Growing up I always wondered who I would become in my adult life. I had a loving personality and my favorite things to do were nurture animals back to health and feed all the strays in my neighborhood because at least then I knew they were eating! I can recall my family always joking that I would grow up to be a veterinarian, which sounded enjoyable at such a young age, but I quickly realized it was not for me. Throughout junior high and some high school I never knew where I would end up, but then late in my sophomore year my dad became ill. We spent countless hours in and out of hospitals, surgery after surgery, illness after illness. Spending all this time with him really opened my eyes and made me want to explore the medical field. I knew there were so many options, but nursing was not my first career choice. Graduation rolled around and I was still unsure, so I followed my heart and took some time off schooling to figure out what was next. Shortly after graduation, I took a position in the hospital as a phlebotomist.
Although I loved this job, it wasn’t my forever and opened my eyes to what was next. Day in and day out I got to witness first-hand the impact that nurses made on the lives of others and this is when it finally clicked, I was meant to be a nurse. When I thought about being a nurse, I thought about the more fun side of it and my first choice was a labor and delivery nurse where I would be able to spend my time helping families bring new babies into the world. That was until my sister became a prison nurse and opened my eyes to how truly rewarding this career field really is. Prison nursing rise above others and take care of inmates even when they know these people have done things that ended them up in the system. I’ve always been one to see the best in everyone and this is a way for me to be able to do just that. Although these humans are criminals, they still need medical attention and who are we as people to deny them of that. I’ve spoke with my sister often and ultimately came to the decision that I would enjoy pursuing a nursing career in the prison system. Prison nursing is not for the faint of heart and typically is a career path that many nurses tend to avoid.
One reason nurses tend to avoid a position in the prison nursing career field is the feeling they get of being unsafe when in the presence of the inmates. In the book Essentials of Correctional Nursing, author Lorry Schoenly, Ph.D, RN, CCHP-RN (certified correctional health professional-registered nurse), helps to explore the different aspects of remaining safe while working as a nurse within a prison. From the beginning of nursing school, we are taught that nurses should always do what they can to keep the patient safe and provide any care necessary to aid in saving the patient’s life. Lorry proves to us that this is not the case in the prison system by presenting us with facts such as, “Unlike many other patient care environments, nursing in corrections requires that safety come first, followed by therapy and treatment goals.” (Schoenly 55). While it may be necessary for nurses to aid in life-saving measures, the most important aspect of prison nursing is that a scene must be secured by officers before medical staff is allowed to be present and provide the care needed. Although many nurses have little knowledge on this, they are trained during the onboarding process that the officers are there to keep not only the inmates safe from physical harm but more importantly, to keep the nurses safe.
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In a typical hospital setting, or even a doctor’s office, nurses tend to feel less threatened by their patients and their number one priority is to take care of the patient and get them the care they need. In the prison, this is not the case as nurses are faced with the fact that their patients are criminals and need to be treated as if they are still dangerous to others. Prison nursing requires nurses to have an understanding of how to be able to interact with the patient and provide treatment while keeping themselves safe. We are constantly using our senses in everyday life but in the prison world these become even more important. Sight and hearing are two of the most significant as these will allow us to see things that can lead to dangerous situations and to hear things that can help us intervene before something drastic happens.
While these are the most basic of our capabilities, we must also use our sight to be constantly scanning the work area and travel routes to be taken to monitor for safety threats. It is important to stay within sight of an officer and never lead yourself into a blind spot without making sure it is secure first. It is important to remember to never move into an area that is not able to be visually scanned before entering. Hearing is also highly important as it is used to hear alarms and to be able to hear commands from officers that are there to keep us safe. Lorry also writes in her book, “Consider using the ‘sixth sense’ when monitoring personal safety while on duty in a correctional facility.” (Schoenly 56), meaning that the sense of a situation not feeling right should be considered. If you are in this situation, you should leave immediately or request additional resources. Activating safety procedures when needed and monitoring personal safety is a responsibility that each nurse is held accountable for.
While staff is highly responsible for keeping each other safe, environmental safety is just as important. When building facilities, maximum visibility is taken into account for the housing units, treatment centers, and outdoor areas. Although it is not possible for every area to be completely open, the prison has other equipment in place to help make visibility possible. Things such as mirrors, watch stations, cameras, and even towers are used to be able to monitor every part of the prison at all times. Going further into the medical center, exam rooms are arranged in a way that prevents the entrapment of the staff member and always keeps the room exit accessible to them. Exam rooms are stocked with only equipment that is necessary for treatment and storage areas within the direct patient areas are locked with keys that are secured by staff members.
These areas are also designed to be limiting to the inmates and not allow them to have access to public rooms or hallways in addition to have separate bathrooms from the staff members. Specific areas of the medical units are locked, and inmate and inmate workers are not allowed in these areas without an escort. Since inmate workers are present within the medical units, we as nurses need to remember that patient confidentiality is to be maintained while still keeping staff safety in mind. Patient privacy needs to be considered when giving tasks to inmate workers, such as ensuring that patient record information should be shredded by health care staff before being disposed by inmate workers. The last important thing to keep in mind when inmate workers are present is that healthcare staff should keep track of inmate workers and ensure they are being regularly rotated out of healthcare to avoid familiarity with the staff and cause a security risk to them.
