A day in the life of a nurse manager at the TDCJ Hospital in Galveston

Jul 17, 2015, 09:45 AM by KirstiAnn Clifford

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(Above) Hicks says his nursing staff is like family to him. (Below) Hicks stands near the 4th floor entrance to Hospital Galveston.

“Organized chaos.” That’s how nurse manager Bryan Hicks describes most days Hicks3at the TDCJ Hospital in Galveston. And when I join him shortly after 10 a.m. on a Friday morning, I quickly understand why.

The hospital, which is commonly referred to as “HG” or Hospital Galveston, sees between 200 and 300 patients a day. And by patients, I mean offenders that have been brought in by bus, ambulance and van from prison units all over the state.

HG is the only maximum security prison hospital operating on an academic campus anywhere in the world and is attached to the John Sealy Hospital by a long hallway on the fourth floor. I know I’ve arrived at HG when I come to a security area with multiple layers of bars blocking the entrance.

Hicks gives me a stern handshake and warm welcome. He’s excited to show me around – it’s not that often they have visitors from the “free world,” as they say.

Each floor of the hospital has different wings separated by heavy-duty gates – a security picket in the middle controls the movement between the wings. Hicks yells out to the security officer to open the gate and we walk right into the middle of a busy ophthalmology clinic, with offenders dressed in white and wearing handcuffs being escorted to and from exam rooms. They wait for their appointment in a holding tank with a television. As a nurse manager, he oversees outpatient ambulatory care, which includes 42 rotating specialty clinics.

“Today, we are holding an eye clinic, gastroenterology clinic and an ENT clinic in this area,” said Hicks. “Yesterday this was oncology. Tuesday it was neurology and Monday it was general surgery. There’s lots of activity and it looks like chaos, but it’s not. I know exactly what’s going on and so does everybody else.”

For many offenders, the care they receive at HG is the most comprehensive care they’ve ever received – many have never had health insurance or gone to see a doctor before.

Hicks4Hicks is called to the GI clinic, where he advises one of the physicians to admit a patient directly from the clinic into one of the open beds in the hospital. Then, he helps a nurse who is having trouble getting patients called down from the holding tank to their appointment.

His phone beeps and rings almost constantly, and he floats between the different clinics to answer questions, keep patients moving smoothly, and troubleshoot any issues. He says he spends his days “putting out fires,” and that was almost a literal part of his job description this day – a loud voice suddenly booms over the intercom, announcing smoke and an electrical smell coming from the third floor. I follow him as he jumps on the elevator to check it out – luckily, it’s a false alarm. Construction workers were welding together a broken gate.

“Well, that problem’s solved,” said Hicks smiling. “There’s never a dull moment around here!”

It’s clear that Hicks loves his job. He’s been at HG since 1988 and seems to know every single person, whether they are a security guard, nurse or physician. And although he’s busy, he takes time out to ask an employee about a new grandchild and say hi to a physician he hasn’t seen in a while – it’s the little things like that that probably led to him receiving “Employee of the Month” at the hospital in June. He takes pride in his job and the work done at HG, saying the standard of care is just the same as it is in the John Sealy towers or anywhere else on campus.

“We are delivering cutting-edge, evidence-based, research-supported care to this Hicks2population,” said Hicks. “These offenders have been found guilty by a jury and they are paying their debt to society. I don’t care why they are in prison. I care about why they are here in my clinic today.”

The clinics close every day at 4:30 p.m., with the last patients escorted back to the buses for the trip “home” to their unit. Hicks walks me back to the front security area, where he talks about how great his nursing staff is – and how they are always looking for more people to join their tight-knit family.

“It really is a very pleasant place,” says Hicks. “If you came tomorrow, you wouldn’t notice the bars so much. It’s amazing how quickly they just go away.”