In our last post, we discussed the Correctional Nurse Manifesto with seven propositions. This post discusses the meaning and importance of the first.

Correctional nurses treat incarcerated persons with the dignity and respect deserving of any patient

Joe is a large, intimidating man who is convicted of kidnapping, rape, and murder. He is known to scream obscenities at the nursing staff when they make rounds in the ad seg unit where he is housed due to many rules infractions in the medium/maximum security prison where you work. Now you see his name on your sick call list as you prepare for the morning round.

Joe, and many individuals like him, are a part of the patient population most correctional nurses encounter day-in and day-out. They are not easy to care for and often not easy to face. Joe has done despicable things in his life and he isn’t improving during his stay at your facility. The security officers don’t think much of Joe and treat him with contempt. It would be easy to do the same. Is Joe deserving of treatment with dignity and respect? Many would say ‘No’!

Yet, nurses working in the criminal justice system are in the profession of caring and are bound by an ethical code that values every human being. The Code of Ethics for Nurses states:

“The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by consideration of social or economic status, personal attributes, or the nature of health problems.”

Joe is definitely a unique patient. He presents with poor social skills and some undesirable personal attributes. How can a correctional nurse overcome repugnance to these characteristics of a person like Joe in order to treat him like a patient? Here are some tips for treating every inmate, even those like Joe, with the dignity and respect deserving of any patient.

Focus on who you are, not on who they are

It can be difficult to deliver good nursing care when you focus on the ‘worthiness’ of the patient. In fact, who the patient is is less important than who we are. As correctional nurses we have signed on to provide “evidence-based nursing to protect, promote, and optimize health and abilities; prevent illness and injury; facilitate healing; alleviate suffering through the diagnosis and treatment of human response with care and respect; and advocate for individuals, families, groups, communities, and populations under the jurisdiction of the justice system (Correctional Nursing: Scope and Standards of Practice, ANA 2021). Just as lady justice delivers her service blindfolded, those in our profession must do the same. It is the definition of who we are.

Ramp up your valuing

Being reminded of the values basis of our profession is another way to overcome negative emotions toward distasteful patients. The ANA Code for Nurses provides a helpful foundation for valuing. In particular, the inherent nursing values of human dignity and worth of every individual is emphasized. Even the patient who has committed the most evil of acts, then, is deserving of the nursing care we have been trained and employed to provide.

Don’t look too closely

The less you know about your patient’s crimes, the better. Some information can’t be avoided. If you work in a maximum security setting, you know your patients have likely done something violent; but, leave your curiosity at the gate when you come on shift. Consider your nurse-patient relationship as a human-to-human intervention. Nurses working in other settings rarely know the criminal history of their patients. Does that hinder their ability to provide professional nursing care? Doubtful. Seek a mental perspective in your care interactions that strips away any value judgments about your patient’s  history or past lifestyle.

See the big picture

Within the microcosm of the individual nurse-patient interaction rests a larger picture of compassionate care. The modeling nurses provide in respectful communication and concern for patient welfare contributes to the civility of the larger institution. By being who we are meant to be as nurses we are instruments for change within the workplace culture. We can make a difference by stepping up and doing the hard work of caring for patients like Joe.

How do you find the motivation to provide nursing care to difficult patients? Share your tips in the comments section on this post.