Prison and jail medical units are over-represented by female staff, creating a number of challenges to avoiding unhealthy patient relationships. It is a common saying that incarcerated persons go to medical to ‘enjoy the view’, and in one prison system in which I worked, it was explicitly stated to all orientees, “You cannot have sex with an inmate.” As crass as that sounds, it was necessary to make it crystal clear that a sexual relationship with an incarcerated person, no matter if it was consensual or not, was illegal in that state and would be prosecuted. In that same system, former nursing staff were doing time for this very transgression.

Correctional professionals rarely start their careers expecting or wanting a relationship with their patient. So how does it happen? Here are some signs to watch for – not only for yourself, but for your colleagues as well.

Sign #1: Personal life in disarray

Counteractions:

Sign #2: Doing little favors

Having day-to-day contact with any individual makes it easy to begin identifying with their beliefs and sympathizing with their plight. We all struggle to maintain a balance between the need to avoid identifying with our patients and the need to maintain an awareness of their humanity.

Manipulative incarcerated persons will study your attitudes and actions, using them to their own benefit. If an inmate convinces you to do even a small favor, you have started down the path of obligation. Feelings of obligation are universally human, but obligation to incarcerated persons is a serious problem in a secure workplace.

Counteractions:

Don’t do even the smallest ‘favor’ for an incarcerated person if it is against regulation.
Create clear boundaries in your relationships with incarcerated persons — firmness, fairness and consistent words, actions, and interactions protect you and others.

Sign #3: Looking for opportunities for contact

Do you find yourself looking for opportunities to be with a specific incarcerated person? Watch carefully for this. This may be a subtle beginning to an unhealthy relationship.

Counteractions:

If you find yourself attracted to a particular incarcerated person, ask for a re-assignment immediately.
When the incarcerated person comes to mind, immediately change your mental channel –think about something positive and motivational, and change your location or activity to help in re-orienting your thoughts.
If you see a colleague doing this, have a serious talk about it in private.

Sign #4: Correspondence with an incarcerated person

Often, the first step to a more intimate relationship with an incarcerated person involves written communication. A note, letter or email moves the relationship one step further down the road to ruin. Even when not sexually explicit, written communication has been used as evidence of an improper relationship with an incarcerated person.

Counteractions:

Avoid ALL written communication involving incarcerated persons — this includes mailing letters and passing notes from one individual to another.
Do not tolerate these actions from another staff member — call them on it personally and suggest they immediately report the actions to a supervisor.

Sign #5: Falling off the cliff

When things progress and include personal and physical contact, many procedures have been violated, rules breached and laws broken. This point is only reached after many of the above ‘red flags’ have been passed. But it is still not too late to turn back.

Counteractions:

If you know of a staff member in this situation, do something about it. First, confront your colleague and suggest they immediately report the situation to the supervisor. Management and the courts are often more lenient when the individual admits what has occurred. If this is you, notify the incarcerated person and turn yourself in — suggest the incarcerated person does the same. Get help! Consider all your options including counseling, and legal or employee assistance.

If you know about this activity and your co-worker refuses to report themselves, you must do it for them. This action protects your team, your colleague, yourself, and the incarcerated person.

Take action now!

If you see yourself or a fellow staff member in any of the above descriptions, please, take action! Protect yourself and your peers. Unhealthy relationships with incarcerated persons jeopardize not only the individual but also the security of other staff members. You are doing yourself and others a favor by intervening before it is too late.

If you are interested in more information about inmate manipulation, find it at The Correctional Nurse Educator class Inmate Manipulation for the Correctional Nurse.

What have we forgotten? Share your strategies for avoiding inmate relationships in the comments section below.