• The day shift nurse leaves the medication room door unlocked so she can get to the staff break room or the nurse’s station quickly.
• The evening shift nurse pre-pours all her medications for segregation rounds, even narcotics, although she takes the medication cart with her.
• The sick call nurse moved the patient’s chair to the side of his desk next to the door so inmates can quickly enter and leave the clinic room.

These are all common situations in correctional nursing units and all indicate a sense of complacency about personal and team safety. Complacency is an enemy ever lurking in the shadows of our correctional nursing practice.

I recently came across a post about correctional officer complacency by Gary Cornelius that has implications for correctional nurses, as well. He refers to officer complacency as an inmate’s best friend. It is easy to see why. Many inmates are vigilant to see which staff members are complacent about keeping rules and regulations. Sloppy workers are targeted by manipulative inmates for working a con or exploiting lax security situations. As Cornelius states, officers are watching inmates and inmates are watching officers but the officers have other duties that distract from always watching. Inmates, however, have plenty of time on their hands to monitor officers, procedures, and individual routines.

Complacency is described as that comfort zone where you feel  “quiet pleasure or security, often while unaware of some potential danger”. It is a false sense of security in a correctional setting. There is a difference in being comfortable in your environment and being complacent.

Complacency Consequences

One reason for becoming complacent is that serious incidents may rarely occur at your facility. This is a false security as incidents occur across the correctional industry almost daily. I monitor news stories about correctional health care. Here are just a few examples that likely happened, in part, due to the complacency of officers and staff. Cornelius cites other incidents in his post:

• Clinton Correctional Facility escape June, 2015: Analysis of the factors contributing to the escape included many slipshod security procedures. The NY Inspector General’s report is fascinating reading.
• Prison teacher beaten and raped in AZ State Prison: At the time of the rape, officers were not monitoring classrooms and cameras were not in place.
• Officer taken hostage during medication rounds in Lee Correctional, S.C.: The news item indicates a door was left unlocked.

Complacency in Action

Like the proverbial frog cooking in slowly heating water, we, too, can allow complacency to creep in as we become overly familiar with working in a correctional setting. The Inspector General’s report on the Clinton Facility escape indicated a ‘culture of carelessness’ that pervaded the facility. They found officers were not searching employee belongs at the front entrance, night cell counts were not being done, and cell searches were inadequate. What might complacency look like for health care staff?

• Not performing narcotics and sharps counts
• Not locking medication and equipment areas
• Allowing inmates into staff-only areas
• Leaving patients alone in a clinic room while getting supplies
• Storing keys to medication and equipment rooms in unlocked drawers or out in the open
• Walking alone in unsecure/unmonitored areas

Complacency Averted

Since complacency is an enemy continually lurking in the shadows, put measures into place to avoid it. Here are some tips:

• Review security policies to be sure you are following them correctly.
• Request escort when in unsecure/unmonitored areas.
• Report misconduct or security breaches. Complacency creates the potential for violence and injury to others in the facility.
• Ask to be rotated out to a different location or job function if you find yourself becoming too familiar with the environment or too friendly with the patient population. For example, if you always run the A-K medication window, switch with the nurse doing L-Z.

How do you combat complacency in your practice? Share your thoughts in the comments section of this post.