corrections is fantastic!!!

Im still a rookie in corrections nursing, but heres an example of some of the more subtle manipulation I've experienced.... On my first day in orientation an inmate walked up to me and asked me how he could get a full physical. This seems like a very harmless or even legitimate question, right? No, this guy knew full well how to get a physical or non-emergent medical attention. When I turned to him and said bluntly, put in a sick call slip his whole demeanor changed to "oh, yes mam". He was fishing to see how much I knew, didn't know or where my boundaries where. Seemingly harmless questions and requests are how many inmates find which staff they can target and manipulate with their BS. I too have a background in psych, my "universal precaution" in corrections is to assume they all have antisocial personality disorder, if you catch my drift.

Maritesa you indicated that you had refused to work drug rehab because of manipulative behaviours.

Most inmates today are there for some type of drug offense, and if that's not what they were convicted of it had something to do with why they are inside. Unless someone is truly psychotic, crimes are committed for sex, drugs or money, usually a combination of all three. Stories like "I shot my best friend because he swiped my stash" and "I beat up my wife when she told me to stop drinking/shooting/smoking" are the norm. You need to remember, also, that the crime they were convicted of is not usually the only crime they have committed, just the one they were caught doing. They may have been caught stealing a car, but that's only because they were driving it home from the scene where they buried a body. And, at least at the facilities that I have worked at, boredom is a HUGE factor. There are not enough CO's to supervise the IM's while working, so they don't have jobs and have nothing better to do than to talk amongst themselves and pass "helpful tips" to others. If you have a psych background, that would serve you well as most facilities pass out BUCKETS of the older psych meds (yes, they still use Thorazine in these places). These drugs are cheap and the companies like CMS and PHS cut costs every chance they get. Still, all it's faults, I wouldn't work any place else.

Thank you for a positive and factual response. You said that you would not work anywhere else, why? Is this truly your niche? I just would like to hear more, to dispel some fo the horror stories that I have heard. Please tell ?

I'm glad you find my insights helpful and honest. Why do I enjoy corrections so much? Well, I find that you have an opportunity to do some "real" nursing. Not to say that other areas are not "real" as I couldn't work in an ICU or on a Tele floor (all the beeping monitors would make me a nervous wreck in about 3 mins flat). What I mean by "real" is that you have to depend on all of your knowledge (not just what you learned in clinicals) to be effective, safe and respected. There is a great deal of teaching going on because most of the populations have little knowledge of even the most basic health maintenance. When you actually get through to an IM that has little regard or respect for others, but seeks you out because he has finally found someone on this planet he can trust and respect is the best. Following policies are expected and you are (more times than not) backed up by administration. I have worked in hospitals that expected you to follow written policy, except if it didn't make them look good, then you ended up in the dog house for "poor customer service". My favorite part is that there is no family sitting there on their duff, expecting you be in their family members room at all times, just waiting to wipe Grandma's nose or hold the urinal for Uncle Joe. I have also been privileged to work with one of the greatest docs in the business, and I give him a great deal of credit for the whole work culture at the prison where I work. Last, but not least, I like being challanged and this environment has more challanges than the typical hospital or LTC facility. It's not for everyone, but no area of nursing is.

I did both county and state nursing. Each had its advantages and disadvantages. One of the biggest differences was how the inmates and nurses were addressed by the officers (badged officers). In the state prison the officers were respectful of the inmates and medical staff. The nurses ruled when it came to medical decisions of course and the officers listened. If there was an issue they disagreed with, they would quietly pull you aside and talk with you there was alot of give and take. When you were in the units I found the state officers had better control over the inmates. If the inmates were disrespctful, the officers would immediately revoke priveledges. I never had to say a word. There I felt like we were a team and I trully trusted them with my life and felt safe doing it, they rarely if ever swore at the inmates (if seen by the brass the officers would recieve diciplinary action) and they acted totally professional to both staff and inmates. At the county level it was another story. At the county, level many of the "Guards (non badged officers) were down right rude to both the inmates and staff. If you asked them to do something they may or may not do it and if they disagred they said so in front of everyone. You were not a part of a team. When you walked on a unit and the inmates were acting up they would say or do nothing until you asked them. Inmates could lip off to you and again they would do nothing the only time they would step in. I wonder if it was because in our state at the time every civilain had to go through an 8 week academy with the officers so there was a bond. At the county level there was no such academy. The weirdest thing is at the state level for the general population and minimum security,at sick call, there is an alarm in the unit and inmates who have signed up for sick call can leave their unit and walk from their unit to the infirmary without an officer in attendance the inmates had 5 minutes to get there. Same for scheduled medical appts. During the evening and night they came accompanied but shackle free. With the county the inmates were escorted accompanied all the time and they were shackled. The wierd part is I felt safer in the state prison. I know every state is different but that was my experience. (I did 7 years in state and 2 years in county)