[tammyRN64]

I am wondering how other Directors of Nursing in Correctional Facilities are doing? Between getting bogged down with insignificant petty things all day every day and trying to keep up with State reports, contractor reports, Quality Control reports, and meetings...............it seems I don't have teh MUCH NEEDED TIME to get out there with my nurses. I want to see what's going on, give them support and guidance, help them with things they may struggle with. They are fighting us on going to all computer documentation (though it is a condition of employment), the call ins are off the hook, the doctors write crazy orders (though they have been told over and over to stop writing orders for medical shoes, lay-ins, even bed assignment moves)!?!?! I took the position over just a short time ago. Prior they hadn't had any guidance or support. Now we have a good team in place and are trying to get them back on track, but they are "killing us". How are other DON's doing. I have about 60+ staff (including docs and mental health staff), and over 2,000 inmates. Please share with a frustrated DON. Thanks!

[MadisonsMomRN]

I have been a DON but not in corrections. I personally am not cut out for that type of work. I am a skillsy type nurse... not into all of the paperwork. I know the DON's at the prison I work at (moderate/max security) are always stressed because the high turnover/lack of staff. It seems like they are always working and always on call. I just don't know how you guys do it!! I like to come to work, do my job, and leave my work AT WORK. When I was a DON at another skilled nursing facility I was always at work, even at home. Ugh!

I work at a county jail too and the turnover is not that high. Its actually a nice place to work.

I hope you are doing better. Good luck to you!

[palee51]

I'm a DON in an Intermediate Correctional Facility, so maybe my problems are quite the same as yours, but they sure seem to be. I am have been in this position for a short time, and before I came, it was a mess. I am still trying to get my staff up to par, and have hired a lot of new people, but you know how it is......background checks, fingerprints, and Correctional Awareness training for a week. So, even when I hire someone, it takes 3-4 weeks at least for the to begin training on the unit. My biggest problem is with Grievance Reports from offenders who have nothing better to do than find something to "grieve" about. The grievances are ridiculous for the most part, and at the end of the day, they are still going to find something else to find fault with. One of the biggest problems I have is offenders that place SCRs and then refuse. Is there not a way to remedy this? Most of the time they just don't want to get up and out of bed in the morning. The work is frustrating, but I do have a great bunch of people, and they really know what they are doing. I think it's just going to take longer for me to get everything the way I want it. We have in the next few months 1100 more offenders coming into the facility, and I dread the day. New dorms have been built, and we are just waiting for the new chain-ins. By the way, I am also HSA as well as DON.

[**nurse**]

Damn, where'd that beautiful reply I was writing just go to?????? I hate it when a mishit key makes it go poof!!!!

Huge job, taking over a mess. I'm working prn corrections now, but I've been a DON and been in corrections for 10 years. Who's in charge of the doctors? Are you wearing the HSA's hat as well?

You have said you have a good group and that's your number 1 asset right now. Let them know over and over and over how much you value them and why, and prove it by delegating to them, challenge them. Can some of the best at computer documentation spend some time fostering those that hate it? Can the ones that work closely with the doctors kick those flakey orders back to the HSA or you for tactfully telling them 150 times that they can't order that (but perhaps can do x, y, or z)? With staff that big you are going to have to delegate. Some people can plow through huge sick call lists, some people can juggle the pharmacy show, some people can move place to place, find those people and put them to what they do best and make them feel like they are saving your butt because they will. Then instead of checking 20 people on a shift you can check with 3 or 4 and still do your reports.

Eliminate the backbiting and tattletelling. Corrections has a greater potential for a team environment than most places because they don't have to be the greatest nurse the nicest nurse the BEST LIKED nurse to be successful.....It's us against them so much of the time, not getting burned by inmates or DOC. It's a tighter unit, no hospital has a big group of men discussing what a bunch of incompetent slutty nurses they have working there. Prisons do. Kind of makes the nurses appreciate having coworkers that defend and back up and help each other for the united front. So foster that unity. Don't let them rant about a coworker to you or tattle unless they are prepared to back it up with documentation and/or discuss face to face with that worker in your office. Tears and screaming happen, the air clears a little, sometimes resolution happens. Tattleling, lies, exagerations drop dramatically.

Any mentors available? A well run medical unit at another facility in your state or corporation that you can get tips from?

Years ago we used to charge for no shows. It worked well for cutting back but I seem to remember the NCCHC making us stop. DOC might be able to help somehow, like making them go to medical to sign the refusal....during yard time. The grievences are what they are. Sometimes just listening and having some empathy are enough to make them walk away feeling like maybe medical really isn't hating them personally, and helps the whole relation thing. Inmates are a dysfunctional bunch, we're trying to be better than that. Sure surprised me how many of those grievences ended up being the basis for (frivolous) lawsuits so keep your documentation in line with something you'd be comfortable explaining in court. I recently saw a stack I had made copies of and wrote the responses I really wanted to on them......SPEAK ENGLISH!!!!.......In my own little personal memoir file, waiting for that book to be written.....

And remember, the worst day in prison is always better than the best day in a nursing home............