Staffing

  1. I was curious about the staffing levels at facilities with populations similar to the one I am working at. I work in a county jail with a population that pretty much stays around 400 with about 15% of our population female. I'm an RN working as the health service administrator. Other than me, we have an administrative assistant and one LPN per shift around the clock. We have a psychiatrist 3 hours/week, an MD one day/week and a dentist 3 hours/week. We only have an officer on the day shift, so all sick call, treatments, H & P's, MD sick call and psychiatrist sick call all get done on the day shift. The evening shift has diabetics and 2 medpasses (not to mention having to handle emergencies, walk ins, intakes that need to be seen and telephone calls). Night shift has morning diabetics and a med pass where all meds are delivered cell to cell. I am probably sounding like a whiner, but I feel like we are an accident waiting to happen.
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  2. 11 Comments

  3. by   Orca
    I don't work in a county jail, but it sounds like your staffing is a little thin. I work in a 2000-bed high-medium security prison (all male) in Nevada, and we carry two RNs at night. One cares for the inmates in the 20-bed infirmary (average census 10-15) and takes emergent care clinic patients (we average 2-3 per night, normally things like headaches and stomach pain). The other nurse takes care of HS pill call on the general population and lockdown units, and does medication refills for the next night. We have only one med pass at night.

    Because we were having problems getting escorts in a timely manner in the mornings, AM diabetics were made the responsibility of the day shift, where more staff are available for rounds. In the mornings on my shift, the pill call nurse does blood pressures on the lockdown units and reads TB skin tests on new intakes. We do not do intakes at night, apart from the stray transfer from another state.

    It sounds like you need at least one more nurse at night.
  4. by   Bosoxer
    Sounds like your staffing is a little thin for sure. Surely you must have RN's on shifts also? Or is that what you call an administrative assistant? Who covers when you are not at the facility? What about Physician Assistants? You only have a doctor one day a week? It sounds like really thin staffing but how busy do they keep you? Do you guys offer sick call services daily so the inmates can be scheduled and seen if they are feeling ill? Also, what is the length of stay for your inmates in the county jail? Are they usually quickly sent off to State pens? In our state I think county jailers have sentences up to 2 years so most just wanna do there time quietly. We have over double your population and we staff at least 3 nurses on 6-2 shift, 2 on 2-10 shift and 2 on 10-6 shift, although we like to staff 4,3, and 2 respectively. We have a Physician daily as well as a Physician assistant and we have Psychiatry 24 hours a week. They keep us busy busy busy. We also do 4 med line passes, two on first and second shift. Hope this helps some.
  5. by   KaybeeRN
    The one nurse per shift is an LPN slot. Myself, the health service administratoror, am an RN. The administrative assistant is just a fancy name for a secretary. I usually work days Monday through Friday. We have an officer for the clinic Monday through Friday from 8A-4P and weekens 8A-11A. They will only allow one person to see patients at a time, only allow us to bring them down to the clinic area 5 at a time. A lot of time is spent going to get them and returning them to their cell blocks. We don't have set times that we do sick call vs. H & P's vs treatments. We usually do an assortment of all three on a daily basis. We don't have a fee for service here so there are a lot of sick calls picked up daily. Not to mention all of the telephone calls about "Johnny has a stomach/head/toothache" etc.
  6. by   JailRN
    I work in a city jail-holding facility for inmates until they see the judge, We are a level one with about 300max, both male and female,sometimes with trustees, we have 30 trustees and 40 inmates. We have one nurse per shift, we do all intakes, accompany the police surgeon on rounds BID, pass meds TID, check BS< BP, wound care, psych evals, etc, plus the paperwork, we're also on a computer system called TIBERON, which logs all meds given all suicide attempts, hz, etc. Sounds like you need more help. Good luck
  7. by   Mama Val
    I wish we had your staffing. I work in a 210 bed pre-trial facility, we are also responsible for the halfwayhouse and home monitoring prisoners. We have 1 nurse per shift: day shift is 630AM to 1730 then night shift comes on at 2000 to 7AM. Days gets 2 medcall and 2 walk up meds and nights gets 1 medcall. Our PA is Mon-Fri 5AM to 1300 and our Mental Health Clinican is 8AM to 1600 Mon-Fri. We have a dentist who flies up 1weekend a month and our doctor drops in a few hours a week to see any refered cases that our PA wants her to take a look at. Our MHC can't prescibe meds so we have to call our PA or call Psych in Anchorage who can give us a script over the phone for a pt they may or may not know. 3 of our perm nurses are LPN the other is an RN and we do all pitch in and do our admin/office stuff when we get the time. If there is an emergency that can't wait until the nurse comes on shift then the COs are supposed to call EMS. We have had 1 patient die in booking when there was no medical staff on duty (between 1730 and 2000), nothing changed though, guess the prisoner didn't have a family who could protest.
  8. by   sjoe
    I am amazed and blown away by all this extremely short staffing. At our city/county jail with 250-275 inmates, men and women, we had a minimum of 4 RNs and 2 LVNs and a secretary (M-F) on days, 2 RNs and 1 LVN on evenings, and 1 RN (but nearly always 2) on nights. MD/NP clinics every weekday and on call nearby during weekend days. MD on call for phone advice 24 hours. Podiatrist once a month, dental PRN. Psych counselors 2-3X week, psychiatrist once a week. (Note: this was minimum staffing. We usually had one or two RNs more than this during the day.) And we STILL worked hard most of the time (night shift might have an hour or two slack time, if no fights, etc.). We always did have time for meals and breaks.
    Don't know how you all do it.
    Last edit by sjoe on Aug 22, '02
  9. by   JailRN
    sjoe
    what level facility do you work in?
  10. by   sjoe
    I worked at a city and county jail staffed by deputy sheriffs. Good people who were grossly underpaid, so they were transferring to the regular police force for a lot more money when openings arose. Most of the men and women inmates were awaiting trial, had already been through an admitting jail downstairs and were a bit calmed down, as well as ETOH detoxed, by the time we got them.

