Correctional Nursing

What nurses say


We asked nurses to share their experiences working in correctional facilities. Read about the unique rewards and challenges they have encountered.


"The difference in correctional nursing compared to my previous position is more support from a medical team. No one is expected to make decisions on their own when there are questions on how to proceed with care. The team works together to provide excellent care to a unique population."
- Nurse at Women's Correctional Centre



Safety

"Safety is paramount for everyone in the institution. Nurses carry a radio with an emergency button, and correctional officers are always present to ensure the safety of medical staff."
- Nurse at Brandon Correctional Centre


"Safety for everyone is the first priority at this correctional facility. A correctional officer is always present when medical staff are interacting or providing care for inmates, and other medical staff are always available to assist with care as well."
- Nurse at Women's Correctional Centre


"The correctional facility takes many steps to ensure my safety. If it is not safe for a correctional officer to enter, a nurse would not be offered the opportunity. A risk assessment is done nearly each time."
- Nurse at Manitoba Youth Centre


"We are very fortunate to have correctional officers who provide physical presence at all times that the nursing staff are with clients. All staff are equipped with radios to ensure they have a means to communicate in the event of an emergency.
It is always a very fine balance when providing care. The first priority is the security and safety of the staff, inmate population and institution. This can provide some challenges when an inmate is in need of immediate attention and one must wait to ensure the safety and security of staff is in place before providing care to the client in need. The security team is very cognizant of this and make every effort to expedite access to clients while never forgetting that the safety and security aspect is the priority."

- Nurse at Winnipeg Remand Centre


"Safety is of prime concern, and the focus on keeping the environment safe is a different mindset. For example, no scissors are left out, and inmates cannot know the time, date or place of appointments. You cannot walk freely through a building like a clinic or hospital, but doors unlock for you to assure safety. Nurses are seen on camera and always carry a radio for communication.
At my entrance interview in 2013, my manager stated, "In 24 years, I have never felt threatened or scared in this job." My colleagues will say, "It is much more dangerous to work in a PCH or an emergency dept." The team is different in that you are always, 100 percent of the time, with one correctional officer or more when tending to an inmate or during a medication pass.
Once inmates' addictions and mental health issues are better controlled there is much less threat to the staff. We are never alone while seeing an inmate, and there are emergency buttons in the clinics that to my knowledge have never been pressed. The correctional officers will not allow us access to inmates they deem unsafe to be seen at that time. The camera monitoring in hallways and areas are another safety feature. There is also a no abuse policy here, so if an inmate escalates or gets rude, we ask them to leave the clinic. In eight years I have only asked two people to leave and both apologized for their behaviour the next day."

- Nurse at Milner Ridge Correctional Centre



Variety

"I have three specialty certificates including Intensive Care Nursing, Dialysis Nursing and Operating Room Nursing, and I use all of this knowledge routinely as a correctional nurse, as the scope of correctional nursing is broad.
Care includes assessment, treatment and evaluation of a broad range of medical, dental and mental health conditions. As a team, we share our knowledge and expertise with each other to provide an optimal level of care."

- Nurse at Brandon Correctional Centre


"Correctional nurses are responsible for providing care to support physical and mental health of the inmates as well as responding to medical emergencies. The range of care may include wound care, blood work, administering medications, providing treatments, health teaching, psychiatric assessments and health assessments."
- Nurse at Women's Correctional Centre


"Our team believes we are responsible for all care. If we are not able to provide it, we consult a party that can. Our mandate is for code response, medication supports, treatments and dressings, doctor rounds, and sexual health. MYC has grown to include immunizations as an integral piece of holistic care, as well as education to the youth."
- Nurse at Manitoba Youth Centre


