It takes a special person to work as a nurse. I particularly ponder this thought each year around this time. Nursing care in many settings requires 24/7 coverage 365 days a year. Whether in acute care, emergency, long term care, or a correctional facility, nurses are needed, even during weekends and holidays. I am reminded of my naivete more than three decades ago when, nearing graduation from nursing school, I realized I would have to work 50% of my weekends and holidays. What!

More importantly, it takes a special person to practice nursing. Nurses must jump into the lives of their patients at a rough point. Illness, injury, and suffering can be ugly, intense, and deeply painful. We deal with body fluids, needles, gaping wounds, and heart-wrenching loss … and must take it all in stride.

To that end, it takes a special nurse to practice correctional nursing. The criminal justice system is an unlikely health care environment and prisoners are a unique patient population. Here, illness, injury, and suffering are treated in the midst of heightened security, reduced resources, and isolation.

Incarcerated patients are a difficult bunch. Many lack impulse control and anger management skills; making them challenging patients. Some are likely to use health care interactions to gain an advantage in the prison economy such as access to contraband or desirable medications for barter. A few will seek to draw staff into actions that are illegal or, at least, against facility policy.

Somehow correctional nurses must maintain a balanced view of the incarcerated patient population that recognizes both realities – an isolated vulnerable patient population that may also be hostile, deceptive, and up to no good. This is particularly enhanced during the holiday season.

Missing Family During the Holiday

In prior Christmas posts here and here I talked about the issue of family and children with our patients. Holidays are definitely a time that brings family into focus. Many of our patients are estranged from family and friends due, in part, to their criminality and long-standing relationship issues such as addiction, theft, or irresponsibility. Even if some family relationships are intact, distance and travel expense may isolate prisoners from their loved ones.

When you work the holiday in the criminal justice system, an understanding of this situation can lead to heightened awareness of situational depression, guilt, or even suicidal thoughts.

Working Short During the Holiday

Many facilities are on skeleton staffing over the holiday season. Thinning the ranks can mean reduced attention to personal safety and standard operating procedure. Correctional nurses need to be especially vigilant during this time period. In addition, personal holiday activities can occupy our minds and increase distractability in an already risky work environment.

When you work the holiday in the criminal justice system, an understanding of this situation can lead to heightened awareness of personal and patient safety.

Tips to Survive Christmas Week in the Criminal Justice System

Here are a few of my favorite tips for working the holidays in a correctional facility. They are not rocket science and, frankly, are common sense. However, even the most basic of functions need reminding now and then (like washing your hands!)

• Keep an eye out for those patients you know to be vulnerable to depression and suicidal thoughts. This might be a good time to re-evaluate their psychological health.
• Keep a check on personal conversation in front of patients. It is easy to slip into talk of holiday parties or gift ideas for your children. Some of our patients can take advantage of knowing about your personal life.
• Even if staffing is thin, don’t let down on safety procedure. If it takes longer to get a needed escort, wait. Don’t put yourself in jeopardy.
• Watch out for your work mates. Sometimes you can see their vulnerability before they do.
• Finally, embrace the unique nature of your correctional nursing practice. You are a special nurse with a special mission. I am proud of you!

How do you survive working the holidays as a correctional nurse? Share your thoughts in the comments section of this post.