What to Expect as a Correctional Care Nurse and How to Avoid Burnout in Challenging Settings (2023)

With more than2.1 million adults incarcerated in America’s prisons and jails, (PDF, 543 KB), there is a great need for health care providers to support this underserved population. Many people taken into custody are experiencing serious and preexisting health issues, while others will need medical attention to address illness and injury that occurs during incarceration.

The demand for health care professionals, especially nurses, is high and expected to grow. According to the Bureau of Labor Statistics,employment of registered nurses is expected to increase 15 percent between 2016 and 2026, whileemployment of nurse practitioners is set to increase 36 percent. Correctional care is no exception to this trend.

Health care is a field that requires compassion — but this is especially true for those working in correctional health care. It requires the ability to see beyond someone’s criminal record and provide the best possible support for every patient, many of whom did not have access to health care prior to being brought into custody. This resource will address the unique considerations of entering into a career in correctional health care, including strategies for identifying and addressing corrections fatigue.

Understanding the Correctional System Population

Working in a correctional setting means working with a vulnerable and underserved population. A2016 report from the Bureau of Justice Statistics on the health issues in American prisons and jails (PDF, 910 KB)found that incarcerated individuals were more likely than the general population to experience chronic conditions and infectious disease. Of those surveyed, 40 percent reported having a current chronic medical condition, while 21 percent of individuals in prison and 14 percent of individuals in jail reported a history of tuberculosis, hepatitis B or C, or other STDs (excluding HIV or AIDS).

The prominence of health issues in correctional facilities is compounded by the fact that many incarcerated people do not have consistent access to treatment, meaning they arrive with undiagnosed conditions.

“We see our patients at their worst,” said Richard Hammel, the nursing program manager for the Denver Sheriff Department.

When an individual arrives for the intake process, Hammel and his colleagues are tasked with performing an initial medical exam. He said that many of his patients find out for the first time that they have an existing condition like hypertension or that they have contracted an infectious disease.

Others may show signs of substance abuse, in which case they are taken through a detox process.Many incarcerated patients also show symptoms of mental illness, (PDF, 454 KB) which necessitates further care from clinicians.

What to Expect as a Correctional Care Nurse and How to Avoid Burnout in Challenging Settings (1)

A 2017 report from the U.S. Bureau of Justice Statistics assessed the prominence of mental health treatment in U.S. prisons and jails based on a 2011-12 survey of incarcerated people. Of the incarcerated individuals surveyed, 63 percent reported receiving mental health treatment once they were admitted to a prison, compared to 44.5 percent of individuals who received treatment after they were admitted to a jail facility.

Go to a tabular version of “Mental Health Treatments Among Incarcerated Adults.”

What Is the Role of a Correctional Nurse?

Nurses are critical in the continuum of care for people who are incarcerated. While procedures can vary from facility to facility, nurses are typically the first point of contact. Correctional nurses perform intake exams, distribute daily medications and assess when a patient may need to see a specialist for further observation.

Given the responsibilities of a correctional nurse, paired with the range of health issues they encounter, it’s important to have a broad skill set that includes dealing with chronic medical conditions, substance abuse, mental health, infectious disease and injuries. Having experience in an emergency room setting, for example, may help a nurse more easily transition to working in a correctional setting.

Correctional nurses are also expected to work autonomously in most cases, which can be a desirable aspect of the job to many in the nursing profession.

As for specialized training, there is no universal standard for experience or certifications for nurses in order to be hired to work in a correctional facility.Most facilities instead institute on-the-job training to prepare their health care staff, according to the International Association of Forensic Nurses.

Correctional nurses do have the option of earning certifications from theNational Commission on Correctional Health Careor theAmerican Correctional Association to hone their specialized skills.

Health Care in Correctional Facilities

It takes a team to care for an incarcerated population. Below are some examples of the points care providers offer to meet the physical and psychological needs of those in correctional facilities.

Intake Exams

When individuals are incarcerated, they undergo an initial physical assessment to determine what needs they will have during their time in custody, including chronic health issues, mental health and substance abuse.

Who provides this service:nursing staff, including registered nurses, nurse practitioners

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Patients with chronic conditions may need daily medications, which are distributed by a provider to ensure adherence.

Who provides this service:licensed nursing practitioners, registered nurses

Chronic Care

Some chronic conditions, such as asthma or hypertension, require additional treatments and monitoring.

Who provides this service:registered nurses and specialists, including nurse practitioners

Inpatient Care

Incarcerated individuals who have sustained an acute injury or serious illness may need specialized treatment from an inpatient facility, such as a hospital.

