If you speak with Correctional Nurses for any length of time, you will hear stories of encountering disrespect and downright disbelief from their nurse colleagues who work in more traditional health care settings. It is not uncommon to hear from other nurses “Why would you work THERE?” “Can’t you get a REAL nursing job?” “Aren’t you ruining your career?” Yes, many nurses consider working in a correctional facility as a choice of desperation rather than desire. It may be surprising for these nurses to hear from Correctional Nurses that working with incarcerated persons is a satisfying career choice.

Although research on the Correctional Nurse role has been historically minimal, a few have evaluated the unique nature of correctional nursing practice and revealed professional job satisfiers; and research into correctional nursing is increasing. For example, Flanagan and Flanagan in 2001 looked into the correctional nursing role and found that patient teaching, counseling, and physical assessment were primary duties of the role. Maroney in 2005 surveyed nurses working in New York state prisons and found that independent and autonomous practice were job satisfiers. Garland and McCarty (2009) conducted a project to determine Job Satisfaction Behind Walls and Fences: A Study of Prison Health Care Staff. Schoenly in 2015 conducted a Delphi Study regarding research priorities in Correctional Nursing that supported development of these job satisfiers. These themes also emerge when I speak with career correctional nurses about what keeps them in the specialty.

Autonomy

Correctional nurses are most often the primary caregiver in a correctional setting. Providers are likely to have limited hours onsite and then are available on-call. Nurses are the first to evaluate patient concerns and then determine care provision or access to advanced providers such as physicians or dentists. Nursing sick call, in particular, is a very autonomous practice as nurses evaluate patient symptoms and determine and deliver treatment based on medically-approved protocols.

Assessment

The autonomous nature of correctional nursing practice requires excellent assessment skills and the accompanying clinical judgment to determine next steps. Physical assessment and symptom evaluation must be thorough and accurate in order to be communicated to providers and acted upon by medical and mental health providers, when necessary.

Patient Teaching

Incarcerated patients are less likely to be informed about their health status and often enter the correctional setting with untreated conditions and low health literacy. Health assessments can reveal new diseases such as diabetes or hypertension that require development of self-management skills. One of the most important things Correctional Nurses do for their patients is patient education.

Scope of Practice

Correctional nurses, especially those working in smaller healthcare units, make use of their full scope of practice in providing nursing care due to the variety of conditions they encounter and the mandate to provide as much health care as possible in the facility. While this is professionally satisfying, it is vitally important that Correctional Nurses only practice within their scope.

Change the Conversation Dynamic

If you are thinking about entering the correctional nursing specialty, be prepared for surprised responses from your nurse colleagues. They are likely to lack understanding about our specialty and the satisfying aspects of nursing behind the wall. For us already in correctional health care, it can be easy to share the downside of our specialty (Who doesn’t have a story to share about a hair-raising emergency on the tiers?) However, sharing your job satisfaction stories about calming a young and anxious first-time incarcerated person during health screening, or teaching a newly diagnosed diabetic, or helping to solve the puzzle of a strange headache may just overcome skepticism and recruit a new nurse to our specialty.

Has your sanity been questioned in your selection of correctional nursing as a career? Share your story or your take on job satisfiers in our specialty in the comments section of this post.