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Correctional Nurse Dilemma: Compassion or Cynicism

One of the many advantages of working behind bars is the amazingly appreciative patient population. Not only are our patients delighted with our services, but they only access health care when absolutely necessary. This is because, as a rule, correctional patients avoid drugs and have healthy lifestyles. Oh, that this were true! Unfortunately, the correctional patient population, instead, can be unappreciative, have extremely unhealthy lifestyles, and difficult personalities.

Regretably, cynicism has a way of creeping into our minds and hearts as we spend time in the specialty. Let’s face it, our patients want something from us; and it is not always based on a health need. There are several logical reasons for this.

Looking for Some Comfort

Our patients live in an exceedingly controlled environment that is not arranged for their comfort. Seeking comfort and ease is a very human pursuit that is not peculiar to prisoners. Whether a favorite easy chair, a contoured pillow, or organic gala apples; we organize our lives to be comfortable and accommodating to our desires. Our patients are not different in that respect.

However, many of our patients have spent much of their lives controlling their environment through manipulation and deceit. They bring this poison with them into healthcare transactions. So, it is reasonable to be skeptical about patient requests, as special treatment can bring:
  • Status in the prison culture: special food, special shoes, or desired medications for barter or trade.
  • Safety: An inmate may wish to be in special housing or in the infirmary to avoid being hassled or threatened in the general population.
  • A Way Out: An outside trip to a specialist or the hospital can provide a break from the stress and monotony of incarceration.

Objectively Caring

The challenge, then, is to remain objectively caring in our patient interactions.
  • This means really listening to the patient’s symptoms, making objective assessments, and documenting fully
  • Because many in our patient population can use healthcare as a tool for other gain, we may need to seek out corroborating evidence to confirm their symptoms
  • But most importantly, we need to keep from making assumptions about the patient’s situation.
Why should we avoid developing a jaded and cynical attitude toward our patients? One reason is because the consequences are so high. Missing a real diagnosis by routinely dismissing patient complaints as ‘faking it’ or ‘manipulation’ can be a career stopper. Just as important is the corrosive nature of cynicism when we forfeit our professional values in this way.

Just Like Me

Considering our shared humanity can encourage compassion for our difficult patient population. When dealing with a trying patient, consider these statements*:
  • Just like me, this person is seeking happiness in his/her life.
  • Just like me, this person is trying to avoid suffering in his/her life.
  • Just like me, this person has known sadness, loneliness and despair.
  • Just like me, this person is seeking to fill his/her needs.
  • Just like me, this person is learning about life.
Yes, there are numerous ways in which are patients are not like us. Many have not had the advantages of family and safety. Many were not born into a life situation with the resources or support to finish school or attend college. Some have made poor choices and continue to make them. Yet, in fundamental ways we have much in common. Remembering this commonality can help keep your correctional nursing practice compassionate rather than cynical.

How do you stay compassionate in your correctional practice? Share your thoughts in the comments section of this post.

*Hat tip to Sharen Barboza for this list.
Posted: 3/14/2018 10:39:26 AM
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