"Working in Corrections allows me a degree of autonomy in my practice as a nurse and is an extremely diverse work environment. The clients are from varied backgrounds and as a result have varied health concerns. One can be assessing a prenatal in labour one moment, and the next be managing a client with severe withdrawal symptoms. The role is inclusive of public health, primary care/emerg, and community health. We provide basic primary care including but not limited to methadone/suboxone administration, medication administration, dressing and wound care, physical assessments, psychiatric assessments and management of alcohol/drug withdrawal. Emergency care is within the scope of the nursing staff until Winnipeg Fire and Paramedic Services arrive on site to transport clients to local hospitals."
- Nurse at Winnipeg Remand Centre


"I took this position after years of teaching and supporting new staff in an acute medical setting. Here, I was challenged with new learning, such HIV and hepatitis C care, addictions, dermatological issues, quite severe mental health issues, medication safety in prisons and admissions procedures, to name a few on the learning curve.
There is much variety in this job. One day you may be organizing and working at the doctor clinic. The next day you might be doing medication reconciliation and weekly preparation for self-meds and nurse-given meds. You might have a frantically busy clinic day, interrupted by an emergency. And the next day might be peaceful and quiet, with minimal request forms and smooth medication passes.
Some of the medical emergencies I have experienced include seizures, hypoglycaemia, anaphylaxis, physical trauma from altercations, cardiac events, sepsis and attempted suicide attempts.
We are responsible for independently run primary care clinics, wound care, bloodwork twice a week, cardiac, diabetic teaching, chronic and acute pain management, dental referrals, medication compliance checks and teaching, anxiety versus chest pain assessments, chronic disease management (especially diabetes, hypertension and asthma), post operative assessments, and promotion of healthy lifestyles, to name a few. We administer the methadone/suboxone program and talk about addictions."

- Nurse at Milner Ridge Correctional Centre



Challenges

"The correctional nurse has much greater autonomy as medical doctors are not always onsite. The nurse triages all medical complaints and injuries, and responds to Code Red emergencies requiring rapid and accurate assessment and decision-making.
Trauma, drug addiction, sexual transmitted disease and mental health issues present daily challenges. We must remain professional and rise to meet these issues.
Sadly, behavioral issues result in frequent cases of inmate self harm. This population of people commonly feel marginalized, undervalued and misrepresented and their mental health suffers as a result. For many inmates, incarceration means losing their family support system as well."

- Nurse at Brandon Correctional Centre


"In correctional settings, nurses work with victims of violence and abuse, and need to treat the trauma associated with the wrongs that have been done to them. Nurses also need to work with individuals who are perpetrators of violence and abuse to others. We need to be able to put this aside and provide non-judgmental care to all those entrusted into our care.
This can often be difficult as there are clients who present angry and abusive to the service provider, no matter what degree of kindness or respect you show to the client, and their crimes can be very heinous.
I do believe the most important characteristic needed to work as a correctional nurse is to be non-judgmental. The second is to have a great sense of humour, as this can turn a situation around instantly."

- Nurse at Winnipeg Remand Centre


"If there is an institutional search or an area locked in for various reasons, we do not have access to the inmates. This means there can be unexpected down time, or there can be days that are overwhelming because so much is packed in due to unpredictable emergencies.
You need excellent communication skills and the ability to say no to unreasonable requests or drug-seeking behaviours. You may deal with many inmates who are limited in their coping strategies and resilience, many who are very marginalized and others who can be very manipulative and conniving."

- Nurse at Milner Ridge Correctional Centre



Teamwork

"As a team, we share our knowledge and expertise with each other to provide an optimal level of care.
Collaboration is vital. Medical staff work closely with numerous other teams within the facility including dietary, chaplin, caseworkers, cultural facilitators, public health and correctional officers."

