Inmates live in a harsh reality and a scarce economy. Stripped of most personal possessions and living on an imposed schedule, they have little control over their lives. Correctional nurses see the same patients day after day, sometimes for years, and can get to know their patients well.  However, inmates must still be kept at a distance as familiarity can lead to personal and professional harm. I’ve written in the past about being fair with inmates, avoiding being drawn in by a con, and avoiding being a target for manipulation. In this post, I’d like to talk about another important principle – staying out of inmate conflicts and arguments.

Your patients will try to get you to referee their disputes if they see indications that you are someone who “wants to help”.  Here are a few examples of healthcare-related conflicts that you might be asked to resolve.

• Contraband medications are found in a cell and both inmates receive the same discipline. The wronged inmate pleads with you to come to his defense.
• One inmate pushes ahead of others in the pill line. An argument ensues and you are asked to intervene.
• An inmate complains loudly that another inmate is getting special treatment and favors. They start shoving each other.
• An inmate gives you a verbal message to give to another inmate in a different housing unit: “Tell him I’m coming for him.”

In each of these cases, it would be easy to get into the middle of the dispute. In fact, it may seem the best option. However, intervening can cross the boundary from professional to personal. This boundary needs to be clear and firm in correctional nursing practice.

Maintaining order is the role of custody officers. An officer should be assigned to monitor and intervene in a medication delivery area. If officers regularly leave an area where you are administering medications, seek a resolution to the issue through proper channels. An officer should be the one resolving inmate arguments in a pill line.

If you are asked to come to the defense of an inmate in a dispute, such as the situation above involving contraband medication, redirect the inmate to the grievance process. You can be empathetic without intervening. An example statement might be “I’m sorry this is happening but I’m not the right person to help you.”

A clear request to break facility rules is easier to handle. In the case of a request to pass on a verbal message, simply state “Please don’t ask me to break facility rules. You know I cannot pass along a message to another inmate.”

How to Avoid Inmate Conflicts

Practice these personal rules to avoid getting entangled in inmate conflicts

• Refuse to act as a messenger between inmates
• Don’t play favorites – treat all patients fairly
• Don’t be drawn into discussions about inmate disputes
• Know the custody process for inmates to resolve conflicts

Follow the Process

Most correctional settings have a process for inmates to resolve problems. Here is an example from the PADOC Inmate Handbook.

“Problems on your housing unit should first be directed to a Corrections Officer on the Unit. If the officer cannot resolve the issue, you should bring the problem to the attention of your counselor or Unit Manager. If the issue is not resolved at that level, it should be brought to the attention of the Zone/Area Lieutenant, Shift Commander, then the Major, or the proper chain of command at your facility.”

Develop Skill

Most situations can be resolved by knowing and acting upon the rules and regulations of the correctional system under which you work.

• Become familiar with all inmate requirements
• Keep a reference copy of the inmate handbook in the medical unit
• Ask advice of a respected officer peer
• Improve your knowledge of facility rules by having a custody leader speak at a medical unit monthly meeting
• Practice appropriate responses to inmate requests for intervention

Have you been asked to sort out an inmate dispute? Share your experiences and actions in the comments section of this post.