Who provides this service:radiologists, respiratory therapists, phlebotomists, pharmacists, physical and occupational therapists, registered nurses and nurse practitioners and specialists such as surgeons, gynecologists and oncologists

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Patients may have existing conditions such as schizophrenia or bipolar disorder or may need aid if they experience trauma within a correctional facility.

Who provides this service:behavioral health care specialists, counselors, nurse case managers, social workers, psychiatrists

How Does Working in Correctional Health Care Differ from Traditional Settings?

While the mission of a correctional nurse is the same as any nurse — to provide the best possible care for every patient —working in a correctional facility has some distinct differences from traditional health care settings.

Correctional facility protocols are, in a word, strict. The presence of a deputy or corrections officer is required during exams, making it difficult to maintain patient-provider confidentiality. When an individual knows someone else is listening, they may not feel comfortable speaking openly about their health problems.

The safety and security measures of a correctional facility may be unfamiliar to those who have only worked in traditional health care environments, but correctional nurses and clinicians can still provide compassionate care for their patients. For example, Hammel said that he and his staff are trained to assess whether it is safe to ask the officer on watch to step out briefly during an exam. This helps build trust with the patient so they are less likely to withhold any relevant information that may impede their care plan.

The need to be vigilant and protective of one’s personal information is another aspect of the job that may feel foreign to health care providers outside of the correctional environment. Providers are advised not to share any details about their life outside of work with patients who are incarcerated, which can create some barriers for building trust and showing empathy.

“Sometimes nurses like to use themselves as a tool in treatment and share stories [to empathize]. That is just something you can’t do here,” Hammel said.

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Instead, Hammel implements the following strategies when building rapport with his patients:

  • Ask questions to gauge a patient’s fears, concerns and general thoughts about their health issues.
  • Take time to appreciate a patient’s perspective.
  • Follow through with what you say you can do for a patient.

There is also a perception that treating individuals in a correctional setting is less safe than working in a traditional environment. However, Hammel said that, in his experience, this perception is largely a myth.

“I have never felt afraid or been attacked [in the workplace],” he said. “There are deputies close by to step in and make sure everyone is safe, both the patient and the health care worker.”

Other correctional nurses have voiced similar sentiments, saying thatworking in a correctional facility often feels safer than in a hospital.While there is not current data to compare the experiences of correctional nurses to those in traditional settings, safety and security are top priorities for correctional facilities. The presence of correctional officers, the access to call buttons in every room, and training to identify the early signs of escalating and agitated behavior are all factors in preventing incidents between patients and providers.

The Silent Danger of Working in Corrections: Employee Burnout

Whilecompassion fatigue is a common term known among health care providers, clinicians and other professionals working in a correctional facility may experience a more specific feeling known ascorrections fatigue.

Corrections fatigue is “the cumulative negative change over time of corrections professionals’ personality, health and functioning” that results from poor coping strategies or a lack of resources necessary for the requirements specific to working in a correctional facility, said Caterina Spinaris, executive director of Desert Waters Correctional Outreach in Florence, Colorado.

Corrections fatigue occurs when someone experiences a series of stressors during their day-to-day life. “These stressors interact,” Spinaris said. “They are cumulative.”

Environmental factors can be broken down into three categories:

What to Expect as a Correctional Care Nurse and How to Avoid Burnout in Challenging Settings (2)


Stressors related to the interaction between people in the workplace, including colleagues, leadership and the overall culture of a professional setting.


Stressors related to the presence of violence, injury or death. This can include the loss of a patient, witnessing violence or the general suffering of incarcerated populations.

What to Expect as a Correctional Care Nurse and How to Avoid Burnout in Challenging Settings (4)


Stressors related to the process or support in a facility, such as a lack of resources, equipment or staffing needed to do a job well.

This form of burnout can be avoided so that correctional professionals can provide the best possible care for incarcerated people.

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Signs and Symptoms of Corrections Fatigue

You may be experiencing corrections fatigue if you have:

  • Difficulty relaxing as a result of the need for constant vigilance
  • An increase in consumption of alcohol or other substances
  • Prolonged irritability
  • Persistent anxiety
  • Sleep problems

How to Avoid Corrections Fatigue

What to Expect as a Correctional Care Nurse and How to Avoid Burnout in Challenging Settings (5)

Build your support system

This can include your partner, family members, fellow colleagues and friends.

What to Expect as a Correctional Care Nurse and How to Avoid Burnout in Challenging Settings (6)

Practice mindfulness

Find activities that help ease your stress and process your feelings. This can include journaling, meditation, exercise and other calming activities.

What to Expect as a Correctional Care Nurse and How to Avoid Burnout in Challenging Settings (7)

Find activities that don’t intersect with work

Finding a balance and separating your personal life from your work life can help avoid burnout. Hiking and outdoor activities, for example, put you in an environment that is completely different from your job.