    Also people came from the prisons, like Pelican Bay, and stayed with us while they were awaiting trial in a city or county court for some offense locally, in addition to the offense for which they were serving harder time. I found these people easier to get along with than our regular guests, as they knew the score, didn't need to test the limits (since they already knew them), and had nothing to prove (they already knew they were "tough guys"), unlike our regulars (who must have liked the place, despite all their yelling and griping and lawsuits, since they kept coming back year after year. Doing life on the installment plan.)

    I worked there a total of 4 years before I quit. We kept getting these idiots appointed as nursing supervisors who knew absolutely nothing about corrections (and little enough about nursing, for that matter) who continued to pile on requirements and policies that were senseless, time-consuming, as well as simply dangerous for the staff. Talk about people easily manipulated by the inmates! They were clueless, one after the other. The union, SEIU, was no help, big surprise there. I finally had enough and hit the highway.

    More than you asked for, but it did me some good to "share."
    Last edit by sjoe on Aug 22, '02
  11. by   TerriRene
    I work for a 400 all male parole violators facility. They are not there more than 90 days. Staffing: Days 3 RN's 3 LPN' S, 1 dental assistant, 1 medical records assistant. Evenings: 3 LPN's. Nights: 1 RN. Physcician three days weekly. Dentist 2 days weekly. Psychologist 2 days weekly.
  12. by   fiestynurse
    I am the Health Services Administrator for a county jail with 900 inmates. I have a DON, Administrative Assistant, 3 Medical Records Clerks, and a mix of 20 RNs and LVNs. LVNs do med pass twice a day. An RN is on duty all 3 shifts. 2-3 RNs days, 2 RNs evenings, and 1 RN nights. I also have a separate 14-day evaluation (Tb testing) nurse that works in the afternoons. LVNs assist with diabetics and function as second nurse or back-up for the RN. Our staffing levels are contracted and I must maintain a certain amount of nursing hours per payperiod or get fined $7,500! We also staff extra for busy nights (ie: New Year's Eve)
    I think that the staffing is good, but I still have nurses that don't get dinner breaks or put in large amounts of over-time?
  13. by   dnnc52
    Where I worked was 400beds, 1-RN 7a-3p, RN or LPN,11a-11p, then LPN 11p-7a,with a secretary 20hrs/week, we had intakes,H&P,Sickcalls, medpass and Diabetics, and a new task nailcare(nurse and officer present while triming their own nails)? However they get razor blades to shave. So I dont' understand why the hype over the nail clippers.?

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