Accepted a position in a state prison....

TriciaJ, RN · Oct 13, 2013

Get hold of the book "Games Criminals Play and How You Can Benefit From Knowing Them"; can't remember who wrote it. It will give you a lot of insight. Best wishes on your new job!

Orca, ADN, ASN, RN · Oct 14, 2013

Stick to policies and procedures. Deviation from them is the path to compromise. Don't bring in or take out anything for an inmate, or offer to pass along messages to or from them. Know that the population you serve is mostly trying to game you. Assessment skills are your friend. Many of the inmates you assess will be exaggerating or totally fabricating symptoms in order to get a trip to the hospital, medications or something else. Document well what you do, because inmates frequently file lawsuits just because they can. Since most of them have no money, they can file lawsuits free of charge by including a pauper's writ, and there is invariably an inmate law clerk who will tell them that they have a good case. An inmate sued me for failure to treat him adequately or in a timely manner after an injury, and my documentation got the case thrown out very early on because it completely refuted everything the inmate alleged. Avoid using terms of endearment, which can be (and often are) misinterpreted as expressions of romantic interest by inmates. Use hands on treatment only when absolutely necessary, for the same reasons. Never go anywhere alone with an inmate, for safety reasons as well as the possibility of allegations of misconduct. Don't turn your back on an inmate, or leave sharps or medications out where an inmate might grab them.

The custody mantra of firm, fair and consistent serves correctional medical personnel well also.

Good luck on the new job.

DavidDudley · Oct 14, 2013

I accepted a part time position in a state prison. It starts on Monday. Do any of you veterans have any advice for a newby?

Based off of my 5 years of correctional experience here is my advice:

In addition to what Orca said, DO NOT talk to the inmates about anything other than their medical related issues. When you start talking about personal matters then your asking for trouble. One thing that you need to understand about inmate mentality is that their #1 objective is to just consume anything and everything and provide absolutely no value to society. They want everything, more food, more drugs, more narcotics, more power, and they will try to talk to you and dig into your life to find some kind of weakness and then they will attempt to take advantage of that weakness. There can never be anything personal or emotional involved in your conversations with them.

But aside from how you deal with inmates, how you deal with staff is also a big thing. Following policy and procedure to the letter is key because supervisors will try to micro-manage you and make your life a hell. A big part of staying out of trouble with supervisors has alot to do with kissing their butts and never taking revenge on them or talking back. I had to learn the hard way.

Don't talk about any of your personal business with any of the nurses or even get close to them. All they like to do is gossip, lie, back stab, be hateful and be 2 faced. And be as hard working and pro-active as possible because as soon as you show even the slightest bit of slack they will report you to supervisors immediately.

For me, I was always reported for any and every little slip. I had to walk a fine line all the time or i was reported. The same nurses who were super nice to me to my face were the same ones who always reported every tiny thing about me to management. Terrible work environment IMO and I'll never go back. Good luck to you my friend.

Orca, ADN, ASN, RN · Oct 17, 2013

But aside from how you deal with inmates, how you deal with staff is also a big thing. Following policy and procedure to the letter is key because supervisors will try to micro-manage you and make your life a hell. A big part of staying out of trouble with supervisors has alot to do with kissing their butts and never taking revenge on them or talking back. I had to learn the hard way.

You started out with sound advice and then strayed well off the path. Don't assume that every correctional work environment is like yours. I am a DON in a state prison, and I am anything but a micromanager. If someone starts kissing up to me, I wonder what they are trying to conceal or compensate for. I give my employees credit for their skills, knowledge and experience. I give them guidance when they need it and stay out of the way when they don't. I have a good crew, and I seldom need to intervene except when we have policy changes.

Don't talk about any of your personal business with any of the nurses or even get close to them. All they like to do is gossip, lie, back stab, be hateful and be 2 faced. And be as hard working and pro-active as possible because as soon as you show even the slightest bit of slack they will report you to supervisors immediately.

Again, an overgeneralization based upon one person's experience. I don't get a lot of reports of staff issues, because the people I have generally work very well together and they resolve issues as they go along. I get involved when I have to, but that doesn't happen often.

