Is 1 nurse to 500 patients acceptable?

[corrections_nurse]

I am an LPN at a local correctional facility. We have an extremely bad turnover rate for nurses. We are supposed to have a Head Nurse in the AM and the PM (AM works 8A-4:30P and PM works 3P-11:30P, both M-F). The "regular" nurses work one week on Mon, Tue, Fri, Sat (AM 6A-4:30P, PM 4P-2:30A), and the alternate week you work Sun, Wed, Thur, Fri (AM 6A-6:30P, Fri 7A-11A. PM 6P-6:30A, Fri 7P-11P) So 2 nurses on each shift M-F (1 head nurse and 1 regular nurse per shift). Oh and we are ALL LPNs.

You now see how the shifts are set up but the real problem is we have at this time 550 inmates/patients. Even if we have a full set of nurses we usually have 275 inmates/patients to 1 nurse. I work nights and we are short a nurse on days so they have pulled our head nurse on nights to cover day shift. So 90% of the time I am working it is 1 nurse to 550 inmates/patients. I have to do diabetics, pill pass, order medications, check in medications, daily weights/VS, Sick calls, Blood work, see EVERY person in booking, PPDs, wound care, tend to every emergency, oh and last but not least PILL PASS! I give anywere from 500-600 medications a night which takes around 4-5 hours.

My main question is how legal is it to have that type of inmate/patient ratio to nurse? Also it is impossible to get all the tasks I have mentioned above and some BP, weights, Sick calls, etc. are not completed because there is not enough time to complete everything. Can I be held accountable for everything not being completed since it is not humanly possible for me to complete everything? I will be finishing my RN school May 2014, and I am worried about the liability of the workload that I currently have. Should I suck it up? Find anothed job? Or quit and focus on school? Any help would be greatly appreciated and if you are in a similar situation let me know what you do.

[corrections_nurse]

I know that some are potential pts but when you are giving medications to over 400 inmates plus sick calls, diabetic checks to 20+, wound care, breathing treatments, daily vs, screening new inmates, ordering meds, etc and dealing with at least a couple of "emergencies" each night it gets a little stressful and hard to complete all the tasks at hand. My typical day consist of 4pm-6pm diabetics, 6-10:30 pill pass, sick calls up to 11:30 at night, and health screenings. Each health screening takes around 10min, with vs, ROI, general questions, and ppd. I have anywhere from 5-30 I see each night in booking (usually around 10). Also I am checking in meds and placing them on the carts which takes about 30min. After 12 I can't bring any inmates down to medical unless it is an emergency. So all things are not always completed depending on what events happen each night. Right now I work 4 10 hour shifts, so I'm working 4-2:30am qnd it is so hard to get everything completed in that amount of time. Not to mention they deduct 30min of pay for a lunch that I haven't had in over 6 months. It just feels I'm over worked, under paid, and under appreciated.

[Erikadawn RN]

Welcome to corrections. I use to be the nurse who ran around crazy to get things done. Somehow I managed, then u went out Fmla so that my son could get surgery. When I came back, there was another nurse, why? Because no one could get everything done like me. Do what you can, without killing yourself. Take your lunch every night, you need it. When suck calls start backing up, meds not put away, etc. They will find help.

[NottaSpringChik, BSN, RN]

I can't imagine how you could possibly get all of that done.

[OfficerRNBSN]

Custody and medical serve 2 different jobs in a jail/ prison. My job as a nurse is to provide medical care, what or why theybare incarcerated is not for me to worry about. We as nurses should strive to provide the best possible care, whether to an inmate or patient.

I view it differently. I do what is legally required of me, and I'm really interested in EBP and the sciences of healthcare. However, I view the medical role in a corrections setting as existing to keep the inmates well enough to stay inside the fence, i.e. jail or prison. They're there for a reason, and if they're constantly ill, malingering, or given too much "oh that must be awful, let's send you to the hospital" then they're not serving all that required time inside the fence.