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What It’s Like Working as a Prison Nurse

Treating people with nothing but time is challenging and sad, but entirely essential.

by Tiffy Thompson
Jun 8 2016, 6:16pm

"You can't feel safe there... They must say disgusting things to you."

"They must look at you like you're a steak."

Kate Olivia has heard it all. Working "on the inside," she sees what incarceration does to people. Olivia is a nurse in a provincial correctional facility in Northern Ontario housing both maximum- and medium-security inmates. She told VICE what it's really like to treat people with nothing but time.

VICE: Walk me through going to work. Do they pat you down?
Olivia: No. But when we're hired there we agree to follow the rules. We don't bring in metal cutlery, we don't have cell phones—we keep them in our personal lockers. I can have a pen on me, but if I'm doing a med run I'm not going to keep it on top of the med cart where somebody could pocket it. Awareness of your surroundings is something you have to have at all times.

On the maximum security side, there's a range with cells. They get locked in for quiet time every day, otherwise they're out mingling in the range. The medium security side is a little less restrictive. We assess inmates that have ongoing health issues to determine when and if they need to see a doctor, if it's appropriate to treat it at our facility or if they have to be sent out to the hospital, which we do often. There are no beds there; anything that would require that kind of monitoring, they would be sent to the hospital for.

If I'm doing a med round, I go to all of the units with my med cart and administer medication. It's similar to administering medication at a nursing home. At each unit there are guards that stay with you while you're administering medication.

So you are responsible for handing out drugs?
The nursing staff administers medication to everybody that's ordered medication. They're on all kinds of medication—a lot of them are on cardiac meds, diabetes meds, psychiatric medication. We see a lot of inmates on Byphentin which is a different formulation of Ritalin which is harder to abuse—a lot of inmates try to divert their medication. It's a form of currency in the jail. Part of our job is monitoring them when they're administering it, doing a mouth check, trying to do our best to make sure they're taking their medication appropriately and complying with their treatment plan, whatever that may be.

What are the most common ailments?
Overwhelmingly, [prisoners are] dealing with mental health issues. The correctional staff and the nursing staff have to work together to monitor their behaviours, to listen when they're having problems, and to identify when they might be having an acute mental health crisis that will need more frequent monitoring. If they have a concern about somebody's safety, they'll do more frequent checks on them or they'll remove items from their cell that could be used to injure themselves, and they have ongoing assessments.

Do they often get injured while in jail?
They might try to hurt themselves to see the doctor. Sometimes it's a self-injury because that's how they cope with how they're feel—a lot of anger or emotion. A lot of the time, people get in fights in there. Because they're housed in the same area with people they don't get along with. They might owe someone money for drugs. 'That guy fucked my girlfriend five years ago', or 'my family doesn't like your family.' That sort of thing.

Have you ever feared for your safety while on the job?
I have never feared for my safety there, ever. We see a lot of challenging behaviours at the jail. We have to deal with them, but when it gets to a point where it's no longer therapeutic for us to engage with them, at that point the correctional officers are the ones that have to deal with them.

The male inmates—sometimes they can be inappropriate, but that's no different than any other patient population. For the most part, I've found dealing with the incarcerated population, they're pretty respectful to the nursing staff because they know that we're there to help them. They can say challenging things to me sometimes but it's almost never sexual in nature. [It's often that] they're frustrated about something, or they're mad because they've been busted diverting their meds and they have to live with the consequences.

Do you see a lot of marginalized people in the system?
First Nations populations, absolutely. If you look at the social determinants of health and wellness, we see a lot of the same family members, the same names. It's cyclical, they come in over and over. It's almost something that they're born into. Who do we learn from? We learn from our parents. If you take away someone's ability to learn from their parents, someone's ability to parent their children, that's going to come up for generations and generations. It's still a fractured system. I don't even know how to go about fixing it. It's huge.

What memory stands out to you?
It was my first job out of nursing school. That population—if they know you're green they might try to walk all over you. When I was doing my rounds, they'd come for their meds without their t-shirts on, or they wouldn't comply with the mouth check. Then we had an inmate that was moved to that unit, that wasn't local. I don't recall the exact nature of his charges, nor would I be able to disclose them, but I'm pretty sure they were violent in nature, and he was involved with gangs. He was street-wise and held a lot of respect. Essentially, he brought all of the inmates on that unit in line for me. Every time that I was working and I went to that unit and he was there, they were all lined up with their t-shirts on, and they were respectful—"yes, miss," "thank you." And he said to me once, "Now isn't that better miss?" and I said, "Well, yes, it's very nice, thank you." And he said, "I keep thinking about my sisters. I wouldn't want them disrespecting my sisters and I don't want them disrespecting you either." It was actually very touching.

All photos by author.

Why do you want to work there?
For the most part, they're not criminals to me. They're my patients. A lot of them are just normal people. A lot of times it has to do with an addiction. Either they're drug charges or they're charged as a result of something they had to do to support their addiction, and I can't pretend that at some point in my history I wasn't one or two choices away from maybe, being in a similar situation that they were when they found themselves being arrested and going to jail.

What do they talk about to you?
Sometimes they'll say they're innocent. A lot of the time they talk about regrets. They're regretful that they're there. They feel bad that they "fucked up again" (their words). A lot of time they'll feel bad about their kids because they wanted to try harder and improve their life for their children but they're stuck in this cycle. A lot of them legitimately try to change their lives, but they're released into the exact same situation that they were in when they were arrested—the same social circle, the same circumstances of living, the same family dynamics. Sometimes it's not even shocking to see them coming in over and over again.

Adults need to be accountable for the choices that they make in their life, and that's the way our society is structured, but a lot of the time, I think, wow, I know how hard it is for me to break some of my habits! And I have a high quality of life, I'm educated and have a good paying job. I want for almost nothing in my life and I still struggle with breaking habits in my life. I think we all do.

What's the worst part of the job?
You see a lot of really sad things. And it's very challenging too because, obviously, it's a jail, we have people that come in that have done terrible things. That have done awful things that turn your stomach, that make you feel sick. But you have to treat them the same way that you treat any other inmate in there. You have to treat somebody who molested children, you have to provide them with the same access to healthcare and the same rights as somebody who blew over, or was a breach of probation, or stole a pack of smokes from Mac's. It's hard. It's really hard to do that. As a nurse, we have to treat everyone equally. Regardless of what kind of a person you might think they are that should have nothing to do with your job as a nurse. If you're unable to do that, you shouldn't work in corrections.

What do you need to be a good correctional nurse?
Our society says you have to pay back this amount of time for what you did. But it doesn't mean you're an animal, that you're not a human. It doesn't mean that you don't have these vulnerable moments that are fucking terrifying, and it doesn't mean you don't deserve some amount of comfort, or information that can be of comfort to you.

People think that to be a corrections nurse, you have to be tough, you have to be ballsy. Well yeah, you have to be able to set limits to create appropriate boundaries within your therapeutic relationship with the inmates, absolutely. But it doesn't mean you can't provide them with the same thing that you do with other populations as a nurse. For the most part, you have to do a lot of limit setting, offer them a lot of consistency, and a lot of compassion. It's such a huge role in what I do—listening to them and validating what they have to say.

This interview has been edited for length, clarity, and style.

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