Each of the eight women said she wanted a challenging job, something significant to add to her nursing background. What they're getting is an assortment of rapists, murderers, thieves, abused children and confused teenagers, people who generally think little of themselves.
The women are enrolled in the nation's only master's degree program in forensic psychiatric nursing at Catholic University. They are learning to listen to and guide the criminally insane back to reality and self-respect.
"At first I was scared out of my mind," says Ellen Drosnin, who completes the two-year program in its first graduating class next month. The first patients she encountered in her first year of graduate training were at St. Elizabeths Hospital's John Howard Pavilion, a facility for the criminally insane. The inmates were mostly men, many were "big black guys," recalls the thin, white nurse.
"You know intellectually they've been rapists and murderers . . . . I was prepared to find them less than human, but they were likable. Some had a sense of humor, were bright and had compassion for each other."
For Annette Ferguson, the image she won't forget from last semester's assignment when she and Drosnin worked with women inmates at the D.C. jail is the chilling sound of the great iron doors clanging behind her. "You know you can't get out unless someone in the facility lets you out," she explained.
But Drosnin and Ferguson also remember tears at the end of the semester when they said goodbye to the eight women they met with each week. Women loosely considered crazy and dangerous by the system. Unstylish women who wore ill-fitting gray overalls. Women who cried for children they could not touch during visits.
"They tested us . . . let out little stories about their crimes, just to let us know how bad they were . . . to see if we'd come back," says Ferguson. "For many of them, it was the first time in their chaotic lives that they've established meaningful, trusting relationships."
The nurses are not fond of the phrase "criminally insane," for it conjures up images of padded cells or shriveled human beings huddled in catatonic trances. "I'd rather call them mentally ill offenders . . . . they look like you and me," says Dr. Vallory G. lathrop, deputy director of nursing at St. Elizabeths, who initiated the Catholic U. program.
Many of the patients at facilities such as John Howard are schizophrenic, Sharon Sloboda, program director, explained. Schizophrenia doesn't refer to split personality, but to disorganized thinking and illogical associations, which means some individuals don't understand cause and effect. These are the individuals who are likely to be found not guilty by reason of insanity (NGI).
In addition, students work with pre-trial patients who are being assessed for mental competency to stand trial. Those who can't distinguish right from wrong never stand trial.
Still other inmates develop their mental illness while incarcerated, because they cannot cope with the loss of their freedom, the isolation and the strife of prison life.
The frustration can be overwhelming. Their therapists must be prepared to deal with anything. "We must always have a deep respect for the potential of violence," Sloboda said. "You always have to have your escape route planned."
The eight enthusiastic women from Catholic U. are a new breed of nurse. Far from the traditional role of white-capped nurses, these plainclothes practitioners are part psychologist, doctor, social worker and lawyer. "It's not going to be a matter of find (a job), but a matter of creating one," points out soon-to-be-graduate Martha Kline.
The low priority of penal programs in most states, plus the evershrinking pot of federal funds, is in direct opposition to the recent trend of court-ordered treatment programs for mentally ill prisoners. The latter may be an advantage for forensic nurses.
The potential for early detection and treatment of mental illness would be tremendous if there were more prison programs, one student points out. Students working at community mental health centers have seen the need for specialists to intervene in crises such as suicide attempts, hostage-holding and abuse cases. They also have seen the benefits of treating the offender and his or her family.
"We made a difference," says Ferguson with pride. A few of the nurses' patients improved enough to earn outpatient status. At John Howard, says Sloboda, "the word is that if you have one of the students from Catholic, you'll get better."