I have encountered many nurses who have never considered working in a jail or prison. In fact, very few nurses decide on a nursing career with the thought “I want to be a jail nurse”. This patient community is fairly invisible to healthcare professionals. Once encountered, possibly by way of a job posting or meeting someone like me, there are some common questions that come to mind. Lets explore them together to demystify the corrections healthcare environment.
Question #1 – Isn’t it unsafe to work in a jail or prison?
It is true that safety is a major concern in this environment. However, many precautions are taken to allow a safe work environment including the presence of custody officers in the care area. I often liken the patient population to that of an urban emergency room. In some ways a correctional nurse is in a safer situation because the arrestee or offender is clearly identified and everyone is on alert. This is not necessarily the case in an urban ‘free world’ setting. During the orientation period most agencies provide intensive safety training to healthcare professionals. When interviewing for a position in corrections, ask questions about the safety measures in place at the facility
Question #2 Isn’t healthcare in prisons and jails substandard?
Since the ’70’s, correctional healthcare has been held to the standards of the community. Case law and advocacy groups have established a body of work which has led to improvement in medical and mental health care for the incarcerated. When considering a position at a facility, ask about accreditation. Two main accrediting bodies NCCHC (National Commission on Correctional Health Care) and ACA (American Correctional Association) are available. These two operate similar to the Joint Commission (JCAHO) in that they provide an outside source determining that quality standards are being met.
Question #3 Won’t I be working with poor practitioners – nurses and doctors who can’t get a job anywhere else?
Nurses and physicians come to the correctional environment for many reasons. Many have a true desire to help the underserved in our society. Some see it as a calling as well as a job. There are many truely dedicated practitioners working in jails and prisons, often in very challenging situations. Licensure, peer review, competency evaluation and credentialling are all standard requirements, just as in the ‘free world’.
Question #4 Won’t I put my family in danger with all the diseases inmates carry?
This is a surprising question to me, but I have heard it enough to know it is a concern. Due to the high level of drug and alcohol abuse among those coming into the jail environment, personal hygiene is often poor. In addition, addictions and lifestyle choices lead to increased levels of Hepatitus B & C, HIV, and tuberculosis in this population. Nurses working in corrections, however, have all of the protections of standard precautions and vaccinations as do those in other settings. Nurses in the corrections environment must be ever alert to disease transmission and must carefully adhere to infection control practices.
Question #5 Why would I want to make a career of correctional nursing?
Correctional nursing is a specialty practice area with its own distinct body of knowledge and specialized patient population. Many nurses stubble on to this specialty by accident and continue on enjoying the many challenges and benefits. Some jokingly say they work in a ‘Gated Community’. Correctional nursing often provides a less stressful and physically demanding environment than traditional hospital nursing.
Maybe another question has come to mind as you read this blog post. Include your question (or comment) in the comment section and I will answer on a future post.
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Great blog Lorry! Looking forward to reading more and seeing you at our Nashville Conference in August. Keep up the good work.
I have been a nurse for about 27 years. About 25 years ago, I had moonlight job at a nursing agency. My first assignment was at a city jail. I bravely took the assignment, and when I presented to the detention center, I was told I was assigned to the women’s center. As the cells closed behind me, I started to panic. I was led to the “medication window” and my assignment was to dispense meds. The areas was so cold and dark. I finished my shift and I went to sign out. When I got to the guard in charge of letting me out, I noticed I did not have my badge. The guard said to me” I can not let you out without your badge”. I kept looking at him to see if he was smiling or kidding, he was not ! He told me to go find it because it could be a security breach. I went back to my station and lo and behold, my badge was on the floor. I took the badge to the guard and ran out of there so fast and I have never looked back! I totally understand his actions now !
Thanks for sharing your story, Phyllis. Working in corrections can, indeed, be scary – especially if you go in unprepared.
Lorry, in response to Question #5 Why would I want to make a career of correctional nursing?, I would like to add that correctional nursing is an opportunity for you, as a nurse, to make a dramatic difference in a patient’s life. Many of the people that cross our path in the correctional setting have never had the chance to access healthcare (medical, mental health and dental) in meaningful ways. A thorough evaluation with an appropriate treatment and patient teaching goes a long way in helping this population to learn about the benefit of lifestyle changes, proper care and how to access available community resources when they get released.
A great addition to this post, Kathy! Thanks for including it.
Hi Kathy and Lorry…I enjoyed both posts, “Myths” and this one. I am presenting “My Time in Jail” at an upcoming Wound Care Conference. I am sure during my Q&A there will be similar questions.. great content!
I hope Kathy remembers me….she was a great supporter of our wound care team creation in our facility.