What to Expect as a Correctional Care Nurse and How to Avoid Burnout in Challenging Settings (8)

Get help

If serious symptoms such as depression, panic attacks or substance abuse begin to manifest, consider seeking help from a mental health professional.

Treatment TypeIn PrisonIn Jail

Received any kind of treatment



Prescription medication






Both prescription medication and counseling/therapy



Citation for this content: Nursing@USC, theonline FNP programfrom the University of Southern California

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Which nurse is more prone to burnout? ›

Critical care nurses tend to suffer the highest rates of burnout. Critical care specialties include the emergency department (ED) and intensive care unit (ICU). Emergency department nurses tend to experience the highest rates of burnout.

How much do Correctional nurses make in California? ›

How much does a Prison RN make in California? As of Oct 19, 2022, the average annual pay for a Prison RN in California is $99,968 a year. Just in case you need a simple salary calculator, that works out to be approximately $48.06 an hour. This is the equivalent of $1,922/week or $8,330/month.

How do you prevent nursing burnout? ›

  1. How to Deal With Nurse Burnout: Coping Strategies and Tips. ...
  2. Take Inventory of Your Stressors. ...
  3. Engage in Healthy Activities. ...
  4. Practice Mindfulness and Breathing Techniques. ...
  5. Set Boundaries. ...
  6. Consider Changing Careers. ...
  7. Learn Compartmentalization. ...
  8. Seek Support.

How do you solve nursing burnout? ›

In this section, experienced nurses offer their best tips for nurse burnout prevention.
  1. Develop Strong Interpersonal Relationships. ...
  2. Set Boundaries Between Work and Personal Life. ...
  3. Get Enough Sleep. ...
  4. Care for Your Physical and Mental Health. ...
  5. Seek Out Regular Therapy or Assistant Programs.

What state pays the most for correctional officers? ›

Correctional Officer Salary by State 2022
  • California: the average salary for a corrections officer is $81,890.
  • Mass.: the average salary for a corrections officer is $77,890.
  • NJ: the average salary for a corrections officer is $77,270.
  • RI: the average salary for a corrections officer is $74,220.

What type of registered nurse makes the most money? ›

The 10 Highest Paid Nursing Jobs in 2022
  • Certified Registered Nurse Anesthetist – $202,000.
  • Nursing Administrator – $120,000.
  • Neonatal Intensive Care Nurse – $120,000.
  • General Nurse Practitioner – $118,000.
  • Critical Care Nurse – $118,000.
  • Certified Nurse Midwife – $114,000.
  • Informatics Nurse – $102,000.
5 Sept 2022

How much do LVNS make in California prisons? ›

As of Oct 25, 2022, the average annual pay for a Correctional LVN in California is $61,619 a year.

What are 4 strategies that help prevent professional burnout? ›

Preventing Burnout
  • Early recognition of burnout and related risks. ...
  • Cultivate ability to self-reflect. ...
  • Complete a periodic assessment and realignment of goals, skills, and work passions.
  • Exercise regularly.
  • Eat a well-balanced, healthy diet.
  • Get enough sleep.

Why is it important to prevent nursing burnout? ›

The Importance of Preventing Nurse Burnout

A failure to prevent nurse burnout results in: Safety incidents caused by overwhelmed nurses. Staffing shortfalls caused by poor retention. Dissatisfied patients who received low-quality care.

How do you deal with burnout in healthcare? ›

Practice stress reduction techniques including deep breathing exercises, yoga, and meditation.
  1. Take time off before burnout sets in. ...
  2. Connect with friends and colleagues to reduce feelings of isolation.
  3. Keep your appointments with your regular physicians to maintain good physical and mental health.

What causes nurses to burnout? ›

Demanding workloads and aspects of the work environment, such as poor staffing ratios, lack of communication between physicians and nurses, and lack of organizational leadership within working environments for nurses, are known to be associated with burnout in nurses.

How can healthcare burnout be improved? ›

6 Strategies for Decreasing Nurse Burnout
  1. Train Leaders to Recognize and Address Burnout. ...
  2. Improve Nurse-to-Patient Ratios. ...
  3. Include Nurses in Policy Discussions. ...
  4. Implement Support Programs. ...
  5. Involve Nurses in Scheduling. ...
  6. Reduce Non-Clinical Tasks.
14 Jan 2020

› nurse-burnout ›

It is defined as emotional, mental, and physical exhaustion caused by excessive and prolonged stress. It impacts nurses' personal lives, the patients they t...
Everybody gets stressed out sometimes, but over a longer period of time, it can become burnout—in other words, emotional exhaustion and disengagement. Many nurs...
Another study defines nurse burnout as: “A widespread phenomenon characterized by a reduction in nurses' energy that manifests in emotional exhaustion, lack...

