Is it really like Orange is the New Black? A correctional nurse’s perspective

“I’m a women’s prison nurse,” I state as I swirl my drink at the bar.

Whether it’s the bar or a family holiday gathering, here are some of the top responses that follow each time someone, usually 18–55 years of age, and white, asks me what I do for a living:

“I didn’t even know prisons had nurses.”

“Tell me one of the craziest stories. I bet you have a lot.”

“Are you ever afraid of being assaulted in the prison?”

“Have you ever been hit on by your patients?”

However, by far, the number one response I’ve received after disclosing my current place of employment: “So, is it really like OITNB?”

I’ve yet to really perfect the best response but I decided I should probably sit down and reflect a bit before season three hits Netflix and I’m confronted with the question at a much higher frequency. Luckily, I deleted my Tinder account, so I’m momentarily saved from answering these questions in text form.

Here’s my usual thought process before I respond: Do I attempt to kill the mood and talk about all the traumatic lived histories I’ve encountered? Do I let out my pent-up confusion and frustration about our correctional system? Do I gloss over my experiences and flip the conversation onto their career? How do I convey the dynamics of caring for a patient who was raped repeatedly as a child by her own father, can’t produce a bowel movement, and is currently serving time for the drug abuse she engaged with to cope? How do I convey the stark dichotomy of lived realities I encounter? Some days I answer questions like, “Are you able to give me something for my dental pain?” from a patient complaining of her unresolved meth mouth, 26 weeks pregnant with her tenth child, and never graduated from high school. Other times I answer phone call questions after a prison nursing shift on my ride home from my sister who asks, “Should I do CrossFit or hot yoga tonight?”

To clarify some of my inner turmoil when I’m asked this question, tidbits of the following experiences float through my head right before I decide to indirectly or directly answer: “Is it really like OITNB?”

To give some background, part of what I do as a nurse is triage medical health service requests received from the patients, handwritten, regarding some aspect of pain or discomfort related to their general health. The two options I have are to: 1) write back to the request with medical advice and hope it’s received, or 2) add the patient to “nurse sick call” where I assess the patient in person. Typically these requests are illegible with misspellings and grammatical errors. “I can’t make a boo boo” (e.g. produce a bowel movement). During nurse sick call, I once explained the three holes of the female body to a 25-year-old. I’ve had to explain to adult women that tampons will not stop you from urinating. I’ve attempted to rationalize why it’s important to not make homemade tampons (e.g. wads of toilet paper in a pad lining) and why paying one fifth of your monthly prison salary (around 14 bucks a month) on a box of tampons (3 bucks) could be worth it so as not to endure the symptoms of bacteria vaginosis. I work with a gynecologist who won’t discuss abortion with women who enter the system pregnant. I’d confront her but there are very real consequences in addressing provider management and “stirring the pot” within corrections—I’d rather stay at my job and provide quality care. I’ve had to rationalize to women why it’s important to lose your bunk space to stay the night in the infirmary for observation and closer monitoring. Can you imagine losing your home or safe space in order to seek medical care?

I’ve had to deescalate and triage anxiety attacks from chest pain up to five times per nursing shift. I’ve had to search for 15 minutes for echocardiogram (EKG) leads in order to obtain an EKG on a machine that barely works most of the time. I use open and contaminated bottles of wound wash and non-sterile gauze for wound dressing changes. I sometimes have to count all the needles and medical sharps twice a shift before I take care of a patient, since prison security and “safety” often overrides patient care. I’ve had to argue with officers about allowing patients housed in the infirmary to walk the halls.

I’ve had to defend myself to my nursing supervisor when he told me that my “charting (nursing documentation) makes it really easy for lawyers to create a case” because I directly disclosed the amount of days a patient experienced a delay of healthcare treatment regarding her follow-up visit of a newly identified liver mass, 10 centimeters large. I’ve had to send a patient to the local emergency department who needed a bolus of fluids because we were out of normal saline for intravenous infusion. I’ve had a 60-year-old woman explain to me the hardships of having to ask for more toilet paper. I have 20-something-year-old women with blood pressures floating around 160/110, and I have to think of ways of how to decrease salt intake when I’m limited by what’s offered in prison. “Maybe next meal, use only half a packet of Ramen noodle seasoning.” I’ve had an officer tell me, “I’m supposed to tell you that maggots were not in the food tonight.” The television news told me two weeks later after family members contacted the local newspaper. No family member ever did report the hanging of their daughter in the mental health ward. The prison still ended up renewing the contract with the private food services corporation 7 months later. I’ve consoled a woman about the sexual harassment she’s been receiving by a male guard. I’ve consoled a woman who lost her parents while incarcerated. I’ve had women physically assaulted and too afraid of disclosing the abuse because she doesn’t trust the system to take her seriously.

While I’ve definitely come across patients with similar histories to Pennsatucky and other characters on the show, and we do use very similar language such as “commissary,” the “hole,” “contraband” or “chow,” I don’t think the show conveys the harsh reality of the prison industrial complex or the amount of women struggling with co-morbid chronic mental and physical illness. My main critique of the show is that it does not portray the utter lack of healthcare management for women and men who are or who have been incarcerated. But people quickly diminish my main critique, saying “It’s just a show, it’s dramatized. It’s not meant for that.” Which makes me wonder if it’s fundamentally a good thing that people are starting to think, however simply, about women in prison. Or are the misrepresentations doing more harm than good? Further, what does this show do for children whose parents are incarcerated?

My usual audience in these conversations, privileged white people, may not be equipped to discuss racism, inequality, mental illness, or injustice when asking me my thoughts about OITNB.  When they do engage in such a conversation, they would rather agree with me or pass me another drink, and state, “That must be hard. Maybe you should consider another job.” There is one response I have yet to receive, but yearn for, when I disclose what I do for living, “What can I do about the prison system now that I’ve been exposed to some of the harsh realities via OITNB?”

I have reflected on this show many times, as a current prison nurse and practicing feminist, especially since I have a hard time watching it after a nursing shift at the prison. I used to think it was because I had had enough “prison” in one day, but in reality, while I sat hoping this would bring awareness of the injustices of the medical care provided within the system, it simply provided another venue to hyper-sexualize lesbian relationships and center the main context on the experience of the white educated female. How am I to relay my experiences in relation to the show? And then, through this reflection, I suddenly realized that maybe I should reconsider my main critique on how it misrepresents the prison healthcare system since perhaps a few more people might read this article if I use the title, “Is It Really Like Orange is the New Black?”

Header image credit: Claudia Strazza/Flickr