First year in nursing in a correctional setting

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    I am a new nurse and just started working @ a Federal prison this week. After orienting at all the facilities I will be on a med surg unit. Can anyone give me some ideas/pointers on organization or their routine for a 12 hr workday? There will be a max of 7 patients (inmates) per nurse. Also has anyone started their nursing career @ a prison vs a hospital, were you able to develop a good foundation?

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  3. 12 Comments...

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    Im actually starting this week too and was glad to see your post, cant wait to read what other nurses have to say! Thanks
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    maybe you'd get more responses if you posted this in the "correctional nursing" forum? just a thought. congratulations on graduating and on your new job!
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    I think your Orientation will help answer your questions.

    Sounds like you are working in a prison inpatient hospital/infirmary.

    Safety is first. followed by safety, safety, and did I mention safety?

    Do not make enemies of the guards, any other staff, or inmates.

    Let the inmates know you are businesslike, not a patsy who will fall for their manipulations. I'm dead serious about this. This point will be hammered into you repeatedly during Orientation.

    Be nice to inmates, courteous, but always, always, always professional and never personal.

    Absolutely never complain about a guard.

    Recognize that the primary focus of a prison is for staff (guards and yeah, even other staff, in that order) to go home healthy.

    After that is getting people to court and complying with judicial/legal orders.

    After that is everything else - including Medical, be it for routine med pass or sick call, or even urgent matters.

    In other words, a nurse might think she's just GOT TO get a prisoner to a doctor's appointment. If the facility is locked down, forget it. Unless he starts bleeding, convulsing, not breathing, he is not going to the doctor just then. And if a riot is occurring, he just might have to die, that's all. No guard or medical personnel will be allowed to endanger themselves to help even the most urgent patient.

    I have seen this personally, was upset at the time, but was smart enough not to insist that the Sergeant immediately provide access to med services. It was a stabbing or head trauma, I think. Well, the guy was ok in the end, but even if he had died, I think no one would have faulted the sergeant for doing what he did, which was put safety first.

    I wish you a great career. God bless you for caring for people who have had some very rough, painful, disadvantaged starts in life. Just don't let your feelings get in the way. Use humor when you can, be civil.
    Crux1024, flyingchange, and mommajoz like this.
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    I worked in prison for almost 2 years, but we didn't have an infirmary like the one you're at. I wholeheartedly agree with KookyKorky, on all counts.
    The best thing you can have when you walk in to work in a prison is a good attitude, followed by good people skills. Inmates are generally much more compliant when you take a second to explain WHY you can't give them medicine X or they're not allowed to have item Z for whatever their complaint is. There is a huge opportunity for patient teaching if that's your thing and when the situation merits.

    Working in prison is amazing at developing your assessment skills. It takes a while to get comfortable with your own judgement, but you'll start to be able to pick out legit complaints as opposed to inmates looking for a "field trip" to the ER or medical.

    As for the organization of your workday, I never had to deal with an actual med-surg wing; we were set up to run like a clinic more or less. But my day consisted of sick-calls from 0800-1030 and/or pill line from 0800-0830 depending on staffing; then catching up with charting from 1030-12ish, lunch, more sick calls/lab draws/vaccinations/med counseling appointments/translating and assisting MD/PAs/miscellaneous other duties from 1300-1500, KOP (keep on person) pill line at 1500, insulin line at 1700, SHU rounds from 1800-? and then hand off to the next shift. It's a busy day, but you actually get some down time because of the q 2 hour-ish counts, so it's less intimidating than it sounds.

    It might be slightly harder to start nursing in the prison setting, just because you have a lot more autonomy than you would in a community setting, but if you're confident in your skills and willing to ask a lot of questions, I'd recommend it! Best of luck!
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    Just one thing to add....the one term I know the officers where I work don't like (and I mean even a little) is guard, or jailer. At least here that is the case. They prefer C.O. or Deputy, or Officer. Just a heads up so you don't offend on accident.
    Multicollinearity likes this.
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    Excellent point, Jaila . Most of our inmates called them "the cops", which confused the crap out of me at first, lol.
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    Depends on your shift. I work in an infirmary. I started out of school here. Never sure what is coming up. I only wish for 7 patients. We get anywhere from 10-15. I just remember the golden rule treat others as you want to be treated. I respect them and treat them well, but only give them what medically necessary. They try to manipulate you at every chance. When I tell them no they are most respectful. At my facility at night there is no doctor, but we can call him if necessary. I have had to call him in the middle of the night to send someone out. Hope that helps.
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    Show to others the behavior and respect you expect from them, you will more often than not find it returned. You treat people in need of healthcare and they all deserve high quality, respectful care.

    At the same time, never forget that they are in a very controlled, powerless position and any perks or power they can get from you my be huge in their world. (Information, turning your back while being seen so they can snoop info/pocket something - even a paperclip!) No matter how much they may like or respect you, they will always have this dynamic in their lives while incarcerated.

    So safety, safety, and more safety! Get to know and appreciate the C.O.'s, they are the ones who have your back if things go bad. Safety is their job.

    But always remember that the patients you treat you could as easily have treated at a community health clinic, very down on their luck, and felt sympathy for their struggles with the hands they have been dealt. You're just meeting them after they chose how to play the hands, rather than before.

    NEVER giver personal info, do realize you are a target to be manipulated by many - consistency and following standard orders and rules is key - NEVER "bend" the rules - no "eh, I see you need it, so I'll give you this Tylenol even though your PRN order ran out yesterday," (seriously, would you do this on a hospital unit? no!) but keep treating patients with the respect and professionalism every patient deserves. Incarceration is their punishment for crimes, not poor healthcare while incarcerated.
    Crux1024, tokidoki7, kneal, and 1 other like this.
  12. 0
    Quote from Jaila
    Just one thing to add....the one term I know the officers where I work don't like (and I mean even a little) is guard, or jailer. At least here that is the case. They prefer C.O. or Deputy, or Officer. Just a heads up so you don't offend on accident.
    Ha. Typical. If you ask a guy who happens to be a jailer in a county jail what he does for a living he'll say "I work for the sheriff's office." The quetioner usually then will ask something like "Oh, really, you're a deputy. That's cool." The jailer may then reply "Yeah, it gets pretty dirty sometimes." The questioner will then ask something like "Hey, were you at that wreck at ______ the other night?" Jailer, "Nah, I didn't make that one." Questioner, "Well, how about that shooting down at _______; what was that like?" Jailer, "I heard it was pretty bad. I wasn't there." Questioner, "What area do you usually work?" Jailer, "Ah, um, well, right now I'm a deputy that's assigned to the jail." Questioner, "Oh, I didn't know that deputies had to work in the jail." Jailer, "Well, yes, there are deputies in the jail to watch over the inmates." Questioner, "Oh, so you're a guard?" Conversation then ends awkwardly for jailer and questioner. 90% of them want to be street cops and try to play the part. We don't pretend to be jailers though.

    If it's someone at a state prison you're talking to it's more like "Hey, man I heard you were a police officer now. Where you working?" CO, "Tucker SuperMax." Other person, "I thought that was a jail." CO, "It's a prison." Other person, "So you're a prison guard?" CO, "I'm a corrections officer." Other person, "So you're not a cop then?" CO, "Well, I am to the inmates, and I am allowed to carry a gun outside." Conversation then ends awkwardly for both parties.

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