What is it like working in Jail? The idea of working in a Jail and/or Prison can be a little disconcerting, especially when there is little known about this work environment. The same is felt for friends, family and loved ones who are concerned for your safety who are accustomed to the portrayals in mainstream media. As a nursing student, an individual will go through a variety of clinical settings from Medical-Surgical to Psychiatric rotations but will rarely step foot into a Jail/Prison setting. But fear not, I hope to ease everyone's mind and let you all know that the Correctional setting is one of the most safe and controlled environments for a variety of reasons.
The details in the following are specific to my own workplace and might not be applicable to all workplaces, but different variations of safety measures will exist.
The Correctional setting varies from many other settings because Safety is a top priority. From entrance to exit, most facilities are built with safety in mind. The workflow of both Custody teams and medical staff mesh and intertwine and steps are taken to mitigate the risk for everyone. At the most basic level, Custody encompasses a variety of roles while maintaining the safety of all inmates including their own staff and any adjacent staff (ie. Medical staff, Forensic Mental health, program staff). As medical staff you will be providing a variety services for the inmates which will require a set of safety measures which we will review next.
THE FACILITY
Like I had mentioned, buildings are built with safety in mind. Many of the processes will attempt to control the flow of incoming and outgoing personnel while accounting for each and every person and/or inmate in the building. Looking at most Correctional buildings you will notice that there are a variety of entrances that require a certain set of clearance levels. Certain doors are open to the public or civilians such as the lobby or visiting areas. Then there are doors only for staff such as you and custody. And lastly, there are doors only accessed by Custody staff. Many modern jails/prisons will have centralized rooms that oversee everyone coming in and out. It is not uncommon to be walking around the facility (inside or outside) only to be met by a surveillance camera looking at your or the path you're taking. They attempt to cover each nook and cranny of the building being able to follow an individual's movement from start to finish from hallways to elevators, excluding the inside of bathrooms. The ability to account for everyone going in and out, including their movements are key to increasing safety.
In regards to movements, Correctional facilities have control over the large steel doors separating corridors electronically and manually with keys. These separations are put in place to control the movements of certain staff, especially those transporting inmates to and from court / medical floor / other areas of the building. They can keep inmates in the right areas and open only when appropriately supervised by staff. If a nurse is attempting to enter a housing pod for medical care, the centralized control room will open the door when deemed safe after reviewing any risks on the other side. At my facility, in addition to a central control surveillance, radio confirmations of clearance are required before entering a housing unit. Be aware that they have their own policies regarding safety. The mixture of surveillance and confirmation helps reduce any mistakes on their end.
Housing units
As a nurse, you will most likely be located on a medical floor, a designated area that may mimic a clinic or hospital setting (Infirmary for prisons). This will be separated and secured by the same set of doors and will be controlled by a central surveillance or through badge/fingerprint access. Any planned movements will be accounted for by Custody ahead of time and live movements are often relayed to the central control to confirm the safety of proceeding to the next area.
As for the rest of the Correctional facility, layouts may differ but generally housing units will be separated by the severity of charges or even gang affiliation. There is usually a centralized area for Custody/ Deputy/ Correctional Officer Staff that oversee the housing unit or "pod". Again this is another safety feature as they must have eyes on all things that are happening on the pod. There is usually quick access onto the pod as Officers have to be able to act quickly in case of any emergency. For example, the facility I am at has a centralized Officer desk that sits directly in the middle of the pod. All pods reflect the same layout throughout all floors so that safety measures can be consistently repeated regardless of the housing unit. Some facilities have this Officer area in the corner of a pod with every cell facing outward, but this varies from facility to facility.
Your Personal Bodyguard
In my opinion, the best safety measure that is common practice at most facilities is the Staff escort in and out of housing pods and for the duration of your stay on the pod. Knowing that you will have your own personal guard with you at all times ,while interacting with any inmate, gave myself a little bit of comfort when I first started. This type of escort is quite common within many correctional settings. Any staff that is not Custody or badged staff generally require an escort during the entirety of their activity or task.
For example, when entering a pod our facility requires Custody escort when interacting with inmates. They will notify you if the inmate is not clear for a face to face encounter (ie. behavioral reasons such as being disruptive or being uncooperative). If deemed safe to interact, the officer will allow several options for interaction. You may be able to speak through the cell door as they normally have small vents so that both sides can be heard. Additionally, many traditional cell doors have a small food port that can be opened and closed with a lock. This can be used for things such as a blood glucose check, oxygen + pulse check and even a blood pressure. If you need the inmate to be out of the cell, they also have the ability to open the door and supervise your interaction.
