Communication is a central part of nursing practice. It includes not only the words we choose, but how those words are delivered in the moment. In correctional settings, nurses often have limited time for interaction, with brief exchanges occurring during medication line, sick call, chronic care clinic, and even while moving through the unit.

Balancing efficiency with the need to build a therapeutic relationship—while also identifying and addressing a patient’s health concern—can be challenging. In these fast-paced environments, it is easy to fall into familiar communication patterns that may not always support the best patient outcomes.  

Below are several common pitfalls that can occur in everyday interactions. Recognizing these patterns is the first step toward strengthening communication and enhancing patient care.

APPROVAL OR DISAPPROVAL 

A patient is dying of lung cancer in the prison infirmary and suggests that he wants to end his life. The nurse tells him that this is absolutely wrong, and he should not think this way. The nurse on the next shift hears about this in report and lets the patient know she doesn’t think it is a bad idea, although she would not be able to help him. In both cases the nurses are sending a message that nurses have the right to share their personal feelings and make value judgments for their patients. However, nursing ethics prohibits this. Instead, the nurse should help the patient express his ideas and feelings without fear of judgment. In this scenario, the patient should also be referred to mental health and hospice, if possible. 

AUTOMATIC RESPONSES

During a busy medication line, a patient asks the nurse to take a look at a rash developing on his left hand. The nurse does not look up from the medication drawer and states, “Drop a slip for a sick call visit.” Although this might be the standard process, an automatic response without any indication of concern for the patient’s health is unnecessary. A better response would be to acknowledge the rash on the hand and say “Yes, that looks like it needs to be evaluated in Sick Call. Drop a sick call slip and you will be seen.”

ASKING FOR EXPLANATIONS

The patient is being evaluated after a self-harm incident. While completing the physical evaluation, the nurse asks her, “Why did you cut yourself?”. “Why” questions can accusatory and cause insecurity, resentment and mistrust. A better question might be “What’s on your mind right now?”.

DEFENSIVE RESPONSES 

A patient is a no-show for his Hypertension Chronic Care visit. When questioned about it, he says the doctor is an idiot and is giving him all the wrong medications. The nurse responds, “Dr. Smith is an excellent physician, and you should be glad we have him.” Defensive responses are unhelpful and can cause anger and frustration. Instead, listen to the complaint without judgment. Perhaps, a better approach would be to ask the patient what medications he thinks he should be prescribed. This is an opportunity for patient education about his disease process and the evidence-based treatments and guidelines followed at the facility. 

INVALIDATION

The patient arrives at Sick Call and complains that the last nurse he saw for this problem purposefully gave him the wrong treatment because she “hates men.” The current Sick Call nurse becomes irritated, stating, “That is ridiculous! Our nurses would never do anything like that! You don’t know what you are talking about.” Invalidation is demeaning and belittling. It suggests a superiority perspective and is unhelpful in resolving an issue. Instead, you should assure the patient that you will be following the Nursing Assessment Protocol that has been developed using evidence-based research and is applied equally to all patients presenting with his symptoms. 

Can you recognize any of these patterns in your own practice? Most of us rely on familiar responses, especially in fast-paced environments where time is limited and demands are high. These communication habits are often developed over time and may feel efficient in the moment.

Taking a step back to reflect on how we communicate—even in brief interactions—can open the door to small but meaningful changes. These moments matter. They shape how patients experience care, how much they trust us, and how willing they are to share important health information.

In the next post, we will explore ways to build more effective interactions and strengthen communication in everyday correctional nursing practice.