- Nurse at Brandon Correctional Centre


"The difference in correctional nursing compared to my previous position is more support from a medical team. No one is expected to make decisions on their own when there are questions on how to proceed with care. The team works together to provide excellent care to a unique population."
- Nurse at Women's Correctional Centre


"At my facility, the medical nurses work closely with the in-charge and juvenile counsellors and also have the ability to work with our mental health, psychiatric and community public health teams. We welcome open conversation with external parties such as FASD clinicians, hospital outpatient clinics and reservations or home communities of our youth."
- Nurse at Manitoba Youth Centre


"The health care team consists of a multi-disciplinary team, which includes public health, psychiatry, physician services, LPNs, RNs, RPNs and clerical support."
- Nurse at Winnipeg Remand Centre


"I am fortunate to work with highly dedicated professionals providing compassionate care to individuals who engage in risky behavior. Our role is to provide patient care the same way we would to anybody else. If you are fair but firm and treat them with respect, they will show you the same respect in return.
The team consists of the manager, a mixture of nurses such as LPN, RN and RPN, a physician who does clinics once or twice a week, a dentist who comes four or five times a month, the local emergency department, public health nurse and other health care specialists. There are two medical assistants who book appointments and diagnostics, track charts, arrange clinics and prepare for new admissions or transfers.
Three clinics run simultaneously in different buildings, and the staffing for the medical side includes three nurses on days and two nurses on evenings for a population of 42 to 520. There are also other others there, such as psychiatric nurses and the public health nurse.
If you are a new nurse, and there is a skill you do not feel comfortable doing, you can ask another nurse to assist you in learning or defer to a nurse who has that skill."

- Nurse at Milner Ridge Correctional Centre



Fulfillment

"I thrive on change, and I'm passionate about addressing the many challenges faced by marginalized people in our society. Improving the education, treatment and care the incarcerated receive is paramount.
Correctional nursing promises the unique opportunity to safely promote wellness in custody. A nurse must juggle multiple hats to meet the behavioral, medical and dental needs of some of society's most vulnerable people. You are part of a dedicated team of nurses who can care for clients for years before saying farewell as they reintegrate back into the community. "

- Nurse at Brandon Correctional Centre


"I was always interested in correctional nursing as I wanted to provide service to those who are often left behind by society. In a correctional facility, the population often receives the best care they have ever received due to their life circumstances. It's also an opportunity to expand skills in a safe environment where nurses are supported by a team. It's very rewarding and I would highly recommend it as a career. "
- Nurse at Women's Correctional Centre


"Becoming a correctional nurse may be for you if you are empathetic, non judgemental, and open to growing your nursing skills, as well as adapting to a harm reduction approach to care. I get great value out of empowering incarcerated youth about medical choices and sexual health. "
- Nurse at Manitoba Youth Centre


"After moving to a rural setting, I started to look at part-time options closer to home. Advocating for the well-being of the incarcerated, and the mystery and intrigue of correctional nursing, called me.
When I applied back in 2013, my manager said, "You will either love it or hate it." Well, I love it! Here I am at retirement age, but I love my work and I enjoy my team. I do not find the work that stressful, and it energizes me and does not deplete me. (Note: I work half time.)
Don't get me wrong: This is a challenging population to work with and almost everyone suffers from trauma. Most have addictions to drugs or alcohol. Mental illness is overrepresented, and their conditions - often based on poor lifestyle choices - are complicated and sad. You will interact with individuals who have been charged with various crimes. They often enter jail at rock bottom. But empowering inmates to make positive changes is something I find very fulfilling. You can make a huge impact during their most vulnerable and distressing life moments. This position will expand your assessment skills and enhance your autonomy for critical decision-making. I continue to broaden my capacity for empathy and compassion.
There is also ongoing training in areas like basic life support, fire safety, suicide prevention and computer skills. Experts are brought in for staff education in diabetes, wound care, hepatitis C/HIV management and laboratory bloodwork.
My biggest advice: It is NOT for everyone, but if the idea of working in correctional nursing interests you, please reach out to a corrections nurse and ask if they would recommend the job. I can honestly say that all my co-workers would say YES!"

- Nurse at Milner Ridge Correctional Centre