When I began my career in nursing, I never imagined that I would end up working as a correctional nurse. I always imagined that I would work in
acute care in a hospital or eventually in the community. Working with marginalized individuals piqued my interest in working in mental health. A correctional nurse is a bit more like a social worker. We have a serious moral compass and are able to adapt to a very unstable setting. It is unlike any other nursing environment.
When I start my day as a correctional nurse, I enter a nondescript door that is controlled access. I am greeted with a buzz and a police officer asking to verify my identity. There are cameras everywhere in the grey windowless environment. Contrary to belief, I am actually quite safe.
There are often a few guards to each inmate when a correctional nurse assesses them. The jail environment is unpredictable but also predictable in many ways. You often see many of the same inmates over and over again unfortunately. You begin to develop relationships of care, and you see them when they relapse with addictions or suffer mental health crisis.
Every inmate that is admitted is entitled to a basic head to toe assessment. During this time, you will determine if they are withdrawing from street drugs or alcohol. It is the jail nurse’s duty to ensure that they are safe to stay as withdrawal can sometimes result in dangerous symptoms such as seizures.
Partnerships as a Correctional Nurse
As a jail correctional nurse, you collaborate with community health teams to try to ensure continuity of care. A jail nurse works in partnership with police, jail guards and community mental health teams. We often share care of inmates and our goal is to keep them out of jail and try to anticipate the need of access to resources in the community.
When working at the jail, we work in teams of two registered nurses and doctors that round on patients every morning. The nature of the job is unpredictable but the correctional nurse has a lot of autonomy to decide on client care.
Each morning begins with rounds on the inmates that are on deck. The holding facility I worked in would house women, men and youth. There were also inmates that were on immigration hold, so they may have entered the country illegally. Sometimes more than thirty inmates are present.
The nurses are their to ensure patients have dignity, basic human rights and access to their routine medications while incarcerated. Many patients live with HIV, so it is essential they receive their antiretroviral (ARV) medications daily to ensure they do not develop drug resistance.
Often the clients are withdrawing from street drugs so the jail nurse is also there to ensure they do not suffer. Occasionally, inmates will have sustained wounds from their arrest such as bites from police dogs or cuts and bruises from resisting arrest. They also may be injection drug users, who may have wounds such as an abscess or infections. so often the jail nurse will provide wound care.
Quick Thinking as a Jail Nurse
Working with inmates is challenging at times but also rewarding. A correctional nurse has a high level of independence in making decisions. Correctional nurses use critical thinking to quickly decide if a client is too acute and needs to be transferred to acute care in a hospital.
There have been shifts were a patient was showing the signs of a heart attack and my partner and I had to radio each other on the walkie-talkie to run and get oxygen and call the paramedics at the same time. When you work in jail, you must be flexible and able to adapt to an ever changing environment.
In jail, the correctional nurse has the authority over police to determine if a patient is too ill to be in jail and needs to be transferred to a hospital. It took an adjustment to have the confidence to authoritatively ask the police to release an inmate to the hospital.
Overall, working in jail gave me a strong sense of autonomy and a greater understanding of mental health and addictions. There is something rewarding about being able to allow inmates to have the basic human right of access to healthcare and dignity.
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