An "optimal", normal day at my prison, weekday day-shift:
Two nurses and a CNA taking care of the infirmary that can house 6 men for anything from medium risk psych "I said I was going to kill myself in the recieving room" to end stage HIV and the rare really acute thing like some TPN running or new CVA or something just out of ICU. Walk in, get report, assess the guys in the infirmary and then start sickcall/treatments while keeping an eye on the infirmary guys. Sick call is triage for any health complaints by the inmates, they drop a note and are scheduled to come over and be seen. The goal is to fix as many as you can with over the counter stuff, education, without dropping the ball on anything that might need a doctor immediately.....schedule for a doctor visit another day possible because he's already got a line scheduled for that day too, but weed out all the athletes foot/ acne/ mild back pain kinda stuff that you can.
While all this is going on, there is a dental assistant and possilbly a dentist seeing THIER line of guys. The aformentioned doctor is seeing scheduled acute visits and chronic disease visits, there are guidelines set by an agency called the National Commission of Correctional Health Care that sets the guidelines and accredits facilities along the lines of JHCCO for hospitals. There's a nurse assisting him, taking off his orders, and perhaps doing HER own thing with infectious disease.... keeping the statistics and follow up for TB testing, MRSA & CA MRSA, that stuff. Discharge planning for guys getting released that need help with care for diabetes or hiv or whatever. There's a full time med nurse pouring for all the guys on the compound and ordering the meds they give themselves and keeping track of thier compliance, ordering the stuff for the infirmary and emergencies. There is a DON and a Health Services Administrator. There is a full time mental health staff with 4 or 5 counselors and a psychiatrist that comes once or twice a week.
At our place, we have one MD 5 days a week and one NP 5 days a week. We use MD's from other prisons in the state to share call. We get to very good understanding with these docs. We interact almost not at all with doctors at the hospitals. They usually talk with our MD's if someone is sent out.
NO special training. We will hire straight out of nursing school
, though it's good to have a little seasoning on you because your assessment skills are so critical, as well as your confidence when telling these guys what they need to do, or what's wrong with them.
One other thing common to prisons, we are also the emergency people. You can and do call 911 sometimes, but that's AFTER YOUR evaluation and notifying security and (unless there is no pulse or spurting big quantities of arterial blood). We are the response when they fall out of the top bunk and have a bloody head and won't respond, break themselves on the basketball court, hang themselves, or the infamous chest pains and seizures that happen. Also psych emergencies, like taking themselves or thier roomie hostage with a pen or a razor to a throat.
All in all, it's kind of dynamic and exciting on a limited level. We do a lot without much money. MASH with a lot more rules.
Did I answer them all? There's of course more more more that we do, but in a nutshell............ Oh, officers, we will have one in the medical department when maybe 8 or 9 inmates are in there loose, but there's lots more security that can get there quick and once you've been in for a while you become very effective at being security yourself. I'd swing a hole punch in a minute if I needed to. And I sure wouldn't let one of them grab it first.
Good luck with your report.