Why do we stay in correctional nursing?

Model isolated on plain background in studio puzzled

The last several posts have described the challenges and distinguishing features of correctional nursing. Well what are the reasons nurses stay in the field? I thought that I would be in the field about five years before moving on to something new and that was 31 years ago! What is it about correctional nursing that keeps us?

Here are some of the reasons that I am aware of…maybe some of these will resonate with you.

  • We can see our patients every day, for years and years, and so have time and opportunity to establish a strong, therapeutic alliance. This is especially true of prisons where an inmate may spend their lifetime. In jails and detention facilities offenders may not stay very long, but a relationship can be built here also because most of them come back again, again, and again for repeated offenses. The amount of time we can spend with our patients, facilitates teaching and coaching them to manage disease and live healthier lifestyles. They are dealing with loss, grief, in some cases death, and at some point will seek redemption, meaning and purpose in life. A nurse may be the one contact that initiates and supports that change. I remember a prisoner who cried at a ceremony we held at the end of eight weeks of psychoeducational classes. He told us that he had never finished anything before, didn’t think he could finish and now realized he was capable of more. It wasn’t “a con”; he went on to get his GED and learn a trade.
  • Prisons and jails may be considered somber and inhospitable places but for many it is a better environment than how they lived in the “free” community; perhaps homeless, unemployed, sought after by the police or other criminals, high on drugs or alcohol. By contrast, a correctional facility is a highly controlled environment. Advantages here are that disease can easily be detected and treated, and sometimes as in the case of tuberculosis and STDs, the public benefits as well. Lifestyle behaviors that contribute to chronic disease can also be modified during imprisonment. Examples include smoking cessation programs, diabetic education, medication adherence and harm reduction. In some ways it is a perfect place to promote change; the patients are available and easy to interest, their progress can be monitored and outcomes measured. When our patients relapse, as inevitably happens when making lifestyle change, they can re-enroll in the program and do it all again, each time making incremental but positive improvement.
  • A related advantage is that this controlled environment is “safe”; a safe place to work. A light hearted way we express this is when we say that at least in prison we know who the criminals are; they all wear the same uniform. We have custody staff monitoring our every movement and every one going in and out is searched for contraband. The only time I have ever been threatened with a weapon was when I worked in an emergency room at a university hospital and the only time I have been hit, I was working on a med-surg unit in a community hospital. After 31 years of experience I would say that a correctional facility offers a very safe and controlled environment in which to provide health care.
  • Lastly, it is a fascinating field. Here is an example from my experience. One day a nurse is seeing patients who have requested health care attention, for complaints typically seen in an ambulatory care clinic, (low back pain, skin irritation, sore throat, and nasal congestion) and then along comes a patient with mild CNS symptoms and gives a history of GI upset and myalgia. He has escaped from civil warfare in Nicaragua and was picked up in the U.S. recently without immigration papers. Given this description what medical problems would you be considering might be the cause of his symptoms? Ultimately the patient was diagnosed with a severe case of trichinosis that has infected his brain, undoubtedly from eating undercooked infected meat on his desperate travel to America. He recovered fully in the capable care of correctional nurses. The range of clinical problems we see in our day to day practice is a marvel.

Why are you still a correctional nurse? What is it about the field that keeps you coming back to work each day? Is it because it is so different from every other specialty, or is it that you can see how much good you can do and the satisfaction of making a difference? Maybe take a moment and give thanks for the things that make you proud to be a correctional nurse. Let us know about your experiences in the comments field in this post.

If you would like to read more about correctional nursing go to Essentials of Correctional Nursing; the first and only textbook written so far about the practice of nursing in this specialized field. Order a copy directly from the publisher or from Amazon today!

Lorry Schoenly, co-contributor at this site, has published a book by the title, The Wizard of Oz Guide to Correctional Nursing, to help nurses manage the transition to this very different setting. If you would like to order a copy of The Wizard of Oz Guide to Correctional Nursing, by Lorry Schoenly go to Correctionalnurse.net and order it through Amazon.

Photo credit: © bruno135_406  – Fotolia.com

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