Ten years into practicing nursing, I was experiencing burnout, exhaustion, and apathy. I spent three of those 10 years working as a staff nurse in med-surg and perioperative units and the rest in various positions in home health and hospice. [caption id="attachment_104502" align="alignleft" width="222"]
Kelly Langford, RN[/caption] Since I wasn't willing to switch careers, I decided to try a different specialty -- something challenging, a bit more exciting, and outside my comfort zone. Flipping open the local newspaper to the classified section, I began scanning the pages for anything to pique my interest when I saw the ad: Part-time Correctional Facility Nurse needed for County Jail. In my mind's eye, I could envision myself in an episode of "Cops" or "Law and Order." Life was finally going to get exciting! My nursing career was about to take a trip into the unknown.
Stepping Into the Unknown
I called the number listed in the ad, and the person I spoke with seemed genuinely excited to interview me. She said my work history sounded perfect, and she was eager to put me to work as a corrections nurse. My hands began to shake, and I felt nauseated as I pulled up to the building. I kept asking myself, "What in the heck am I doing?" Taking a deep breath, I steadied my nerves and gave myself a quick pep talk, "It's only an interview. They won't throw you behind bars." The nurse manager met me in the front office, and I followed her through to the secured section of the building. She produced a large set of old skeleton keys and inserted one into the lock of an enormous, time-worn, steel door. We walked together through the doorway, and she locked it behind us. "Always close and lock this door," she said. "We are entering the section of the building where there are inmates." The nursing office was a cramped, windowless room with gray cement walls, dim fluorescent lighting, and sparse furniture. A desk with an older computer screen sat to the left, a medicine cart straight ahead against the far wall, and a patient examination table to the right. The nurse manager began the interview. "As corrections nurses, we have to be one part nurse and one part corrections officer. Does that bother you?" she asked. "My mother was a state trooper, so I am not new to the world of law enforcement," I told her. A smile lit up her face. "If you pass the background check and drug screening, consider yourself our newest corrections nurse," she said.
Welcome to the Jungle
My days were often fast paced and unpredictable. One afternoon when I was passing out the evening meds, a jailer grabbed me and said, "We need you in medical right away." The officers had just brought in a known drug dealer. Zeus (the drug-sniffing dog) had gotten the better of the man, and he was in pretty bad shape. As I walked into the nursing office, I saw the guy lying on the examination table and moaning in pain. On his left arm was a deep tooth-shaped wound, and I could see similar bloody wounds on other parts of his body. I sent him out to the nearest emergency room. He needed more care than we could provide. Another interesting moment began as I walked into the jail one morning. As the sky was beginning to lighten, an officer greeted me. "Could get kinda exciting 'round here today," he said, filling me in on the arrest of a well-known militia leader who was being held in the drunk tank. "Word on the street is that we could have a potential riot on our hands," he said.
The nursing office, now relocated to the second floor, was a larger space, but with a 360-degree view of the drunk tank and the cells we called "gen pop." I spent the rest of the day observing this prisoner, who was committed to a hunger strike. The riot didn't happen (much to his dismay), and he was transported to another facility later that day.
An Unusual Place To Heal
My preconceived vision of a jail was as a place where thieves and murderers are held. But the truth is that there were people with so many different illnesses who lived under the roof of that jail -- people with substance use disorders, people with schizophrenia, and victims of mental and physical trauma who had never received formal treatment and the chance to heal. Denise, for instance, had anorexia. Denise was a member of the "frequent flyer club" at this facility. When I first laid eyes on her, she had dark circles under her eyes and filthy hair. She was hyperverbal and paranoid. Denise had been using methamphetamines and was off the medications for her mood disorder. Proper medications, nutrition, and hygiene working together gradually produced a metamorphosis in Denise. Her skin began to glow, the dark, sunken circles under her eyes vanished, and she transformed into a rational, likable person. She became invaluable as a resource for new women booked into the jail with similar pasts. Jeff was another memorable case. The officers brought Jeff into the jail intoxicated and angry. His blood pressure was sky high, and he was suffering from alcohol withdrawal. Jeff was placed on a treatment regimen. His medications for hypertension were adjusted as needed, and he followed a low-sodium diet. The redness from Jeff's face began to fade, and he no longer seemed to be in distress.
"I just want to thank you," he told me one day when I was checking his vital signs. "You have helped me so much. I feel human again."
Opportunities to widen and deepen my empathy presented themselves during my time as a corrections nurse at the jail. I have held the hand of a weeping female inmate as she confided to me her history of sexual abuse and her perceived failure as a parent. And then there was Steven, who was arrested on suspicion of child rape. He was tearful and kept his gaze fixed on the floor as I asked him the intake questions and performed a mini-physical. I handled his care without bias and did not add injury to his dire situation.
Being able to grant someone dignity and respect even in the face of a suspected crime is a small act of human kindness and professionalism.
Tony, another repeat offender, had a mental health condition and was often aggressive. As the months went by, he and I slowly developed a rapport, but Tony's condition began to deteriorate. I made pointless calls to long-term care facilities for individuals with mental health conditions, but no one would accept him due to his history of violent crime. I was heartbroken for this poor soul. When I last saw Tony, he was still housed in a cell by himself. He wore diapers and couldn't consistently feed himself. I don't know what happened to him in the end.
Corrections Nurses Develop Superpowers
Yes, I can boast that my time at the jail molded me into somewhat of a super nurse. While I didn't gain the ability to fly or X-ray vision, I did become an expert at packing a tunneling abscess without breaking a sweat and administering a (mostly) painless tuberculin skin test. Even though I didn't develop the ability to leap tall buildings at a single bound or shoot webs from my palms, I did acquire an expert eye for spotting an impending drug overdose and lightning-speed assessment/triage skills for signs of a stroke. My empathy is broader, my skills are sharper, and my knowledge of physical and mental health conditions has grown substantially. I felt helpless many days and jaded on others. Correctional nursing brings one face to face with the consequences of untreated mental health conditions, the bottom rungs of substance use, and a pinch of human nature at its worst. Working at the county jail was transformational and a growth opportunity for me as both a nurse and a human being. Share your nurse story with us! 
