7 minute read
Compassion Behind Bars
Correctional nurses provide more than medical care
BY SHANNON POTEET
Jail isn’t usually a place associated with hope or compassion. But for more than 400 inmates in the Coweta County Jail, that’s exactly what the nurses in the infirmary division aim to provide.
The patients do not come in voluntarily.
“They are not the happiest. They don’t want to be here,” Infirmary Division Director Breana Greene said. “But you treat them the way you want to be treated.”
She has worked at the jail for more than a decade and has served as division director for the past six.
The Coweta County Sheriff’s Department oversees the jail and its operations. Ensuring inmates are treated fairly and receive the care they need is a mission the department takes seriously.
Greene oversees both county and contract workers. The infirmary team includes a medical director, nurse practitioner, doctors and 12 nurses.
The infirmary staff reviews all medical screenings taken during the intake process. This includes information about chronic medical or
mental health issues, Greene said. Verifying health records and connecting with inmates to determine what is really going on with them can be difficult, she said – they are not always forthcoming at first. And most do not arrive with their medical records in hand, making the task harder.
Compassion and care
The intake process is designed to ensure all inmates receive the medical care they need, but it can also be the first time a person receives a diagnosis.
“A lot of them don’t have access to medical care,” Greene said.
This can be because they have no health insurance, live in poverty or struggle with other issues that prevent them from being treated by medical professionals.
Those who struggle with mental health or addiction can be diagnosed when the psychiatrist sees them, she said.
Once patients are on the appropriate medications, they often begin to improve, and they also have access to counseling services.
“They get sober here,” Greene said. “When you get to know them sober, you get to know their dreams and hopes and aspirations.”
It is a side of people Greene and Infirmary Division Assistant Director Barbara Walker say they enjoy seeing.
“What I love the most is when we actually reach that one person,” Walker said. “A lot of times it’s not even when they are incarcerated –it’s when I see them out in the community and see them doing better.”
Knowing people can succeed after their time in jail is what continues to drive Walker to provide the best care she can, she said.
“They are like, ‘I saw you in the jail, Miss Barbara. You really encouraged me, thank you so much,’” Walker said.
It is a reminder of why she became a nurse, but the story doesn’t always have a happy ending.
“Sometimes they get off the drugs and have high aspirations about how they are going to change their lives – but then they come back, and they are a different person, addicted again or not on their medication,” Walker said.
It is a heartbreaking reality for the nurses who work so hard to help instill hope and resilience in the population they serve.
Sons and daughters
“You hear people say ‘they’ are coming in from the surrounding cities, but ‘they’ are actually the sons and daughters of this county that are addicted to drugs and have mental health issues,” Walker said.
Walker said she wants people to understand community members are the ones suffering, not outsiders.
“People distance themselves from opioid addiction and mental health issues in our backyard,” she said. “You get to know them without the addiction; you get to know who they are. You cheer for them every time.”
In addition to substance abuse issues, Greene and Walker say they have seen a dramatic increase in mental health conditions among inmates.
Walker said a lack of resources in the community, and adult children living at home with mental health issues their families don’t know how to handle, increases the problem.
“When families have issues, the police are called, and the families think this will expedite them getting the care they need. It doesn’t,” she said. “They just … go to jail.”
It can often make it harder for people to receive the services they need, Greene said.
Inmates struggling with mental health issues are put on a list so state hospitals can review their files and determine if they will take them in, she said.
“But because they are in jail and in a structured environment, instead of the streets or ER, they often get waitlisted,” Greene said. “In reality, they just need that higher level of care that only a mental health hospital can provide.”
Still, she and her staff say they do the best they can with the options available to them and hope more help becomes available through other avenues for the people they serve.
“There are currently judges who are attempting to improve services and outcomes for that demographic, and it looks promising,” Greene said.
Challenges after release
Greene said there also is a need for better discharge planning when an inmate is released from custody.
While incarcerated, inmates receive medical care, counseling and medication. At release, they are given a two-week supply of their medications and told they need to follow up with a doctor.
“Unfortunately, some of them can’t do that,” Greene said. “They don’t have funds or insurance, or even a way to get there, and they can’t continue their medications.”
This leads to additional mental health issues and recidivism.
Greene said she is looking at developing deeper relationships with Coweta Cares, the Coweta Samaritan Clinic and Coweta FORCE to combat those challenges and to reduce the number of people who end up back in jail.
“The community is great about coming in and supporting us,” Walker said. “And we have so many organizations willing to help others.”
Goodwill currently offers training to women incarcerated at the Coweta County jail, designed to equip them for employment after release. It is one of several programs offered locally to help inmates gain the necessary tools, skills and access to resources that are aimed at reducing the likelihood of them reoffending. Those services have become more crucial than ever as shortterm sentences began to lengthen because of challenges arising from the pandemic.
“We used to see inmates here for a year or less, (and) now they can be here for three or four years,” Walker said. “They are backed up due to court issues during COVID, and delays are just getting worse.”
Reducing the number of repeat offenders helps prevent the backlog from growing, she said.
Expanding services
A new expansion is underway at the Coweta County Jail. Once finished, it will add more than 31,000 square feet and another 206 beds. It will also include an infirmary. With the new space, Greene said she will be looking for additional staff.
She plans to begin hiring additional LPNs and medical assistants in November and December.
For Greene, the ideal candidate will be firm, fair and compassionate, she said.
While they say they understand a career as a correctional nurse is not for everyone, for Greene and Walker, the rewards far outweigh any negatives.
“We are safer here than they are at the hospital,” Walker said. “(Hospital nurses) go in alone. We always have an officer with us.”
Greene said she and her staff love what they do, and they try to show it in the way they treat their patients. Their mission is to provide hope in an often hopeless situation, Greene said, and are committed to continuing to provide the best care possible for those who find themselves inside the walls of the Coweta County Jail.
