Correctional settings offer unique challenges to nurses who seek to offer quality healthcare to incarcerated individuals. Prisons are overcrowded and nurses work under strict security regulations. The same skills that make nurses good emergency room (ER) nurses are the skills correctional nurses need.
Some nurses fall into correctional nursing by accident. However, most find it a fulfilling career, and the patients are often appreciative. In this guide, we spoke with a correctional nurse who talked about what it’s like to work in a jail or prison. Learn the steps needed to become a prison nurse and how much they make.
Q&A With a Correctional Nurse
Lynn Scussel is the associate director of nursing education at UWorld where she assists in leading a team of subject matter experts to develop content for the National Council Licensure Examination (NCLEX) question bank.
She began her registered nurse (RN) career in Connecticut as a staff nurse. In 2003 she earned a master of science in nursing and became a forensic nurse clinical specialist while working as a correctional nurse at Northern Correctional Managed Healthcare Facility, a level five super-maximum security prison in Connecticut. Scussel then transitioned into education as a nursing school instructor for Quinnipiac University, Goodwin College, and the University of Connecticut.
While working for UConn, she piloted a new clinical experience for nursing students within several different correctional facilities in Connecticut. She later relocated to Chicago in 2008, where Scussel worked as an NCLEX content developer for Pearson VUE.
She now resides in central Florida and has over 13 years of experience developing NCLEX-style items.
What led you to pursue correctional nursing specifically?
I could probably give the credit (or blame depending on your perception) to my mother, who is also an RN. When I was young, I remember her reading a lot of true-crime, serial killer books and watching “America’s Most Wanted” shows. She was intrigued by the story of how a serial killer evolved into a person who could commit such heinous acts.
I also had my own interests in how the human body worked and absolutely loved psychology in high school and college. I knew I wanted to pursue working with criminal investigators and possibly pursue juvenile criminal research one day. My mother had a friend who worked in corrections when I was in high school, so I was aware that working in that environment was an option as an RN.
Correctional nursing is definitely not highly advertised, so it is not often on a nursing student’s radar to pursue that field of nursing, but it was an interest of mine.
What does a ‘typical’ day look like for a correctional nurse?
Ha ha! The real question is, “Is there such a thing as a typical day in corrections?” The truth is the answer is yes. The nurses have a routine each shift that we hoped we could get through. The reality is anything at any time during the shift could completely disrupt that routine.
I always told people it was like going to the circus and waiting to see what the patients would do that shift. I said that with genuine honesty because I never knew what was going to happen, and a lot happened in the two and a half years I worked there.
The patients in corrections often made me laugh. Many of them had talents that were wasted since they were locked up, but also, the behaviors and things that they would say for a reaction were entertaining and made the staff giggle or shake our heads in disbelief.
Many patients enjoyed putting on a show for attention.
What are some of the biggest challenges of your work as a correctional nurse?
The biggest challenge of working in corrections is finding your confidence — not only in your nursing skills but also in yourself.
Some patients in corrections could be very rude to the staff. I had to remind myself not to take any of it personally and understand that they behave this way to get a reaction. I quickly learned if I do not react, most of them would eventually get bored and stop the behavior.
I do want to be clear, though, not all the patients in corrections behaved this way. There were patients who were always polite and respectful to staff and even some patients that would insult another inmate in my defense.
Finding confidence in your nursing skills was another challenge. Patients can be very creative and at times, meeting with a nurse was just recreation time for some patients in corrections. Meaning they would request to see a nurse for various reasons (rash, cold symptoms, pain, [gastrointestinal] issues) and then once the inmate was in the treatment room, they might be making up symptoms just so they can be out of their cell and have a conversation or be assessed.
For many of them, it was the need for the physical touch they received. Therefore, I had to be confident in my physical assessment skills to identify which reports of illness were feigned versus real. Not only did I often need to explain to the inmate why I would not recommend that they needed to be seen by the doctor, but also that they did not need any medication or lotions.
Some of them tried to school me and test my knowledge of the human body! Confidence was key to surviving as a correctional nurse because the patients could smell self-doubt a mile away, and those nurses became prey.
And the greatest rewards?
I found the greatest reward of working in corrections was the feeling of making a difference for some patients. Not all the patients acted inappropriately. Some patients took advantage of their situation in a positive way. Meaning they listened when you taught them something about their physical and mental health.
Other patients were very honest in admitting that they were not actually sick, but really just needed to talk, or have that physical touch and assessment to get them through the next minute, hour, day, week, month, or year. I had patients that purposefully tested my nursing skills and then complimented me when “I passed their test.”
There was one inmate that swore every day he was an innocent man, and he was persistently polite and humbled by his situation. I heard, after leaving corrections, that he was, in fact exonerated and found innocent based on DNA evidence. That was a happy ending for me that he never gave up and eventually was given his truth back.