Which type of nursing is the most stressful? ›

Most Stressful Nursing Positions
  • Intensive Care Unit nurses (ICU) ICU is an extremely high-pressure environment and these nurses work with patients who have significant injuries and disease with added morbidity risks. ...
  • Emergency Department nurses. ...
  • Neonatal ICU. ...
  • OR nursing. ...
  • Oncology Nursing. ...
  • Psychiatric Nursing.
27 Jan 2021

Which profession has highest burnout rate? ›

According to Microsoft's 2021 Work Trend Index, the following occupations have the highest amount of burnout-related job turnover:
  • Physician.
  • Nurse.
  • Retail and Fast Food Worker.
  • Social Worker.
  • Police Officer.
  • Air Traffic Controller.
  • Emergency Response Worker.
  • Lawyer.
7 Sept 2022

Who is most affected by burnout? ›

U.S. Workers' Burnout Rates by Industry, 2022

Currently displaying rows 1 to 14. These results are based on the Gallup Panel Workforce Study, conducted Feb. 3-14, 2022, with 12,319 U.S. full-time employees, including 1,263 K-12 workers. Within the K-12 employee population, teachers are the most burned out, at 52%.

Who is more likely to burnout? ›

Recent data looking specifically at burnout in women is concerning. According to a survey by LinkedIn of almost 5,000 Americans, 74% of women said they were very or somewhat stressed for work-related reasons, compared with just 61% of employed male respondents.

Who are the happiest nurses? ›

(The following are America's 15 happiest nursing jobs.)
  1. Outpatient Case Management. ...
  2. Office Nurse. ...
  3. NICU Nurse. ...
  4. Informatics Nurse. ...
  5. Legal Nurse Consultant. ...
  6. Health Writer. ...
  7. Private Duty Nurse.

What is the easiest nurse to be? ›

Easiest Nursing Jobs Availabile
  • Clinic Nurse. ...
  • Traveling Nurse. ...
  • School Nurse. ...
  • Summer Camp Nurse. Average Annual Salary: N/A. ...
  • Nurse Administrator. Average Annual Salary: $68,000. ...
  • Public Health Nurse. Average Annual Salary: $56,000. ...
  • Researcher Nurse. Average Annual Salary: $62,000. ...
  • Home Health Nurse. Average Annual Salary: $64,000.
31 Aug 2022

Why are nurses more prone to burnout? ›

Demanding workloads and aspects of the work environment, such as poor staffing ratios, lack of communication between physicians and nurses, and lack of organizational leadership within working environments for nurses, are known to be associated with burnout in nurses.

What is burnout nursing? ›

Nurse burnout is a widespread phenomenon characterized by a reduction in nurses' energy that manifests in emotional exhaustion, lack of motivation, and feelings of frustration and may lead to reductions in work efficacy.

What causes burnout? ›

Common causes of burnout include: lack of adequate social support; taking on more than one can handle at work, school, or interpersonally with family and friends; and poor self-care. Burnout is a serious matter.

How does burnout affect workplace? ›

Employee burnout has a negative impact on an organization by decreasing morale and increasing employee turnover. Changing the hours or duties of an employee are two effective strategies for dealing with employee burnout.

What happens in a workplace right before employees hit burnout? ›

One of the critical signs of burnout is when employees are unable to concentrate or remember important things. Companies may need to investigate, especially when employees are constantly making mistakes or forgetting important deadlines or meetings.

What burnout means? ›

“Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: feelings of energy depletion or exhaustion; increased mental distance from one's job, or feelings of negativism or cynicism related to one's job; and.

How do you handle burnout at work? ›

Handling job burnout
  1. Evaluate your options. Discuss specific concerns with your supervisor. ...
  2. Seek support. Whether you reach out to co-workers, friends or loved ones, support and collaboration might help you cope. ...
  3. Try a relaxing activity. ...
  4. Get some exercise. ...
  5. Get some sleep. ...
  6. Mindfulness.

How do you deal with staff burnout? ›

How to help your team deal with burnout
  1. Understand the root cause. Before you take any action, take the time to understand the root cause of your team's burnout. ...
  2. Be an advocate. ...
  3. Demonstrate compassion and empathy. ...
  4. Take care of your own wellbeing.
5 Feb 2021

› which-professionals-ar... ›

According to the Mayo Clinic, job burnout is a type of job stress in which you might feel physically, mentally, and emotionally exhausted. You might also questi...
Psychology says theres are three different types of burn out that affect mental, emotional, and physical health.
Experiencing workplace stress for prolonged periods can lead to burnout.1 Burnout symptoms include feeling exhausted, empty, and unable to cope with daily life....


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