[360joules]

I am starting a job in the North Carolina Corrections Department as an RN. I have worked ER for 5 years, Tele for 3 years and Psych for 3 years. Before that I was a Paramedic for 10 years. Oh, I'm male BTW.

I have read a good deal of the posts here about inmates and their tricks. I consider myself fairly good at assessment, but want to avoid rookie mistakes.

I'm afraid that my 20+ years of prior experience to: (1) accept subjective complaints at face value and to (2) avoid doing anything I wouldn't want to explain to Plaintiff's attorney in open court will leave me open to manipulation until I learn the ropes.

Anyone have a "Cliff Notes" or "Top 10" list of tips they could offer to help jumpstart me?

[**nurse**]

Sounds to me like you have an excellent background for dealing with inmates. Do what you've done, with fine tuning as you learn your new environment. It's all about assessment, and documenting that assessment. You've seen most of it in the ER and psych unit, I'm sure. Look at the scale and the weight. Lift up the arm and drop it to see if the unconcious guy will drop it on his face or move it to the side. And to keep your sanity, don't worry too much about the malingering. So what if they win a few? It doesn't make you stupid, just less motivated for thier particular game.

What I found more difficult than stopping malingerers was keeping my objectivity after being in corrections for a time. I had to make the decision to turn back around and stop worring so much about being duped and worry more about a real assessment. These guys are not the most open communicators, they aren't real smart, or they don't know any other way to get needs met except by some kind of manipulation BUT that doesn't mean that there's not something significant going on sometimes. I've found some kind of astounding things looking at someone who came to sick call or an emergency visit for an off the wall or unrelated complaint. Sometimes too they really are satisfied when you tell them that whatever is worrying them is nothing to be concerned about, they can put a warm wet towel on it or take a couple tylenol and come back if ......

Once they know you'll actually look and evaluate with the purpose of treating things that need treating, and that you don't have a problem with making some people unhappy if what they want isn't what they need, you'll have respect of staff and inmates. If someone gets over on you once, learn and laugh and go on. The trickiest thing for you to learn is all the things you can't give out because it's contraband. That's up to your individual institution and sometimes varies by housing unit. Ask before you give out ANYTHING for a while.