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Correctional Healthcare Article


Lorry Schoenly, PhD, RN, CCHP Correctional Healthcare
with Lorry Schoenly, PhD, RN, CCHP


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How to better communicate with prison doctors and nurses

The healthcare ethical code requires not only not doing harm, but also focusing on what is best for the medical and mental health of the patient

Do you think the health care staff at your facility are from another planet? Do they misunderstand what you tell them and make no sense in what they ask of you? Here is a short primer on how to talk to doctors and nurses so they understand and listen to what you are saying.

Colliding world views
World view can have a major influence on communication and collaboration. While correctional officers rightly view each situation from a security, command and control perspective, health care professionals have a therapeutic viewpoint when considering the inmate population.

The healthcare ethical code requires not only not doing harm, but also focusing on what is best for the medical and mental health of the patient; in this case, inmate-patients. What can seem like requests and actions that ‘coddle’ or favor a particular patient may, instead, be necessary for healing.

Nurses and physicians, by virtue of their profession, are not respecters of persons and have a professional obligation to seek the best possible health outcome for a patient under their care.

The challenge is to provide that best possible health outcome within the required security parameters. Security and medical staff must understand each other’s worldviews and language to negotiate a satisfying solution to meet both goals.

Get real
Another communication issue involves the best way to exchange information about a particular inmate issue. For example, an inmate in a housing area might need medical assistance.

If the medical unit is called, questions may be asked that seem unnecessary. The nurse may ask specific questions about what the inmate is doing, saying, or how they look.

You may want the nurse to arrive quickly and not want to stay on the phone answering difficult questions. You may not have the words to describe what you are seeing or why you think a nurse should see the inmate.

However, the more information the nurse has the more prepared he or she will be to manage the situation once on the unit.

The more practical and realistic your description of the situation, the better. Describe what you are seeing and what symptoms the inmate is reporting.

Armed with this information, the nurse can make decisions about what equipment to bring, additional assistance needed, or if it would be appropriate to have the inmate transported to the medical unit for evaluation and tests. Here are some examples:

Instead of “The inmate is nuts”, try “the inmate is banging his head against the wall, is out of breath, and looks like he is about to pass out.”

Here's another example: Instead of, “the inmate is sick and needs a nurse", try  “the inmate has vomited twice, is sweaty, and complains of a sharp pain in his right side.”

Find common ground
Safety for staff and inmates is a common concern for both security and medical staff. Healthcare staff with experience in other settings such as a hospital, physician office or nursing home often needs reminders about their safety.

Seeking the good of the patient is so entrenched in medical practice that other issues can fade to the background, especially in emergency situations.

Even experienced correctional health care staff may ‘forget’ that they need to wait for clearance before assisting in a man-down situation. Through mutual respect and seeking common ground, security staff and medical staff can work together to reach common goals.

When security and medical work together the system works much better and life is good. Efficient and effective health care is delivered while security and safety is maintained.

Tell us your story about working with medical. What advice can you share that worked for you?

About the author

Dr. Schoenly has been a nurse for over 25 years and is currently specializing in correctional healthcare. She is a clinical education specialist and author actively advocating for excellence in this practice setting. Her web-presence www.correctionalnurse.net provides a forum to interpret correctional healthcare to the public and healthcare community. Lorry is a strong advocate for development of the specialty practice of correctional nursing. She speaks and writes frequently on correctional nursing practice issues. Her book, Essentials of Correctional Nursing, will be published in July, 2012.

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