At 1300 hours I felt my belt clip for the steel ring that held my 186
key, chit, and whistle. I checked my coat pockets for anything that might
be considered contraband. I discarded the papers that revealed my home
address or phone number. I drove cautiously on narrow country roads alert
for frightened wildlife that threatened to unnerve my disposition. I
smiled impishly to myself when I garnered a parking spot vacated by the
day shift officer. Certain the car doors were locked, I began the long
walk toward my work site.
The loud buzzer indicated that the Sergeant had unlocked the Main Gate
electronically from behind his protective, steel enclosure. I pulled the
door open. It closed with a loud, hollow echo behind me. I cleared the
metal detector and drug scan. Another loud buzz indicated the Sergeant had
opened a second door. I proceeded under the razor wire to the next gate.
The tower guard recognized me and with the touch of a button allowed the
heavy steel gate to slide open. I stopped at the Control Center and passed
my key-chit through a barred window to an officer who exchanged it for a
heavy set of institutional keys. I fell in pace with the dozens of
convicts seeking access to the gymnasium, commissary, library, school,
medication window, or work detail.
I reached my final destination, the Infirmary Area of an 1800 maximum
security male prison. There I would receive my assignment from the shift
Supervisor. Perhaps I would deliver medication to the inmates in the
Restricted Housing Unit; administer insulin to the diabetics who were
restricted from handling syringes, administer medication medication at the
"pill line" to the inmates who were restricted from the Self-Med
Program, tend to the geriatric inmates housed with the Infirmary Area,
provide sub acute care to the inmates discharged from the community
hospital, or provide routine physical exams in compliance with the state
mandates. Whatever the assignment it was certain to be interrupted by a
"block call," "P.V. return," "lock-up,"
"lock-down," "recount," or any number of jail house
crises.
The hours would literally fly by. By 2200 house (that's 10:00 Military
Time) I would find myself scrambling to compose my harried self in
preparation for the change of shift routine.
When asked by my family, friends, and colleagues, "What do you do
there?" I would proudly reply, "Everything from file reports to
pronounce people dead!"
My job description has changed since I began my correctional career in
1994 as a Registered Nurse. My enthusiasm for the work I perform has been
strengthened by my decision to proceed from labor to management. Now I am
frequently asked, "Do you like it there?" And I respond with
profound integrity, "I wouldn't want to work anywhere else!"
I have been institutionalized! I use phrases such as "Key Up,"
RHU," "POC," "ODR," and "The Hole" to
access restricted housing areas and communicate management issues to
administrative staff. Occasionally stand in front of doors to public
buildings waiting to be "buzzed". I check doors to be sure they
are locked before I open them, and I check them after I lock them to make
sure they are locked! When asked, "Are you ever afraid at work?"
I respond, "Only of the Superintendent!"
A correctional setting is an inter-dependent working community. Industry
and vocational programming provide employment opportunities for inmates.
Educational programs promote literacy. Psychological services promote
social stability and decrease recidivism.
Inmate idleness is further reduced through participation in recreational
activities and volunteer programming. Family relationships are maintained,
to varying degrees, via on-site visits, phone calls and letter writing.
For confidentiality and security reasons, medical staff use extreme
discretion and caution in fielding concerns generated by inmate family
members.
Every health care issue represented in the free community is represented
in a correctional setting. In addition, modern medical technology, the
diagnosis and treatment of new disease, managed care, and cost containment
must all be realized within the parameters of strict security. This
security component can often times conflict with learned medical models
and nursing protocols. The greatest challenge for correctional medical
professionals is finding the balance between "treatment and
security" that will promote the quality of health care reflected in
the Department of Corrections (Health Care) Mission Statement.
Health care for the prison population is guided by policies that are now
consistent with community standards. The courts have played a significant
role toward improving prison health care that, until recently, was
considered primitive and inadequate. The National Commission of
Correctional Health Care and American Correctional Association are two
organizations that promote quality health care by establishing standards
of practice and monitoring adherence. The NCH acknowledges the special
skills required of correctional health care professionals by offering
special certification for accomplishments and resources for self
improvement.
New employees are introduced to [Pennsylvania] Department of Corrections
policies and procedures at mandated training that is provided at the
Elizabethtown Academy near Harrisburg, PA. Medical staff require three (3)
weeks of basic training. In addition, each institution is required to
provide 40 hours/year of additional in-service. Annual training in Tool
Control, Key Control, Defensive Tactics, and Professional Ethics reinforce
quality security practices that prevent complacency in this unique work
environment.
Pennsylvania administrates 25 states prisons. Registered Nurses (Diploma,
A.D., or B.S.N. prepared) and Licensed Practical Nurses are employed at
each institution. The varying nurse backgrounds contribute to a well
rounded labor force that promotes quality care in a composite system of
primary (emergency response), secondary (sub acute), and tertiary
(palliative) nursing care.
The R.N. and L.P.N. labor units are represented by Service Employees
International Union (SEIU) 1199 and the American Federation of State,
County, and Municipal Employees (AFSCME), respectively. Salaries are
comparable to civilian wages and include an attractive state paid benefit
package. Persons interested in pursuing a correctional health care career
should contact the State Civil Service Commission [in Pennsylvania, call
1-717-772-2685] and request an application.
The Department of Corrections offers a unique challenge for nurses
committed to effecting health care. I am confident that staff efforts
toward improving the health care for inmates have absolute ramifications
for correctional staff, inmate families, and the public at large.
Nursing Career Articles