There is rarely a time where inmates are left alone with non-badged staff, there is always an Officer on standby if not directly next to you. Part of their role is to keep you safe while they are on duty. They take responsibility of everything that happens in their pod so they will let you know if it safe to proceed or possibly even ask you to return at a later time if too many liabilities exist at that time.
The Population
First thought of a Jail or Prison and you might be thinking that you will be going face to face with some of the worst individuals hardened by the Institutionalized system. How could you possibly try to help anyone in this setting if you'd be fearing for the worst? At least that's what I thought initially. I came to find out that the people needing help managing their medical conditions are still just ordinary human beings.
Some inmates have downright horrible charges and some menial, but I did not choose to work here just to look up each and everyone's case before helping them (although you may come across the occasional National news headliner!). Aside from being in a system that strips them of several freedoms, having medical and mental health needs puts them in a vulnerable position. Many of them respect medical staff especially when they need help and will rarely seek to lash out at medical staff.
There are those who are just downright disrespectful and malicious toward Medical and custody staff, but you can easily find the equivalent at a local county hospital. Luckily we have Custody staff to prevent any escalation, whereas the hospital will resort to using nursing staff initially. Similarly, psychiatric units within a hospital are normally ran by the nurses and it is up to them as a team effort to subdue someone who is on a danger to others psychotic break. Rude and disrespectful individuals are not limited to just the Correctional setting, but I am glad a steel door and badged staff exist between me and those types of characters.
One of the Safest settings
Although you will be working in a facility filled with alleged/convicted criminals or those with violent backgrounds, the facility and workflow were designed for a variety of safety measures to keep every individual safe. This includes Custody staff, Medical staff and the inmates. Policies will vary from jail to jail but the goal is the same, keep everyone safe at the end of the day. To reiterate:
As you can tell, this type of environment is well controlled in many ways from the structural components of the building to the workflow of custody and their integration of medical staff. It does good job of mitigating risk but it does not completely negate the risks involved in this setting. Don't get me wrong, the system doesn't provide a risk free environment but it is definitely reduced especially when you as a nurse take extra precautions to keep yourself safe. There are plenty of precautions that a nurse can take to help keep themselves safer in this type of environment (and is also applicable to other settings as well!) and will be discussed in the next segment.
If you're still interested in working in this field or got an interview be sure to check out
The Ultimate Guide to Corrections Nursing Interview
The details in the following are specific to my own workplace and might not be applicable to all workplaces, but different variations of safety measures will exist.
The Correctional setting varies from many other settings because Safety is a top priority. From entrance to exit, most facilities are built with safety in mind. The workflow of both Custody teams and medical staff mesh and intertwine and steps are taken to mitigate the risk for everyone. At the most basic level, Custody encompasses a variety of roles while maintaining the safety of all inmates including their own staff and any adjacent staff (ie. Medical staff, Forensic Mental health, program staff). As medical staff you will be providing a variety services for the inmates which will require a set of safety measures which we will review next.
THE FACILITY
Like I had mentioned, buildings are built with safety in mind. Many of the processes will attempt to control the flow of incoming and outgoing personnel while accounting for each and every person and/or inmate in the building. Looking at most Correctional buildings you will notice that there are a variety of entrances that require a certain set of clearance levels. Certain doors are open to the public or civilians such as the lobby or visiting areas. Then there are doors only for staff such as you and custody. And lastly, there are doors only accessed by Custody staff. Many modern jails/prisons will have centralized rooms that oversee everyone coming in and out. It is not uncommon to be walking around the facility (inside or outside) only to be met by a surveillance camera looking at your or the path you're taking. They attempt to cover each nook and cranny of the building being able to follow an individual's movement from start to finish from hallways to elevators, excluding the inside of bathrooms. The ability to account for everyone going in and out, including their movements are key to increasing safety.
In regards to movements, Correctional facilities have control over the large steel doors separating corridors electronically and manually with keys. These separations are put in place to control the movements of certain staff, especially those transporting inmates to and from court / medical floor / other areas of the building. They can keep inmates in the right areas and open only when appropriately supervised by staff. If a nurse is attempting to enter a housing pod for medical care, the centralized control room will open the door when deemed safe after reviewing any risks on the other side. At my facility, in addition to a central control surveillance, radio confirmations of clearance are required before entering a housing unit. Be aware that they have their own policies regarding safety. The mixture of surveillance and confirmation helps reduce any mistakes on their end.
Housing units
As a nurse, you will most likely be located on a medical floor, a designated area that may mimic a clinic or hospital setting (Infirmary for prisons). This will be separated and secured by the same set of doors and will be controlled by a central surveillance or through badge/fingerprint access. Any planned movements will be accounted for by Custody ahead of time and live movements are often relayed to the central control to confirm the safety of proceeding to the next area.
