Adapting to Corrections

[CCFCP]

first off.. forgive my lazy typing. so I've been an lpn for 10 years. I've worked in snf, home health and most recently was a 3 year stretch in ltac. I just landed a job with a compant that supplies jails and psych places with nurses. im at a county jail right now. It's so different than anything I've experienced. I have a lot to learn about illicit drug use and withdrawals from alcohol and street drugs. my real concern is that it seems like there is less urgency with certain conditions and it pisses me off. like someone with orders to monitor bp bid for a week and I get pulled from prebook to pods becaise were short. I get to this guy needing vitals during med pass and bp is some ridiculous *** like 190/123. had the guy have a seat and come back at the end of the line to recheck manually. 188/116. better but still dangerous. looking at vitals history and I see every bp x6 days is outrageous like that. this person has untreated HTN and I was told not to put the guy on the line for the doc the next morning, which is what I did (I wanted to call the doc at 2100 for a x1 dose of clonidine or anything for that matter to bring it down but im not supposed to call because its not a reason to call according to our guide on when to wake the provider), and I was told to put in a referal with a request to have provider check the chart. well last time I put in a provider urgent referral, it took 3 days. im just not OK with it. thoughts?

[Chickenlady]

If he was symptomatic, I would have called for an order. Otherwise, would have him scheduled for provider visit the next day. I was always told "That's where they live", meaning it is something that developed over time, so is not an emergency.

[RNchic]

I work at a state facility and we have on call providers round the clock. Definitely would call with such high BP but my facility we are allowed/encouraged to call for any issues we are concerned about. You might occasionally get a grumpy provider if it is in the wee hours but I would rather call and cover my rear end than not call and get reprimanded for it.