In a prior post, I suggested a Correctional Nurse Manifesto with seven propositions. This post discusses the meaning and importance of the first proposition:
Correctional nurses treat inmates with the dignity and respect deserving of any patient
Henry was a strapping hulk of a man – previously part of a motorcycle gang – 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 security prison where you work. Now you see his name on your sick call list as you prepare for the morning round.
Henry, and many inmates 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. Henry 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 Henry and treat him with contempt. It would be easy to do the same. Is Henry 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.”
Henry is definitely a unique patient. He presents with a low social status and some undesirable personal attributes. How can a correctional nurse overcome repugnance to these characteristics of an inmate like Henry in order to treat him like a patient? Here are some tips for treating every inmate, even those like Henry, 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 “…protection, promotion and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, advocacy, and delivery of health care to individuals, families, communities, and populations under the jurisdiction of the criminal justice system” (ANA definition of correctional nursing). 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 Henry.
How do you find the motivation to provide nursing care to difficult patients? Share your tips in the comments section on this post.
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