Use Your Head

I was eager to learn when I started this job.  I was clear the hospital was not the place for me and I liked that working in the jail would combine my emergency and psych experience. Also, I like working with this population. I managed to steer clear of legal trouble growing up but my friends often didn’t.  There were drug issues and warrants and I’d visited a good friend a couple of times when he was here for half a year. 

This same friend overdosed and died on my birthday about six years after that. The birthday thing was a coincidence. I had stopped hanging out with him about a year before that because I’d run into him in town, high.  He had done heroin for many years and I knew it, but I’d never actually seen him visibly high. He told me he wasn’t and it pissed me off that he would lie to me, because he’s not a liar. It pissed me off that he died too, and if I’m honest, I’m still mad at him about it. Anyway, I can’t change what happened but I can be a good nurse to the people in the jail so I wanted this job.

The first two weeks are online training and it's boring but I took notes diligently because it was a new job and I didn’t want to miss anything. The last day of training my supervisor came in and said, “You’re actually watching those?  You could have just let them play through.”  OK. I know that was meant to take off pressure, but I don’t like feeling like an idiot for being thorough.

My hands-on training starts and I’ve never met a sassier woman than the nurse training me in booking. She and the other nurse also call the deputies Daddy, and Papi, and I don't really know how to handle that. I try to keep myself from being embarrassed, but I get a wave of discomfort every time I hear it. 

I try to be entertained by it but the contrast between the looks on the arrestee's faces - staring at the ground in shame, usually unbathed, often intoxicated - and the blushing deputies is just slightly too uncomfortable to find funny. 

There is no training binder, and the nurse training me talks a million miles a minute, explaining what she is doing and how to do it as she works. She tells me to ask questions because now is the time, and when I do, she tells me I'm a slow learner and need to keep up. She tells me in her 15 years at the jail I'm the second slowest learner she's ever trained, and the other one didn't make it past training. I would be offended by this if I thought it was true, but I don't. So, instead, I just think she's kind of a bitch.

I’m being trained as a booking nurse and all inmates who come into the jail are assessed by us; new arrests, transfers from prisons and state hospitals, and patients returning from offsite appointments.  We get this guy back from an offsite doctor’s appointment to follow up on his broken leg. The initial arrest was for a DUI where he wrecked, got pretty fucked up, and was going to need a second surgery. 

He asked when his surgery was.  The nurse training me stopped typing, looked at him, and with her sultry voice and flavorful accent said, “What, you think this nurse was born yesterday? You don’t get to know that.”  She sounds exactly like Salma Hayek, a mean, sassy, Salma Hayek.

She goes back to typing and after his assessment is done and custody has taken him I say, “I wouldn't have thought twice about telling him when his surgery was. Can you help me understand why that would be inappropriate?” I'm careful with my word choice when I talk to her because I'm uncomfortable.

She said, “You tell inmates about their offsite appointment dates and they’re one phone call away from scheduling a jailbreak.”

We work out of a trailer in a parking garage and there is not enough room for an extra chair so I'm standing. I have my notebook and I’m continuing to take diligent notes despite my supervisor's advise.  I say, “What else do I need to be aware of along those lines? I want to make sure I don’t put anyone at risk without knowing better.”

She looks at me with her curled lashes and perfect lipstick like I couldn’t be dumber and says, “You need to use your head, and recognize, you work in a jail now.” She rolls her eyes and goes back to typing.

I  consider writing, “Use head. This is jail,” so that maybe it will make me laugh later when I’m reviewing my notes. 

But I’m new at this job.

So, instead, I feel just as small as she’s trying to make me feel and say, “Understood.”

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Review

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This story is sharp, layered, and emotionally resonant, offering a vivid glimpse into the complexities of working in a correctional healthcare setting. It thoughtfully explores power dynamics, institutional culture, and personal vulnerability while subtly critiquing both the dehumanization embedded within carceral systems and the survival mechanisms people develop to navigate them.

The story revolves around power, dehumanization, and institutional adaptation. It highlights how working in a jail—an inherently hierarchical, punitive environment—forces people to adapt to an oppressive culture, often at the expense of empathy and vulnerability. The seasoned employees push detachment, suspicion, and coldness as necessary tools for survival. The memory of the friend who overdosed adds emotional weight, demonstrating how unspoken grief underlies the drive to do good.

The tone is reflective, uncomfortable, and subtly defiant. There is balanced tension and frustration with moments of dry humor (“Use head. This is jail.”) and quiet resistance—like continuing to take diligent notes despite the discouragement. This restrained defiance is one of the story’s most compelling elements. The narrator manages to make the reader feel the oppressive, toxic atmosphere without ever having to state it outright.

This story exposes the subtle, insidious ways institutional environments erode empathy and reinforce hierarchical power structures.