidly, and often arrive in booking with unstable and/or acute symptoms. The staff is incredible – experienced, knowledgeable, skilled, compassionate yet limit-setting, and they juggle a patient load that no other health care personnel face.
And yes, I’ve had people ask why I’m not working as a “real nurse”, and why am I working with “those people”. My response was unswerving: that I’ve chosen to work with a microcosm of our county population that is sicker due to lack of consistent medical and mental health care. They, like us, need and deserve health care. This has led to some interesting conversations, I assure you. Corrections Health is Public Health at its best. Once you enter the field, it’s easy to get hooked, and longevity in this elite field is common. You either hate it and leave, or you love it and stay. To this day, the years I worked with jail inmates are the highlight of my 42 year nursing career.
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