As for the rest of the Correctional facility, layouts may differ but generally housing units will be separated by the severity of charges or even gang affiliation. There is usually a centralized area for Custody/ Deputy/ Correctional Officer Staff that oversee the housing unit or "pod". Again this is another safety feature as they must have eyes on all things that are happening on the pod. There is usually quick access onto the pod as Officers have to be able to act quickly in case of any emergency. For example, the facility I am at has a centralized Officer desk that sits directly in the middle of the pod. All pods reflect the same layout throughout all floors so that safety measures can be consistently repeated regardless of the housing unit. Some facilities have this Officer area in the corner of a pod with every cell facing outward, but this varies from facility to facility.
Your Personal Bodyguard
In my opinion, the best safety measure that is common practice at most facilities is the Staff escort in and out of housing pods and for the duration of your stay on the pod. Knowing that you will have your own personal guard with you at all times ,while interacting with any inmate, gave myself a little bit of comfort when I first started. This type of escort is quite common within many correctional settings. Any staff that is not Custody or badged staff generally require an escort during the entirety of their activity or task.
For example, when entering a pod our facility requires Custody escort when interacting with inmates. They will notify you if the inmate is not clear for a face to face encounter (ie. behavioral reasons such as being disruptive or being uncooperative). If deemed safe to interact, the officer will allow several options for interaction. You may be able to speak through the cell door as they normally have small vents so that both sides can be heard. Additionally, many traditional cell doors have a small food port that can be opened and closed with a lock. This can be used for things such as a blood glucose check, oxygen + pulse check and even a blood pressure. If you need the inmate to be out of the cell, they also have the ability to open the door and supervise your interaction.
There is rarely a time where inmates are left alone with non-badged staff, there is always an Officer on standby if not directly next to you. Part of their role is to keep you safe while they are on duty. They take responsibility of everything that happens in their pod so they will let you know if it safe to proceed or possibly even ask you to return at a later time if too many liabilities exist at that time.
The Population
First thought of a Jail or Prison and you might be thinking that you will be going face to face with some of the worst individuals hardened by the Institutionalized system. How could you possibly try to help anyone in this setting if you'd be fearing for the worst? At least that's what I thought initially. I came to find out that the people needing help managing their medical conditions are still just ordinary human beings.
Some inmates have downright horrible charges and some menial, but I did not choose to work here just to look up each and everyone's case before helping them (although you may come across the occasional National news headliner!). Aside from being in a system that strips them of several freedoms, having medical and mental health needs puts them in a vulnerable position. Many of them respect medical staff especially when they need help and will rarely seek to lash out at medical staff.
There are those who are just downright disrespectful and malicious toward Medical and custody staff, but you can easily find the equivalent at a local county hospital. Luckily we have Custody staff to prevent any escalation, whereas the hospital will resort to using nursing staff initially. Similarly, psychiatric units within a hospital are normally ran by the nurses and it is up to them as a team effort to subdue someone who is on a danger to others psychotic break. Rude and disrespectful individuals are not limited to just the Correctional setting, but I am glad a steel door and badged staff exist between me and those types of characters.
One of the Safest settings
Although you will be working in a facility filled with alleged/convicted criminals or those with violent backgrounds, the facility and workflow were designed for a variety of safety measures to keep every individual safe. This includes Custody staff, Medical staff and the inmates. Policies will vary from jail to jail but the goal is the same, keep everyone safe at the end of the day. To reiterate:
- Facilities take account of every individual entering and exiting each and every door
- Movements are visible to Custody personnel so they can see you made it to your destination safely
- Cameras and surveillance exist in all parts of the Jail/Prison
- Access is granted to certain areas based on the individual clearance and doors will not be opened if not deemed safe
- Custody will always tell you when an interaction with an inmate is not advised
- Custody remains with you at all times when you are interacting with an inmate either on a housing unit or within your medical clinic
- If you require privacy (ie. discussing private health issues) Custody remains on standby within a reasonable distance
- Custody will step in if any behaviors escalate or notices any changes in behavior
- Nursing staff will never be utilized to go hands on with inmates
As you can tell, this type of environment is well controlled in many ways from the structural components of the building to the workflow of custody and their integration of medical staff. It does good job of mitigating risk but it does not completely negate the risks involved in this setting. Don't get me wrong, the system doesn't provide a risk free environment but it is definitely reduced especially when you as a nurse take extra precautions to keep yourself safe. There are plenty of precautions that a nurse can take to help keep themselves safer in this type of environment (and is also applicable to other settings as well!) and will be discussed in the next segment.
If you're still interested in working in this field or got an interview be sure to check out
The Ultimate Guide to Corrections Nursing Interview