DavidDudley · Oct 18, 2013

The original poster can take what I say with a grain of salt if they like but it is based off of 5 years of correctional experience in 3 facilities as well as repeated confirmation from family and friends who put in about 20 years in the prison system. Of course I don't expect any DON or supervisor to say that the work environment is bad. But majority of people who work as regular staff and aren't at management level will confirm that there's major issues with correctional nursing environment.

DavidDudley · Oct 18, 2013

I am a DON in a state prison, and I am anything but a micromanager. If someone starts kissing up to me, I wonder what they are trying to conceal or compensate for. I give my employees credit for their skills, knowledge and experience. I give them guidance when they need it and stay out of the way when they don't. I have a good crew, and I seldom need to intervene except when we have policy changes.

I actually never had any issues with the DON micro managing staff. The problem typically isin't in the DON, rather it's in the supervisors that sit in their comfortable offices all day and do nothing but audit your work and magnify every single negative but are silent when it comes to all the positive hard work that nurses actually do. In my past facilities, I almost never even saw the DON anyways.

OfficerRNBSN · Oct 23, 2013

Stick to policies and procedures. Deviation from them is the path to compromise. Don't bring in or take out anything for an inmate, or offer to pass along messages to or from them. Know that the population you serve is mostly trying to game you. Assessment skills are your friend. Many of the inmates you assess will be exaggerating or totally fabricating symptoms in order to get a trip to the hospital, medications or something else. Document well what you do, because inmates frequently file lawsuits just because they can. Since most of them have no money, they can file lawsuits free of charge by including a pauper's writ, and there is invariably an inmate law clerk who will tell them that they have a good case. An inmate sued me for failure to treat him adequately or in a timely manner after an injury, and my documentation got the case thrown out very early on because it completely refuted everything the inmate alleged. Avoid using terms of endearment, which can be (and often are) misinterpreted as expressions of romantic interest by inmates. Use hands on treatment only when absolutely necessary, for the same reasons. Never go anywhere alone with an inmate, for safety reasons as well as the possibility of allegations of misconduct. Don't turn your back on an inmate, or leave sharps or medications out where an inmate might grab them.
The custody mantra of firm, fair and consistent serves correctional medical personnel well also.
Good luck on the new job.

This.

I run the clinic of a long term jail meaning that even though it is not prison we may house inmates in excess of one year.

Tips: do things by the book and never deviate, when the book doesn't apply confer with admin;

inmates have absolutely nothing to do, have very little control over their daily events, and possess very little meaning much of what they do and get is to satisfy some void or validate themselves, this means they will try to get reactions out of you for entertainment, get items just to have something extra, and solicit deeds or favors to satisfy some need or feel validated; be neutral - not cool, fun, kind,bgenerous, sweet, hostile, angry, or anything else; refrain from conversing with them needlessly and give them nothing other than medical supplies or meds when necessary; doubt everything you are told, be observant, and trust everything you see to think you saw.

Inmates are manipulative liars. Many of them are animals. Never trust one and never think, "oh, he seems nice, he wouldn't do anything bad." Being able to assess well is crucial. Being able to discern differences in their stories each time they tell them is important because they are frequently malingering. We can actually penalize them for that, by the way.

Quite frankly, I work my job because I care for the agency. Infer what you will. I only began working as a RN in July 2012, but I had many years of law enforcement experience and am experienced in admin and EMS as well before taking a year to work in a hospital. I am a deputy, patrol qualified, and add this because it adds some nuances to what I do and how I react as a jail RN that do not apply to other correctional nursing staff. My role is to provide basic/minimum health needs to inmates, keep more inmates in jail longer (eliminate outside referrals, appointments, medical releases, etc) to serve their time, and reduce liability of the sheriff.

Orca, ADN, ASN, RN · Oct 29, 2013

I have the advantage of having been a correctional officer in the past. I know how inmates live and how they act when they don't believe that anyone is watching them. It has also helped me in developing a rapport with custody staff in the facilities I have worked in. I have more of an understanding of what they do, as well as an appreciation for it. One group that you need on your side in a correctional setting is custody.