[mom2saul&amaris]

All adivce is appreciated!

I recently started correctional nursing at an all womens facility. Houses approx 400 I/M's.
I love it! The skills that I use are tremmendous. My concerns are these:
We have a total of 4 LPN's (2 dayshift & 2 nightshift). We work alternate days etc. We are each supposed to one pill call and run a sickall as well as attend to any emergiences; Intake; etc.
I am still learning what particular I/M s to be aware of and the ones that truly need medical attention.
During my med pass, I have my MARS in front of me as well as notes left from previous shifts. I also tend not to give the I/Ms a hard time unless they disrespect me or get aggitated. We do blister packs as well as stock meds.
Several other nurses have out right said they could care less about treating the I/m's and will treat or not treat dependng on their mood at the time. One nurse in particular pours her meds ahead of time, then allows no talk in her line with threat of lockdown so they can not question her about med or dose. also she will not fill Rx's or stop meds whether MD prescribed or not.
I also chart everything where they do or not.
What seems to be happening is that they do not like my style, question my judgement and if I have a concern or recommendation about an I/M they will try to get back at me by not tending to those matters.
how do you treat your I/M's? As patients first then I/M's or vice versa?
I know that most will try to get away with everything, but I try to treat by symptoms only and what I feel comfortable with along the guidelines of our SO's. I am wondering if I need to re-evaluate my way or just keep doing it the way I am and continue to CMB.

sorry for the long post.

Thanks for any input!

[happybunny1970]

I've never worked in this setting, but it seems that as a nurse, you really have no choice but to treat them as patients first. If a medication is prescribed and you as a nurse are not giving it as ordered (for no other reason than you don't want to), you face possible repercussions not only from your nursing board for failure to practice (or charges of withholding medicine, which could be seen as 'practicing medicine,' which only MDs can do), but also possible criminal and civil charges if one of them suddenly decides to complain -- loudly -- either to administration or their attorney, or family member who is/has access to an attorney, or decides to call your board of nursing.

These charting errors you allude to could get people in a heap of trouble -- especially if on of these meds they are giving out and charting wrong or not charting at all is a controlled substance -- all it takes is a phone call or letter to the board to suggest that someone has been diverting this medication from the patient/inmate to plunge the affected nurse into a total nightmare where she is guilty until proven innocent.

So I'd say you're doing the right thing -- and I'd keep on doing it. If your coworkers are making things unsavory, the only choices you have are 1) stick it out, 2) report them to administration and be ready to face that particular nightmare, or 3) find another job.

[VegRN]

Originally Posted by mom2saul&amaris

Several other nurses have out right said they could care less about treating the I/m's and will treat or not treat dependng on their mood at the time. One nurse in particular pours her meds ahead of time, then allows no talk in her line with threat of lockdown so they can not question her about med or dose. also she will not fill Rx's or stop meds whether MD prescribed or not.
I also chart everything where they do or not.

They will eventually get themselves into a heap of trouble. I mean, not allowing the I/M to question their meds/doses, not discontinuing a med, no filling prescriptions? What the heck is wrong with these nurses?

Do they fill prescriptions/discontinue meds at other times? Allow for questions at other times?

I can't tell you how many times an I/M questioned the med order when I come in to give them their meds, be it dose, med or what and I check it out and lo and behold, they are right. i.e. the pharmacy enters the order wrong, the nurse transcribes it wrong, there is an Md error or another error.
I also work acute care for inmates and we have had I/M's come in for overdoses/wrong doses on medications and the I/M will tell me "I told that nurse that those were not my meds and she just told me to take them and stop arguing" One time the inmate refused his meds because they were crushed and he doesn't take crushed meds. Nurse told him to stop arguing and take the meds (they weren't his). I can imagine how that turned out. Big trouble for that nurse.

You cannot just ignore inmates questions and concerns. 9 out of 10 times everything is fine but that 1 out of 10 times is what will get you.

[Sunshine22]

I think that you are doing the right thing with the I/M's as far as you have said. If the other nurses have the attitude that they have, they should not last long in this type of nursing. You have to remember that I/M's ahve more rights than we do, and they will use them anyway that they can. I try to tell my staff that they can have the EMPATHY not the SYMPATHY for these guys. They are not dogs, unless they choose to be. During our med passes, I do not allow my staff to conduct sick call, but the I/M's can definitely question doses. If they need to ask other things, they are asked to fill our sick calls and come to Medical. If there is an urgent matter, then by all means we address that at the time. If these other nurses are trying to 'get back at you' for things, you need to keep a small notebook to yourself anf start writing and writing. If it comes down to it, you have notes and times to help you out.

[tirzo13]

i can't agree that the bad nurses wont' last that long in this environment.
They are here because thats the way they are, they can get away with treating patients/IM's that way.
Alot of stufff nurses do here would not fly on the outside, i have worked at 3 prisons, and it goes on in all that i worked at.

This does not mean that you have to change, keep doing what you are doing. Stay gold.

Actually, your coworkers should like you more.
All my inmates know i will do the right thing, and look out for them and listen to the concerns they have, make sure the appointments are going to happen etc.
yeah, some IM's will try to get over, but they are convicts, its what they do.

But since the inmates save their problems for me, this means the inmates do not bother the other nurses, since they know that they won't do anything for them, so all the nurses are happy because i do it, so the inmates leave them alone.
So the other nurses are happy, less work for them.