Corrections Nurse Job Duties

OfficerRNBSN · Oct 18, 2013

Name it. I probably do it. I don't want medical excitement so if you're looking for that then a jail or prison probably isn't the place. If you're looking for people that can't do anything but lie and feign illnesses then this is the place for you. You need a highly refined BS-meter, self-confidence, and wide knowledge base because you'll treat clinic, med-surg, emergent, and chronic care types of inmates as well as dental issues.

I work four 10's, and I stay busy. Oddly enough, I don't really have a lot of interaction with the inmates.

I spend a lot of time on the phone and on my email making the infrastructure required to have our jail clinic hold together. There are 28 med passes in a week (4/day x 7 days). I pass on only eight of those and call it "slinging pill," and I host "sick call" only one day per week, and that's the day before the doctor comes for a visit. I do not and will not see inmates, in situations other than an emergency, without a written request, and I will address only what's on the request. Sick call is a focused history and exam, treating what I can treat, and adding to the doctor's schedule if necessary. Much of my Wednesdays are spent doing what I call "dishing out" meds for next seven days, and every 14 days we have a med change out, i.e. on day 14 all meds are used up, new meds arrive from our contract pharmacy, and they are stocked with MARs printed by the pharmacy on that 14th day to resume. I'm quite proud that I have made this a highly efficient process. Other than unit dose things like orajel, hydrocortisone cream, bacitracin, etc., we do not provide any OTC med items. When I first arrived we were giving out ibuprofen and phenylephrine as needed, but we've culled that due to both cost and inmate abuse. It's not coming back on my watch either. We provide basic needs and inmates are required to pay a portion of medical services and medication.

Much of my work involves administrative issues with procurement, supply, billing, policy, and what I think of as case management, i.e. following up with other providers and pharmacies so that inmates can continue (or start) meds while incarcerated. It's actually more time consuming than I ever imagined it would be. It burns me up that most of them don't take any meds while on the outside and expect us to provide them while in custody. However, I've made great strides in reducing the amount of medication we provide to inmates, and there are some that we will absolutely not provide, despite anyone's prescription, based on cost. As a policy, we do not provide any form of controlled substance although at the moment I have two people on carisoprodol, and that will be short lived nor do we provide sleep aids. Although I am somewhat of a psych specialist we do not provide a full gamut of mental health services and psychotropic medication. I also make written responses to numerous inmate grievances surrounding anything remotely related to their health or wellbeing, and the unique thing about being a RN in a jail is that my judgement is valued by the administration. I'm not "just a nurse" in the way that I felt I was perceived in the hospital. I am solicited for solutions to problems, my ideas manifest, and I am given autonomy and flexibility. There is no traditional RN job that could gives me that satisfaction. I worked in a hospital and learned a lot, but I did not like it in a big way.

Some caveats, I am a fully commissioned law enforcement officer. I am not "merely" a nurse nor a jailer nor a corrections officer. I am unrestricted in what I can do in the jail with respect to enforcement as well as outside the jail, and I do participate in security and enforcement activities. I wear a uniform and, outside the inmate population area, carry a firearm. I was an officer for many years before even considering nursing and was able to continue to maintain my nexus with law enforcement all throughout that time. How that relates to nursing is that it allows me to transport inmates to medical appointments rather than relying on our transport department, as they stay very busy, thus clear more issues off my desk, and I am qualified to assist the detention officers which helps all of us since most of them are very young, inexperienced, or under trained. For me, it allows me to remain an officer and do other "cop stuff" which I grossly enjoy.

No clue what a remand center is.