The death of Bay Area resident Cynthia Palomata last week is a grim
reminder of the dangers faced by correctional nurses. As with many
dangerous professions, correctional nursing can be extremely rewarding
work for the right kind of person. Still, as Palomata's family can tell
you, the potential for tragedy is very high.
Palomata worked as a prison nurse at the Contra Costa County joil in
Martinez, CA. Her family members remember her as patient, kind, and
compassionate woman who loved her work.
"When she took that job, I told her I said 'Aren't you scared dealing
with these people that came out of prison and have problems?' She said
'Auntie, it's a job,'" remembered Palomata's aunt Venus Dioso.
The attack occurred when a newly-admitted inmate, 34 year old Aaron
Nygaard of El Cerrito, faked a seizure in the jail's intake area.
Nygaard was tasered in order to bring him under control, and nurse
Palomata was taken to John Muir Hospital and underwent surgery for her
injuries, but she never recovered. The case has led to concerns about
the safety of civilians working with prison inmates.
This was the second recent death of a Bay Area nurse. The California
Nurses Association said attacks on health care workers are on the rise
and that this and other recent attacks indicate that workplace safety
must be improved through new legislation.
This may, however, curtail one of the main appeals that nurses find in
this kind of healthcare work. One thing that distinguishes correctional
nursing from other kinds of nursing, is that nurses, not physicians,
make the majority of decisions and correctional nurses have greater
freedoms to practice their expertise.
Once, correctional jobs were highly marginalized, but their reputation
improved after the 1976 U.S. Supreme Court case of a Texas prisoner who
sued for violations to his civil rights to access medical services. The
U.S. Department of Justice then asked the American Medical Association
to create standards for correctional healthcare. These standards did a
lot to improve the quality of care in prisons, encouraging nurses to
pursue careers in correctional facilities.
One of the improvements was a system of accreditation after facilities
met certain standards. While accreditation is not require unless
mandated by a court or contract, almost 600 correctional institutions
are accredited, according to Edward Harris, president of the National
Commission on Correctional Health Care.
Now that correctional nursing has been alleviated from the stigma that
such nurses are less qualified than traditional hospital nurses, more
are choosing this path. For a job with increased risk, you would expect
that the pay would be better, and while this is frequently the case, it
is not universal and there are still some correctional facilities that
pay lower salaries than hospital nursing jobs in the same area. There
are other benefits, though. Many find it rewarding to give medical care
to people who have often never seen a physician and were especially
appreciative of medical help. This also means that patients have
different sorts of problems than those that are typically treated in
hospitals. Inmates are more likely to have rare diseases caused by drug
and alcohol use, poor living conditions, or lack of medical care. The
autonomy of the job is a major selling point for some correctional
nurses. Nurses handle emergency medical situations as well as mundane
ones and can be allowed to administer prescription medication when
inmates meet symptom criteria preapproved by a doctor.
But this freedom to have greater medical impact upon patients comes with
serious risks. Further assurances and measures to improve staff safety
must be instated for our nurses.