In a prior post, we suggested a Correctional Nurse Manifesto with seven propositions. This post discusses the meaning and importance of the seventh and final proposition:

Correctional nurses are a force for good in the community in which they work

Heather works in a small jail where her Health Services Administrator and Medical Director are at odds. In addition, the deputies treat the inmates in a callous manner and security procedures are lax. Heather wants to do a good job for her patients and sees a lot of areas that could be improved with some attention. For one thing, new intakes with a known history of alcohol abuse are not being monitored closely. She is frustrated and feels like escaping back to the emergency room job she left a year ago.

It Just Takes One

Never believe that a few caring people can’t change the world. For, indeed, that’s all who ever have – Margaret Mead

Correctional nurses can find themselves working in difficult environments for delivering good care. Competing priorities and friction among various disciplines can lead to great frustration. Barriers to delivering health care in a secure setting sometimes make even simple nursing tasks an all-day effort. Correctional cultures can emerge that lack good-will among staff and among incarcerated persons. It can be hard to image that you, one nurse, can make a difference in a situation like Heather’s. Yet you never know what chain of events you set in motion by taking action in a situation. I am a firm believer that we are in every situation in our lives for a reason; known or unknown to ourselves. If we have concern over an issue, it is an indication that we should act on it for the good of all. By doing so, we fulfill our professional roles and our ethical/moral human roles in the world.

People Wait For a Leader

We can choose to be affected by the world or we can choose to affect the world -Heidi Wills

Group Mentality (or Herd Mentality) can cause people to be swayed into thinking and acting like the majority of their social circle. In the correctional setting, nurses can absorb the nature and mindset of the prevailing culture rather than maintaining their professional perspective. This can lead to a lack of action in the face of inappropriate, harmful, and even illegal activity.

Malcolm Gladwell in his highly recommended book The Tipping Point suggests that people don’t act in the face of need in a group setting for two reasons. One is that they see others are also experiencing this need and no one sees it as an issue. They conclude that they must be misinterpreting what is happening. An example might be seeing an incarcerated person huddled in the corner of his cell during both medication passes in a day, but no one else, including the three officers on duty in the unit that day, are paying attention to the behavior. A nurse might conclude that she is misinterpreting the patient’s actions as concerning, since no one else seems to be concerned.

Gladwell’s second reason for individuals not acting when they come upon an individual in need in a group situation is because they assume that someone else must be taking care of it. He suggests that the responsibility to act is diffused among the group and no one feels a great enough need to act; assuming someone else in authority is probably taking care of it. In a group, people often wait for an indication from others as to how they should act. Be the person who does the right thing.

Start Where You Are

It is the greatest of all mistakes to do nothing because you can only do little – do what you can – Sydney Smith

Correctional nurses are rarely in power positions, yet we have the power to take action that can lead to powerful good. Small actions can have big consequences. In the complex social structure of a correctional community, a courageous nurse doing the right thing can have a huge impact. Chaos Theory suggests that very small changes, such as the movement of a butterfly’s wings, can change the course of our climate. We already know what the actions we take in our nursing practice, such as initiating an asthma treatment or identifying a patient in alcohol withdrawal, can do for our patients. Correctional nurses have the power to be a force for good in whatever environment we find ourselves.

Have you had opportunity to be a force for good in a correctional setting? Share your story in the comments section of this post.