Correctional Nursing, Tran Chu, Arrowhead Regional Medical Center

What were your concerns or fears when beginning your work with this population?

Definitely safety. However, being surrounded by deputies who are always there to help the nurses at the bedside, I realized that this was the safest unit in the entire hospital and I could practice my chosen profession with confidence.

As nurses, we are obligated by the Code of Ethics to provide fair and equal treatment to our patients, regardless of their situation or the reason for admission. Our nurses rarely question why certain patients are in the jail system unless it interferes with our safety. We solely focus on their medical background and admitting diagnoses.

What are the most common conditions that you see?

Working in a fast-paced acute care hospital, we see many types of diagnoses in our unit on a daily basis. Because we’re also a telemetry unit, we do see many patients being admitted for cardiovascular issues such as chest pain.

Are substance use disorders and mental health issues common in this milieu?

Based on specific patients and case-by-case scenarios, I believe substance abuse is relatively common. The opioid epidemic is evident, and patients undergoing withdrawal symptoms must first be screened and then monitored closely in order to initiate appropriate treatment plans. As for mental health issues, it is crucial for our bedside nurses to understand the mental health system, the psychological undercurrents that may affect how patients behave, and when to request a psychiatric consultation.

How do patients’ personal stories differ from those of patients in the general population? Are they difficult to hear?

Every patient is admitted with a different background story. As nurses, we are trained to tune into their stories and take care of our patients using a holistic approach. Just like with any other patient, nurses are responsible for advocating for the patients, regardless of their circumstances.

Regarding COVID-19, how have you and your colleagues responded, and how much concern do your patients express about the virus?

The COVID-19 pandemic has definitely changed healthcare settings forever, ours included. Nurses and essential workers all over the world have become more united than ever. My colleagues and I treat one another like brothers and sisters. We always have a “Let’s do it” mentality and help each other every step of the way.

Symptomatic patients who are admitted through our emergency department are isolated from the minute they are diagnosed and continue to be isolated before they transfer to the floors.

These patients are kept in private contact-isolated rooms until they complete their course of treatment.  As for patients being discharged back to the jail facilities, the nursing staff from our facility communicates with the nurses at the jail facilities so that ongoing isolation and treatment plans can be implemented for patients and for the safety of the other inmates and staff.

The concerns our patients express are mostly fears of the unknown regarding the virus. Therefore, communication and education are key to making sure their concerns are addressed.

How similar is the nurse-patient relationship in this setting in comparison to the general healthcare system? What are the main differences?

Correctional nurses have a different kind of compassion, knowledge and skill set when it comes to taking care of patients in these settings. We treat everyone with respect and dignity, but we always have to consider our surroundings very carefully and think about the approaches we can take to prioritize our safety as well as the safety of other patients on the floor.

There are definitely times when a nurse can feel overwhelmed, and it’s important to know when to involve the sheriff’s deputies. We always strictly abide by our policies and rules, which helps to prevent things from getting out of hand.

On average, how long might you have to get to know a patient who needs nursing care for a chronic condition?

We have patients admitted for many acute and critical conditions. On average, the turnaround times range from about two to three days to a week. However, we’ve had patients who’ve been admitted for chronic and end-of-life conditions who have stayed with us for more than a year.

What kind of security clearance and background checks are needed to work as a nurse in a county jail?

The security clearance and background checks are generalized, like any other specialty in the county hospital. All county employees of ARMC undergo a strict background check before being hired.

What personal and professional characteristics and skills would you recommend for nurses considering this specialty?

Nurses who are unbiased, who can abide by strict nursing and correctional rules/guidelines and who can also focus solely on the patient’s medical status will make good candidates for correctional nursing.

I always encourage new nurses to never lose sight of their passion and to always keep in mind the main reasons they became a nurse. On your most stressful day, just remember that these patients are ill and they need you now more than ever. Prioritize safety and always take care of yourself first — that is how you can take care of others.

What goals do you have for your nursing career?

I wish to pursue further opportunities to develop leadership and mentorship skills within the nursing profession.

KEITH CARLSON, RN, BSN, CPC, NC-BC, has worked as a nurse since 1996 and has hosted the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students at www.nursekeith.com.

In this Article: Career Advice, Mental and behavioral health, Nursing Workforce