I graduated in April of 2017 with an associate’s degree, as one of the few older students in the class. My school was the number one nursing program in Arizona the year before, I don’t know if we were number one the year I graduated. I failed NCLEX the first time and passed the second time. 

When I graduated I had never thought of corrections until I started applying for jobs. It was hard to get into the hospitals because most wanted a bachelor’s degree, the ambition to get one, or young nurses. I interviewed at many, many, many hospitals and home health companies and realized this type of nursing was not for me. So, I kept looking for a job, anything at this point.

Then I interviewed at the County Jail and WOW, I found my niche!

They paid me $100 to come in for 4 hours and shadow someone and I did. I loved it, so I accepted the position. I went to work every day and dealt with inmates (patients) from children (being tried as adults or at the Juvenile facility) to the elderly. Yes, the elderly come to jail too! I have cards for pregnant females, murderers, drug abusers/alcoholics, and inmates here for little things like theft or people that were arrested for not paying speeding tickets. Some stay a long time (years) while they fight their case, or they may stay a few hours. You never know what will walk in the doors next! 

That is my kind of job. I get bored quickly but not here. I left after 2 years for personal reasons, tried home health (they are worse patients than inmates with non-compliance, etc.) and I hated every minute. So, I got a job at one of the prisons and was on a Level 5 yard/Mental Health unit. That is where I am happiest. After a year, I had difficulties with my direct supervisor. So, I called my old boss at the jail and my spot was open so I came back. 

Now what do I do every day, you ask? Well, the same thing I did at the prison. I do what is called “Nurse Line” which is more like a doctor’s office than anything. The inmates put “Health Needs Requests” (HNR) in and they are pulled at night and appointments are made depending on the request, it can be for mental health, medical, or dental. Now we don’t have dental on-site here, like at the prison, so the nurses (1-2 depending on staffing) look and see if there is an infection or emergent need, and then we can offer them over-the-counter medications for just about everything. The policy is, the inmates have to see us a minimum of 3 times before we can refer them to the Medical Provider. Unless we believe they need to be seen sooner, we can always place them on the provider line. 

We have med nurses that pass meds 3x per day, do blood sugar checks, the Nurse Line usually draws blood and sees all the HNR’s, we also respond to any emergencies called an Incident Command System (ICS). So, if the officer deems it necessary for medical emergencies (seizures, falling, self-harm, etc.), inmates fighting, or refusing to follow directives, they call an ICS and everyone responds. Medical has an ICS team but usually everyone responds due to short staffing. 

Intake is where the road officers bring inmates in and medical will accept the inmate or refuse them per policy for many reasons. If the inmate is refused the road officer has a choice to release them or take them to the hospital for medical clearance. Sometimes we even have to be mental health nurses. 

Mental Health has a counselor, 2 LPN’s, and 1 provider. So, if an inmate is suicidal they are seen 2x per day by Mental Health or if they are on a mental health watch or psych house alone, they are seen 1x per week by Mental Health. Mental Health also will respond to ICS’s because it is always nice to have extra help. 

As a correctional nurse in the jail and the prison, I have given IV fluids, IV meds, performed CPR (I don’t know how many times), assisted a provider with suturing an inmate that has self-harmed, and so many other things that would take writing a book to tell it all. 

So, are we real nurses? Oh my goodness yes, and so much more! The little wisdom I want to share and I believe is important for nurses that work in the hospital understand, that when an inmate comes in, call the nurse from the facility and ask about the inmates’ history. They can be trying to go to the hospital for many reasons, possibly have Munchausen’s disease, be dangerous, mentally ill, or really have something wrong that we just don’t have the capabilities to handle (especially at the jail, where there is no infirmary). 

Also, keep in mind that they like to go to the hospital because of the food, medications, or they just want to be pampered. Remember, staff at the prisons and jails are not mean, we have policies and procedures to follow, and we request you not give the inmates extra items or food. It is a waste of your resources because they will be taken anyway. They can drink water, coffee, and some can have milk with meals. They don’t get the privileges like sodas and chocolate cakes, etc. They are inmates for a reason!

We are real nurses and learn a lot about a variety of things. The only difference between correctional nurses and hospital nurses is we are not ACLS trained, and I can ride down the hall on a gurney performing CPR and injecting the inmate with a dose of Narcan or while putting my hand over a deep neck wound after slipping in their blood in the cell. So, yes we are real nurses.

So, please treat us as colleagues, and believe me when I say, WE ARE REAL NURSES!

Bio‐ Kari Rounds, RN