FAQS

FOR ONE I AM JUST CURIOUS ABOUT HOW YOU FELL INTO YOUR CURRENT JOB. HAS IT ALWAYS BEEN AN INTEREST OF YOURS TO WORK IN A JAIL? AS WELL AS WHAT IS YOUR FAVORITE PART OF WORKING THERE?

I knew I was going to be a public health nurse - hospital work never appealed to me - but I never expected to work in a jail. My first job out of nursing school was at a clinic, but I was so bored there; I sat at a desk, had little direct patient care, and a very narrow scope of responsibility. My friend from nursing school worked at the health department in the county jail and told me she learned new things every day and felt safer than she ever had in a hospital due to the constant presence of security staff, and was never ever bored. I applied per her advice and I’ve been here for nearly five years.

My favorite part about working here is getting to know my community. A lot of my patients have arrests in the dozens (I think the most arrests I’ve seen for one person was  225, and the guy is 35 years old). Others may have only a few arrests but stay in jail for 2 years or more while they prepare for trial on serious crimes like murder and sex abuse. It’s not uncommon for me to walk into a housing module and talk music, movies, shoe culture - whatever - in addition to health care with my patients. I can go to booking most nights and know half the people there, and they yell out Hey Nurse Katie, how’s it going? and offer fist bumps. It’s nice to have positive relationships with those who might otherwise be overlooked in the world. It makes me feel very connected to my city.

WHAT IS YOUR DAY TO DAY JOB LOOK LIKE?

My 8 hour shift starts with receiving report from the previous shift nurses. We talk about major events of the day, patients we’re concerned about, etc. I then prepare for my first round; I download my patient list, review their charts, and gather my supplies to take to the housing modules. I spend about an hour or two seeing patients - mostly for wound care, opiate and alcohol withdrawal, caring for diabetics before dinner. This is done in cells or at the deputy station in the middle of housing. I return to my office and chart, then repeat the process for my second round. In between these rounds I respond to emergencies with other nurses (similar to codes in the hospitals) and urgent medical complaints (e.g. an inmate is having trouble breathing, or has chest pain, or was involved in a fight).

WHAT ARE THE MOST COMMON ILLNESSES/ INJURIES THAT YOU SEE?

Drug and alcohol withdrawal, psychosis, skin infections (usually abscesses due to IV drug use, but I have seen live maggots in wounds a few times), poorly managed cardiac issues, poorly managed diabetes, scabies and lice infestation.

WHAT DO YOU FEEL ARE THE MOST PRESSING ISSUES WITHIN THE JAIL SYSTEM, SPECIFICALLY PERTAINING TO HEALTHCARE? AND HOW DO YOU FEEL THEY COULD BE CHANGED/IMPROVED?

I think the most pressing issue in jail health is addressing those with mental health problems. We have staff specifically assigned to help those in need while they are in custody, like social workers, psychologists, medical doctors specializing in mental health treatment. If someone is in immediate crisis (if they are dangerously psychotic, say the are suicidal, engage in self harm, appear very depressed), they will see a mental health specialist urgently. If someone is in custody long enough (and this is rare, the average stay is 11 days), we’ll have them seen by the doctor, stabilized on medications, and make a transition plan to connect them to housing, treatment, and medical care in the community.  

However, the community systems in place are not developed enough to manage the number of people with significant mental health issues after release.  When people decompensate in the community due to their mental health issues, they return to jail to be housed in an isolated setting and decompensate more, then start the whole rehabilitative process starts over again. They then release to the community, and the cycle repeats.

So how do we improve? We spend significant money and effort on medical, mental health, and addiction services and policy change to prevent incarceration, and recognize that jail is the social services of last resort. We aggressively develop these services to prevent people from getting arrested in the first place.

WHAT ARE THE MENTAL HEALTH CARE SYSTEM AND TREATMENT LIKE WITHIN JAILS?

We often say that our jail is the largest mental health treatment center in the state. See above.

WHAT SHOCKS/ HAS SHOCKED YOU THE MOST WHILE WORKING IN A JAIL?

The degree of human suffering so many people endure has been surprising to me; their loneliness, lack of social connection. When social connection wanes, the safety net goes with it; people who face housing, job, or medical crisis have no sofa to crash, no support network. This spirals to houselessness, drug abuse, crime, and subsequent arrests. Life for many of my patients seems to grow more and more difficult, and living outside offers no respite. They become victims of robbery, sexual assault, and violence. Research shows that their trauma started long before I meet them, and it’s heartbreaking.

Check this out - https://www.acesconnection.com/g/aces-in-criminal-justice/blog/pipeline-to-prison-may-start-with-childhood-trauma

WHAT DOES THE FUNDING SIDE LOOK LIKE - ARE THERE CERTAIN RESTRICTIONS AS TO WHAT TREATMENTS YOU CAN GIVE?

Funding is something I’m not privy to. All I know is this - we don’t have a lot of it. While we can’t offer things like acupuncture, physical therapy, or drug treatment in the traditional sense, everyone has access to medical care in a timely manner. No one is charged for meds, hospital visits, treatments, or mental health services. There is a $10 copay to see a doctor, but it is waived if one is unable to pay.