Guest Robert Greifinger, MD, a correctional health care consultant and co-editor of the International Journal of Prison Health talks about the dangers of cynicism in correctional health care practice. Dr. Greifinger is editor of the book Public Health Behind Bars: From Prisons to Communities. His guest editorial entitled “The Acid Bath of Cynicism” can be found in the Spring 2015 CorrectCare Magazine.
The Acid Bath of Cynicism
What is Cynicism?
Cynicism develops when health care professionals distrust the motives of the inmate health request. It alters clinical judgment and patient perspective. The attitude can be pervasive, like a communicable disease spread among both custody and health care staff. There is a tension between the professional duty to ‘first do no harm’ and the correctional punishment mindset. It can lead to ‘dual loyalties’ where correctional health care staff have both a loyalty to their patient the inmate while feeling a loyalty to the institution. This tension and friction can be a major work stress.
The Trouble with Cynicism
Cynicism can cloud clinical judgment and affect the course of treatment. Treatment delays or misdiagnoses result from misinterpreting patient motives.
Avoiding and Eliminating Cynicism
Here are some suggestions to help avoid or eliminate emrging cynicism.
- Be healthily skeptical rather than being cynical. Every health professional needs to be questioning and validating of symptoms. Seeking validation is an important part of health care practice, no matter the setting.
- Mindfulness about cynicism is helpful in avoiding being drawn into cynicism. Thinking about this for a moment with each encounter can help improve perspective and reduce cynicism.
- Reframe the issue from ‘manipulative’ to adaptive. How is the patient adapting to the situation to obtain what they think they need and a semblance of control over their lives.
- Learn the best ways to take a leadership role when the concern at hand is a health care issue. This develops respect among the disciplines.
How do you protect yourself from becoming cynical in your correctional practice? Share your thoughts in the comments section of this post.
NOTE: The Correctional Nurse Manifesto can be helpful if you are struggling with cynicism and other common correctional nurse challenges. Check it out!