My job

‘Above all, be brave’

Sheila Burns, director of nursing at a North Carolina prison service, urges newly registered nurses to try out different career options.

Sheila Burns, director of nursing at a North Carolina prison service, urges newly registered nurses to try out different career options.


What is your job?

My new role is director of nursing at Guilford County Detention Centers, North Carolina. I manage three sites across the county, with around 1,300 inmates including women and juveniles.

Why did you become a nurse?

It seemed to fit my personality and I was always interested in people. When I was 17, I worked as a nursing assistant in a nursing home and enjoyed looking after the residents, even though it was one of the hardest jobs I have ever had.

Where did you train?

I graduated with a bachelor of nursing with registered general nursing qualification from University of Glasgow in 1993. During 2016, I completed my master of science (MSc) degree in global health systems at Queen Margaret University, Edinburgh.

What do you enjoy most about your job?

My role is new. I have worked in prisons in Scotland before, but I am just getting used to the US jail environment and the cultural differences. The most enjoyable aspect of my job is tackling the complexities of the patient population we serve. Prison health has been described as ‘public health intensive care’ so every day brings new challenges that demand creative thinking.

How and where have you developed leadership skills?

I gained my first leadership skills in the Girl Guides. I earned a ‘camp permit’ and took my patrol of seven girls camping for a weekend. I had to organise everything, including cooking, first aid, pitching tents and digging a latrine.

On a more professional level, I worked as a clinical operations manager in a private healthcare company, and as a primary care team leader in Her Majesty's Prison Addiewell, West Lothian. Then I became assistant nurse manager in Wake Forest Baptist Medical Center, North Carolina. I gained a lot of practical leadership, which was consolidated with theoretical knowledge during my master’s degree.

How does your current job make use of your leadership skills?

Collaboration with the officers is a large part of my responsibility and being the voice of the healthcare staff is vitally important.

What is the greatest challenge?

Working in jail environments is challenging because, unlike in hospital, the primary business of a prison is security. The greatest challenge is supporting staff to keep the highest standards of care possible while confronted with a difficult environment. The behaviours of the patients can frequently lead to staff burnout and a drop in the quality of care delivered.

What inspires you?

Watching nurses look after patients with kindness, tolerance, patience and understanding when the response is negative in return. I also get inspired listening to people’s life stories and admire their tenacity and determination to move forward.

What achievement makes you most proud?

Managing to emigrate to the US with two teenagers. I am proud of how they have adapted to a new culture at such a difficult age. The whole process was pretty overwhelming and sometimes I still can’t believe we are here.

What makes a good nurse leader?

A nurse leader’s job is to care for nurses like you would care for patients. If you don’t look after your nurses, how do you expect them to care for their patients? Nurses work hard and a nurse leader should make their job as easy as possible.

What advice would you like to pass onto students and junior staff?

Don’t be too hard on yourself. If you aren’t sure about your current job, think about other options. Nursing has many facets, so explore them all. When you’re early on your career path, give different roles a try. Above all, be brave.

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