While I’d love more nurses to enter the specialty of correctional nursing, it is not for everyone. Earlier I posted about signs that you were destined to be a correctional nurse. This time, I am turning the tables and listing some reasons this may not be the best fit. Recently I asked for input on this subject over at the Correctional Nursing FB group. I have condensed their comments into this list of common themes. Oh, and they are in alphabetical order; not necessarily in any order of importance.

Correctional nursing may not be right for you if you:

1. Are easily manipulated: Many in the incarcerated population have turned manipulation and deceit into an art form. Nurses who are gullible or easily deceived will have a hard time working in this setting.
2. Are judgmental: Dealing with a high percentage of manipulative and deceitful patients can easily lead to a judgmental and jaded attitude to all patient concerns. Correctional nurses constantly struggle to remain objective, especially after being ‘conned’ by a patient. Yet, many correctional patients are honestly seeking a health care solution to an illness or injury when they seek out nursing care. Being overly judgmental toward the patient population can mean missed diagnoses and tragic results.
3. Are too empathetic: Caring is still a part of nursing in a correctional setting; but it must be tempered to fit the environment and patient population. Nurses with a lot of empathy can become targets for manipulation. A segment of the inmate patient population will take advantage of a big heart.
4. Are unable to handle power: As gatekeepers to health care services, correctional nurses do hold power over inmate patients. Some nurses are unable to handle that power and end up becoming bullies in the system by withholding services or ignoring patients they do not like.
5. Are unable to reprioritize: This is probably true in most nursing specialties, but the day doesn’t always go as planned in a correctional setting. Correctional nurses must be able to shift from ambulatory nursing to emergency nurses in a heartbeat. Priorities can change frequently, yet the ‘to-do’ list continues.
6. Are unassertive/unable to deal with conflict: Correctional nurses work in a setting where health care is not the primary goal. Yet, nurses in correctional facilities must still practice with the patient’s health and well-being in the forefront. This often means the need for patient advocacy and conflict management.
7. Don’t like medication administration: The unfamiliar are likely to think that most correctional patients are young healthy men, but the facts speak otherwise. While each institution is different, authors Knox and Burrow in their book Medication Management in the Correctional Setting state that up to 80% of inmates can have prescription drugs ordered for medical and mental health conditions. Much of correctional nursing practice involves the storage, preparation, and administration of various medications.
8. Need the latest technology: Correctional settings are some of the most underfunded health care situations in the country. It can feel like working in a third-world country. Correctional nurses sometimes need to spin gold from straw in order to provide adequate patient care. If you need the latest technology, you may not want to choose this specialty.
9. Take things personally: Those manipulative deceitful patients can also be downright mean. A nurse with low self-esteem or self-confidence may not be able to handle the personal barbs and insults that can be hurled by malicious or angry patients.
10. Want to be part of the punishment: It can be surprising, but some nurses end up viewing themselves as part of the security force rather than providing necessary health care while the patient is incarcerated. Denying health care is not part of the punishment of incarceration.

What do you think? Did we miss any characteristics that indicate a nurse might not find a home in correctional nursing? Share your thoughts in the comments section of this post.