Professionalism matters in correctional health care

As correctional health care professionals, there may be times when we are tempted to conduct ourselves in a less than professional manner simply because we can.

We may be able to get away with speaking to our patients rudely, using profanity profusely, or wearing inappropriate clothing. After all, we work in jails and prisons. This culture is far from prim and proper. And, our patients are inmates. Many may tolerate misbehavior from us that patients on the outside would not and should not tolerate.

I’ve previously written about how I’ve found the book, Games Criminals Play, to be an invaluable resource. One key point that I learned is that many inmates, especially those trying to set up and manipulate staff, want to know whether each prison worker is a fellow inmate or “the police.” In other words, do we side with the inmates, or are we professional workers who take our jobs seriously?

Inmates study staff and look for clues to answer this question. The more professionally we behave and appear, the less likely we are to become targets for setups. Secondly, conveying a professional image will likely improve our credibility with administration and security staff. It’s difficult enough to provide treatment in a non-treatment setting as it is without us undermining ourselves. Finally, the stigma we all face for working where we do would likely be lessened if we exhibited the same professionalism standards that our colleagues in the community exhibit.

So, how can we improve our professionalism?

First, we should dress appropriately. We shouldn’t be dressing as though we’re getting ready to watch the football game on the family room couch if we’re going to work. Dressing sloppily conveys a lack of attention to detail and a lack of taking our roles seriously. Dressing provocatively says that we may be willing to compromise boundaries.

Several months ago I read an interesting article in Clinical Psychiatry News. It was written by a very experienced psychiatrist who had just started doing some corrections work. He felt sympathetic toward the inmates and began wearing green scrubs to work so that he would be dressed similarly to them. I am sure his intentions were honorable, but I feel strongly that trying to be more like inmates in order to bond with them is a big mistake. By doing so one is more likely to be seen as a sympathetic and easy target. I’ve come to believe that most inmates who are looking for quality health care would much rather receive it from someone who appears successful, polished, and detail-oriented.

Second, we should treat our patients respectfully and use a professional tone and language just as we would if we were working in the community.

There is no denying that treating prisoners can at times be very emotionally exhausting and thankless work. There will undoubtedly be some patients that we frankly don’t like and who behave in very hostile and disrespectful manners toward us. However, we must be certain that we do not lower our professional standards by responding with inappropriate behavior.

Third, we must maintain appropriate boundaries with our patients. This is one area where we need to be even more careful in correctional health care than do our community-practicing colleagues. In corrections, other than discussing our professional credentials, we should not be volunteering personal information or answering personal questions.

But wait, isn’t it more important that we’re caring individuals? Isn’t all of this professionalism talk a bit superficial?

Certainly being caring is one of the most important qualities that we can possess. But, if we lack professionalism, we’re not doing our best. And we’re undermining ourselves. We cannot complain about getting no respect if we do not behave respectably.

However, if we exhibit the above-mentioned traits of professionalism, we’ll likely be more effective at what we do. We’re likely to be more respected by inmates and others, we may feel better about ourselves and what we do, and we’ll be showing the rest of the world that working in correctional health care truly is a worthy and honorable endeavor.

Jeffrey Knuppel is a psychiatrist who blogs at Lockup Doc.

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