Job Satisfaction Behind Walls and Fences

• Author: Brett E. Garland,William P. McCarty
• DOI: 10.1177/0887403409333261
• Published date: 01 June 2009
• Date: 01 June 2009
• Subject Matter: Articles

188

Authors’ Note: The opinions and views expressed in this article do not necessarily represent those of the

Federal Bureau of Prisons.

Criminal Justice

Policy Review

Volume 20 Number 2

June 2009 188-208

© 2009 SAGE Publications

10.1177/0887403409333261

http://cjp.sagepub.com

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http://online.sagepub.com

Job Satisfaction Behind

Walls and Fences

A Study of Prison Health Care Staff

Brett E. Garland

Missouri State University, Springfield

William P. McCarty

University of Illinois–Chicago

Health care staff serve important humanitarian, legal, and security functions inside

prisons. Although medical and health staff have become critical to daily life in prisons,

little is known about their work attitudes and outcomes. This article examines the job

satisfaction of 430 health care practitioners in the federal prison system. Ordinary least

squares regression is used to analyze responses to a global measurement of job satisfac-

tion. This analytic procedure was chosen after tests determined that prison-level char-

acteristics would have very little influence on the job satisfaction of this sample.

Work-related variables were stronger predictors of job satisfaction than personal char-

acteristics. Feeling effective in dealing with inmates had the strongest impact on job

satisfaction. Health care staff also had higher job satisfaction when they perceived

greater flexibility and effectiveness in organizational operations and when they had

more positive feelings about supervision. Significant personal characteristics that influ-

enced job satisfaction included race and education level.

Keywords: job satisfaction; prison health care; medical staff

Inmates have a variety of health care needs, ranging from the common cold to HIV/

AIDS, that require medical attention (Maruschak & Beck, 2001). Prisoners always

have been in need of medical care, but, until recent decades, such care, if provided at

all, was often substandard. Historically, it was not uncommon for prison health care to

be administered by unqualified medical professionals or—even worse—by fellow

inmates (McDonald, 1999). In 1976, the U.S. Supreme Court made a progressive rul-

ing in Estelle v. Gamble (1976) that characterized deliberate indifference to the serious

medical needs of prisoners as the equivalent of cruel and unusual punishment. Later,

U.S. Circuit Court decisions clarified that medical care in prisons should be in accor-

dance with modern medical science and professional standards (Fernandez v. United

States, 1991; United States v. DeCologero, 1987). These and other court rulings have

enabled inmates to express medical grievances through litigation.

Garland, McCarty / Prison Health Care Staff 189

Health care providers in prisons are not just important for humanitarian and legal

reasons. Delivering appropriate medical care is actually critical for maintaining

institutional order and security. Violent and destructive outbursts can occur when

inmates feel that their medical needs are not adequately met. Considering that

inmates with mental illnesses are more violent and disruptive than others (Ditton,

1999), diagnosing, monitoring, and treating the mentally ill are key for institutional

control. Failure to appropriately address physical medical needs such as head colds

and injuries can also ignite aggressive behavior. Prisoners with medical problems

can become agitated from their physical discomfort, and they may become angered

by what they perceive as neglect if medical services are not delivered promptly and

effectively. The close proximity in which inmates reside and interact also means that

disease can spread quickly across an institution. Gross inadequacies in medical care

have been motivating factors for several riots, including the infamous Attica riot in

1971 (Prout & Ross, 1988). Whether it is a nurse giving a shot, a doctor stitching up

a wound, or a dentist filling cavities, a valuable service is being provided in each

case, with effects that extend far beyond the immediate medical benefits.

Using data from the Prison Social Climate Survey (PSCS), we analyze the

amount and sources of job satisfaction among a sample of health care professionals

in the federal prison system. In this study, health care staff include physicians and

their assistants, dentists and dental hygienists, nurses, and psychiatrists. Health care

staff also include pharmacists, medical records technicians, health service admini-

strators, and radiology technicians.1

Job Satisfaction and Its Impact in Prisons

Spector (2003) defined job satisfaction simply as “the extent to which people like

their jobs” (p. 210). In the corrections literature, Lambert, Hogan, and Barton (2002)

referred to job satisfaction as “a subjective, individual-level feeling reflecting whether

a person’s needs are or are not being met by a particular job” (pp. 116-117). Low job

satisfaction in prisons opens a gateway to deficits in both individual and organiza-

tional performance. When job satisfaction is lacking, correctional staff have more

work absences (Lambert, Edwards, Camp, & Saylor, 2005) and higher rates of turn-

over (Dennis, 1998; Jurik & Winn, 1987; Robinson, Porporino, & Simourd, 1997).

Absenteeism and turnover resulting from low satisfaction pose financial obstacles to

prison systems (Camp & Lambert, 2006; McShane, Williams, Shichor, & McClain,

1991) and place strain on staff who must fill vacant roles (Camp & Lambert, 2006).

If turnover is consistently high, worker morale may suffer (Lambert, 2001).

Low levels of job satisfaction in prisons have led to burnout (Whitehead &

Lindquist, 1986; Whitehead, Lindquist, & Klofas, 1987). Burned out prison staff can

experience a number of physical health problems (e.g., headaches and stomachaches),

psychological problems (e.g., anger and low self-esteem), and negative attitudes and