I worked in corrections when I was working in urban missions...as a counselor for a private drug and alcohol rehab where we'd also go into prisons and run bible studies and such. I'm very familiar with the needs specific to inmates, and how to interact with them. So it's not the inmates I have an issue with at all. It's that I know NOTHING about correctional nursing, whatsoever.
I've been working agency as I'm finishing up my RN, and got a call to go to a facility I'd never been to. Couldn't even figure out how to get there... it was a mess. I asked for all of the info I could think of that i might need, but was still out of my element as I'd be expected to be in any new facility. I wasn't even sure of where I was supposed to park.
Needless to say, it was horrible. Sharps are controlled and I had no access to them. I'm a diabetic, and b/c I started my shift late as I was given wrong directions and it was so far out in the desert clustered amongst other prisons, my GPS sent me the wrong way....and I was called so late at night that I was given an extra hour to get there b/c of the extremely short notice. My pill call started an hour and a half late and I was killing myself trying to figure out what I was supposed to do and how to do it in a place I'd never been. Usually I'm sent to med surg or LTC facilities and I do pretty well in those places b/c I've been to them before. But in prison, at least this facility, they pre-pour meds. As far as I know that's a HUGE no-no. Inmates are also not allowed to have whatever they ask for as far in terms of OTC's and bandaids and such. I had no clue that the inmates did their own BG's and gave their own insulin and that they don't use lancet pens but stick the lancets into their own finger manually. So what ARE they allowed to have, what in the world is the facility protocol and where do I find this out? The 1 other nurse I was working with was never available to answer those questions, and the inmates used the opportunity to attempt to take advantage of me which didn't work at all, but even the CO's were asking me vague questions about how long I've been a nurse because I had absolutely NO IDEA what in the world I was doing and it was obvious. I even specifically asked my agency...do you guys understand I haven't worked in a correctional facility before? "yes this is your orientation." "Is the facility aware that I've never worked as a nurse in a correctional capacity before? are they o.k. with this?" "yes, we did tell them and make sure it was o.k. before we sent you."
But I had no break b/c i was so far behind. I ended up crashing with a low BG, and attempted to warn the 1 other nurse I was working with well ahead of time...as I was placed into 5 separate pods in which I had to complete med pass for all inmates, which took me all day. After 8 hours of non-stop catch up, I again warned the other nurse that I had to have something to eat or I was going to get sick. She was oblivious, she honestly did not understand that I was serious. It was Sunday, there was no charge nurse, and it was me and a younger LPN who just couldn't understand that I was seriously out of my element with being forced to navigate the prison maze absolutely alone and not even able to find her, either by visually looking OR on the phone or radio....when I needed something.
I had glucose gel in my cart I was using to try to keep myself going until I could get a break, but it turned out to not be enough. When my BG gets low, I get really "stupid" (nothing at all makes sense to me and I can't think of the words I need to communicate with other people) and hysterical. I felt it coming, went into a room with my med cart and locked myself in after walking back and forth between two separate units three times, outside, uphill pushing a med cart trying to find the other nurse b/c I'd run out of insulin needles and the diabetic inmates had been waiting for quite some time.
I ended telling her that she had to finish the dinner med pass, as I sobbed uncontrollably in the floor of the room I'd locked myself and the cart in while I waited for a CO to escort me to the reception part of the building so I could leave. There are VERY few agencies where I live, and the work here is few and far between because of the part of the country I'm in. I did not let my agency know what happened, and I'm pretty confident that the other nurse I was working with didn't either. She was just happy somebody else came in so she didn't have to do med pass alone.
But I felt like a total failure. After that shift, I e-mailed my agency and explained that going forward, I absolutely love to be available to help out in a pinch, but that I needed to re-iterate that I am not available on Sundays, and that I wanted to suggest that at least a cursory orientation of the facilities we go to be provided before being sent to them for work. I realize that there are hazards like what I outlined above associated with being an agency nurse and the blind situations we're put into. We should be aware of that when we take on the responsibility of agency nursing. But I feel like a moron. Not only do I feel like one, I know that I looked like one too. It's nobody's responsibility to care that I'm a diabetic or make sure I eat. It's mine alone. I can't expect special treatment. But I felt so small when that happened, and I was humiliated. Now I'm wondering what I could've done different, or what kinds of questions I should be asking, or how to prevent something like this in the future. Thanks in advance for your help!