What advice would you give to those considering a career as a correctional nurse?
My advice is that correctional nursing can be a very rewarding and challenging career, but it is not for everyone. It is very much a different specialty that requires a nurse to have a special kind of self-worth to make it through the challenges each shift will bring.
Day in the Life of a Correctional Nurse
A correctional nurse is often the first healthcare professional a prisoner sees about a medical condition. The national prison and jail population hovers around 2 million patients, so the demand for correctional nurses is high and expected to grow.
When patients are brought to the jail or prison, the correctional nurse usually does an initial medical exam. This may be the first time an individual learns they have high blood pressure or an infectious disease.
Nurses are a critical factor in the continuum of care for people who are incarcerated. Prison nurses distribute medications and are the first to assess people who may need further healthcare, including ER care.
Correctional nurses must have a broad range of skills and knowledge as they work relatively autonomously. They must be adept at physical assessment and emergency care for patients with physical and mental health conditions. These include:
- Substance use
- Chronic medical health conditions
- Mental health conditions
A prison nurse always has one or two guards present to protect their safety. Prisoners may be handcuffed and shackled, depending on the potential for violence.
Correctional nurses who do well often have years of experience in emergency care. In one day, they may have to dress a stab wound, give mental health counseling, and do a gynecologic exam. ER experience gives nurses the opportunity to improve the skills needed to survive and thrive in the correctional environment.
“I found the greatest reward of working in corrections was the feeling of making a difference for some patients.” — Lynn Scussel, Correctional Nurse
Nurses require these skills to fulfill their responsibilities and get through a day in the life of a correctional nurse. Many employers are seeking nurses with emergency room experience.
- Strong assessment and treatment planning skills
- Ability to function independently and respond to emergencies
- Wide range of medical knowledge
- Detailed documentation
- Basic life support certification
- Mental health experience
- Wound care
- Triage skills
- Health promotion and disease prevention
- Strong situational awareness
- Communication skills
How to Become a Correctional Nurse
Prison nurses begin their career by completing an associate degree in nursing or a bachelor of science in nursing (BSN) degree from an accredited nursing school. After graduation, the nursing student must take and pass the NCLEX.
Every state requires nursing students to pass the NCLEX to receive a nursing license in the state. Additional requirements for licensure in the state depend on the individual state board of nursing. Nursing students must submit the necessary documentation to receive their nursing license.
Once a nurse has become an RN in the state, they may seek employment. Most prison facilities prefer nurses to have emergency room experience. While a nurse may be hired directly into the emergency room after graduation, many nurses find gaining initial experience in a medical-surgical unit helpful.
It takes about two years of experience in the emergency room for most nurses to feel comfortable practicing in a prison system. This time can vary depending on the number of patients and severity of conditions a nurse experiences in the ER.
The National Commission on Correctional Healthcare offers a correctional health professional – RN (CCHP-RN) certification. This certification validates a nurse’s skills and knowledge to deliver specialized care in correctional facilities.
Eligibility to take the CCHP-RN exam is based on a current CCHP certification.
There is no work experience requirement for a CCHP certification. Applicants must have the proper credentials and state licensure. Once the application and $220 fee have been submitted and approved, the applicant receives confirmation they can take the exam. They must complete the CCHP exam within six months.
Eligibility for the CCHP-RN includes a current CCHP certification, an active RN license, two years of full-time practice, and 2,000 hours of experience in a correctional facility within the last three years.
RNs must also have 54 continuing education hours in nursing and 18 in correctional healthcare within the last three years. After the application is approved, the candidate has six months to complete the CCHP-RN examination.
The American Correctional Association also offers a corrections nurse certification. Eligibility requirements include an RN or practical nurse who has at least one year of experience in a correctional facility.
How Much Do Correctional Nurses Make?
A typical salary for a prison nurse varies depending on several factors. According to Payscale, the average base annual salary is $54,000 as of December 2022. However, the sample size for this figure is extremely small. According to ZipRecruiter in December 2022, the average annual salary is higher at $71,970.
The large gap also may be related to the method each site uses to gather data. ZipRecruiter bases the average salary on job postings on their site. Since many employers are seeking BSN-prepared nurses who may be certified, the salary range can be higher.
Payscale gathers data from individuals in the job market. This includes associate degree nurses and licensed practical nurses working in the prison system.
Education is one factor that influences a correctional nurse’s salary. Other factors include certification, geographical location, and practice setting. According to postings on ZipRecruiter, the salary range for a prison nurse varies based on the city. Nurses who are certified can also earn more.
Finally, employers may negotiate a higher salary for nurses with greater experience in the ER or correctional facilities. This helps improve care for the patients.