In an earlier post, I discussed the importance of quickly developing a trust relationship with inmates. We are often given only a short time to get to the bottom of a health issue. Respect, honesty, listening, and follow-through go a long way toward overcoming the inherent distrust our patients have for those in authority. There are ways we might naturally consider helpful in our patient relationships that could actually put us in jeopardy. A booby trap is defined as a device that can harm a victim who unknowingly activates the trap by their own actions. Here are a few booby traps correctional nurses can activate if not careful in patient interactions.

Self- Disclosure Can Be Dangerous

In most personal relationships, trust develops when each participant discloses information about their preferences, personal experiences, and inclinations. Self-disclosure by one person encourages it in the other. However, a manipulative patient could use staff personal information to their advantage; even for purposes of threatening or blackmailing the nurse. Therefore, it is best to keep any personal information disclosure to a minimum. Avoid speaking about family members, upcoming events, work schedule, or identifiable possessions such as make and model of a car or house neighborhood. Instead, personally disclose safe information such as favorite sports team, snack item or television show. This information can build rapport without putting you in jeopardy.

Assistance as a Sign of Weakness

Unfortunately, both the patient and the officer staff can interpret a therapeutic relationship as a sign of weakness. Caring actions can trigger an inmate’s manipulative tendencies to see others for their utility. The exploitation of others can lead to great pleasure and even an opportunity for prideful boasting to other inmates. A helpful nurse can be used by an artful inmate to obtain desirable items or favorable treatment.

On the other hand, many correctional officers believe all inmates are deceivers and see attempts by a helpful nurse to assist patients as fool-hardy. A nurse deemed ‘too helpful’ by correctional staff may be ostracized, criticized, and even labeled as an “Inmate Lover” or “Hug-a-Thug”.

Empathy Can Betray Us

Nurses tend to be drawn to helping others in distress. Certainly, incarcerated patients are stressed and in distress in the correctional environment. The reassurance and encouragement we provide in the course of health care delivery can be of great comfort to the patient population. However, empathy for our patient’s situation can also betray us. Feeling for the plight of our patients in their difficult situation can lead to any number of inappropriate relationships. Therapeutic boundaries can give way and professional perspective blurred. Predatory inmates or those with sociopathic tendencies will take advantage of overly-empathetic staff members.

The Answer: Healthy Skepticism

The answer is not, of course, to become a distant robotic task-oriented correctional nurse. Instead, we must balance empathy and helpfulness with a healthy dose of skepticism. While dealing with the Russians at the end of the Cold War Era, Ronald Reagan popularized the Russian proverb “Trust but verify”. This is a handy phrase to remember when dealing with inmate patients. Work to develop a trust relationship but always verify symptoms and history with objective findings.

How about you? Do you have some advice to share about building a trust relationship with incarcerated patients without falling into these traps? Share your thoughts in the comment section of this post.