What Student Nurses Can Learn from Inmates
Nursing students who spent their community rotation in a maximum security prison began to appreciate the complex life experiences that impact the health of the individuals they serve.
PHILADELPHIA – Nurses often leave patients with their first and most lasting impression of their medical care. In 2004, Mary Bouchaud, PhD, Assistant Professor at the Jefferson College of Nursing, created a clinical experience to help nursing students see every patient they encountered with compassion. She had them train alongside an inter-professional health care team consisting of nurses, physicians, physician assistants and physical therapists at a 4,000-inmate maximum security prison. She recently published her research documenting their experience in journal Nurse Educator.
“I thought that if I could introduce our students to individuals in a prison who required health care, and let them practice providing compassionate, non-judgmental care, then they’d be able to transfer that learning to wherever they practiced,” said Dr. Bouchaud.
Together with Madeline Brooks, an MPH student in Jefferson’s College of Population Health, and Beth Ann Swan, PhD, Professor and former Dean of the Jefferson College of Nursing, Dr. Bouchaud analyzed 10 years of student surveys from the program, reporting how students’ perceptions changed over the course of their five to six week rotation. Through the program, Jefferson nursing students were placed in an all-male maximum security prison, where they rotated through 11 health care units, including a state-of-the-art acute care unit, nurse-run ambulatory and chronic-care clinics, extended and palliative care units, dialysis and behavioral/mental health units, among others. Students spent two to three full days at the prison for five to six weeks. Dr. Bouchaud and Ms. Brooks analyzed the results of surveys taken by nursing students before they began their rotation and after they completed it, between the years 2006 to 2016, collecting a total of 186 surveys.
“Looking across the pre and post surveys, it became clear that the experience challenged many students’ preconceived notions about prisons,” said Dr. Swan. “Students expected prisons to be ‘dark,’ ‘violent,’ or ‘scary,’ places, whereas they often reported the opposite on their exit surveys. They were surprised at the inmates’ respectful behavior and described the prison as a well-functioning community or society.”
Responses from the students were very positive. ‘‘Being able to learn about nursing care in the prison community broadened my horizon of just how much nurses can do,” wrote one student. ‘‘I entered [the prison] feeling like little more than a student. Today I feel ready to call myself a nurse,’’ wrote another.
Students also focused on the opportunity to practice skills such as cultural sensitivity, communication, and providing nonjudgmental care, noting that the rotation ‘‘promotes humane treatment of all people, regardless of their personal circumstances.’’
Rather than focus strictly on preparing nurses for hospital-based care, the Jefferson nursing program and the prison rotation gives students the opportunity to become fluent and well-practiced in population-based clinical care, which is an emerging area of demand and expertise for nurses, and an area that Drs. Bouchaud and Swan have written about in other publications.
“The profession of nursing is changing,” said Dr. Bouchaud. “Nurses make up the largest part of providers in a rapidly evolving healthcare system and have to be equipped with 21st century skills. Today nurses are at the forefront as stewards and advocates of health and wellness, and reducing health disparities and inequities.” An array of diverse clinical rotations is a key aspect of the next generation nursing curriculum established at Jefferson College of Nursing in recent years.