CMS or hospital?

Editorial Team / Admin · Dec 13, 2005

Hello everyone,
I had an interview and was offered a position with CMS. I really liked the mgt. team, but pay was $24--much lower than I was making. It sounds like an interesting job. For those of you with correctional experience, would you take it or continue in the hospital system--higher pay, but really don't enjoy it?
Thank you!

Hello, military spouse,:balloons:

I only have experience from a heath care provider stand point of view, but, CMS is good. Yes, the pay is lower for staff and even NP's for that matter. But, I was satisfied with them.

If you have experience in correctional medicine, then I think you will be satisfied working with them. But, if not, you might want to stay with the hospital. Better pay. I did not like correctional medicine, but, I was working with maximum security/lifers and death row. Just wasn't my cuppa tea.

crjnursewarrior · Dec 14, 2005

Hello, Military Spouse...

About CMS...I have worked for them, as well. They seem like a fair company that treated employees fairly. I only worked for them briefly, but have no complaints. As for the correctional vs. hospital thing...well, my advice would be to see if you could start out on a part-time basis to see if correctional nursing is for you or not. Correctional nursing, IMHO, is a calling. You either love it or you hate it. You sink or swim. Unfortunately, I have seen many nurses come into the correctional setting from a hospital or dr's office background, and be unable to make the adjustment. It is tough for them to remember that the inmates are in the facility for a reason other than to attain healthcare. They are there because they committed, or are accused of committing a crime. If they become ill or injured while there, or if they have a chronic condition that requires monitoring, we must provide them with that care. It takes a nurse with excellent assessment skills to weed through the load of crud they will try to tell you is wrong with them, to find out what is really wrong, if anything. You must always be on your toes. That is where a hospital background would help, as I am sure you have acquired excellent assessment skills in a hospital setting. It just takes some getting used to that they cannot have everything they WANT or ask for...they will expect you to do so, but you cannot do this. That is where the trouble lies for some nurses to get used to. Most certainly, if the inmate needs something, they should definitely get it, but the inmates sometimes have trouble differentiating WANTS from NEEDS. One must also take into cosideration that as nurses we are, as always, pt. advocates and it takes a certain kind of person to be the advocate of a criminal. That is why I say it is a calling, it is either for you or it isn't.

Best of wishes to you...hope it works out for the best. If you have any more questions, feel free to ask. I would be happy to answer any and there are a bunch of great correctional nurses on this board, as well, that I know would be happy to help you with info. :nurse:

crjnursewarrior:Snowman1:

military spouse · Dec 14, 2005

Hello, Military Spouse...
About CMS...I have worked for them, as well. They seem like a fair company that treated employees fairly. I only worked for them briefly, but have no complaints. As for the correctional vs. hospital thing...well, my advice would be to see if you could start out on a part-time basis to see if correctional nursing is for you or not. Correctional nursing, IMHO, is a calling. You either love it or you hate it. You sink or swim. Unfortunately, I have seen many nurses come into the correctional setting from a hospital or dr's office background, and be unable to make the adjustment. It is tough for them to remember that the inmates are in the facility for a reason other than to attain healthcare. They are there because they committed, or are accused of committing a crime. If they become ill or injured while there, or if they have a chronic condition that requires monitoring, we must provide them with that care. It takes a nurse with excellent assessment skills to weed through the load of crud they will try to tell you is wrong with them, to find out what is really wrong, if anything. You must always be on your toes. That is where a hospital background would help, as I am sure you have acquired excellent assessment skills in a hospital setting. It just takes some getting used to that they cannot have everything they WANT or ask for...they will expect you to do so, but you cannot do this. That is where the trouble lies for some nurses to get used to. Most certainly, if the inmate needs something, they should definitely get it, but the inmates sometimes have trouble differentiating WANTS from NEEDS. One must also take into cosideration that as nurses we are, as always, pt. advocates and it takes a certain kind of person to be the advocate of a criminal. That is why I say it is a calling, it is either for you or it isn't.
Best of wishes to you...hope it works out for the best. If you have any more questions, feel free to ask. I would be happy to answer any and there are a bunch of great correctional nurses on this board, as well, that I know would be happy to help you with info.
crjnursewarrior:Snowman1:

Thank you! I've worked psych with adolescents, so maybe (I hope) that will help. Can you give me an idea of the difference in wants/needs in an inmate population. The job sounds so interesting. Went to another interview today and their starting salary is $28.61 plus shift diff (hospital) so if I get that job offer, I just don't know what to do.

Thank you!

nurseT · Dec 16, 2005

Hello Military Spouse,

I WORK IN A COUNTY JAIL AND AM THE ONLY NURSE AS WE ONLY HOLD 225 INMATES. I HAVE A SALARY 38,000.00/YR. THAT WORKS OUT TO 5.00/HR LESS THAN WHAT I MADE BEFORE, BUT THE TRADE OFF IS NO WEEKENDS, NO HOLIDAYS. SOMETIMES I'M SWAMPED IF I HAVE SEVERAL GET SICK AT ONCE AND OTHER TIMES I AM BORED TO TEARS SO I SIT IN BOOKING FOR ENTERTAINMENT. YOU REALLY DO HAVE TO BE SHARP AS THEY ALL ARE FAKING A HEART ATTACK OR SEIZURE ETC. WANTS VS NEED? THESE ARE DRUG ABUSERS AND CHILD MOLESTERS WHO NEVER TAKE CARE OF THEIR TEETH. SO, AS SOON AS THEY ARE IN JAIL THEY KNOW THAT THE COUNTY IS NOW RESPONSIBLE FOR THEM SO, RIGHT AWAY THEY REQUEST TO GO TO THE DENTIST AND HAVE THAT CHIPPED TOOTH CAPPED. THAT IS A WANT. THE COUNTY NOR STATE WILL PERFORM RESTORATIVE DENTAL WORK LIKE CAPS, CROWNS, SELDOM A FILLING, NEVER CLEANINGS. YOU MAY SEE TEETH ROTTED TO THE GUM LINE. THAT WOULD BE A NEED AS THE NERVE IS EXPOSED, BUT IF THEY ARE GOING TO GET RELEASED SOON, YOU MAY NOT WANT TO SCHEDUAL THEM FOR AN APPT. SOME WILL SAY, I NEED TO GO TO AN ORTHOPEDIC SURGEON CAUSE I NEVER GOT MY BROKEN WRIST FIXED AND YOU FIND OUT THE BREAK IS A YEAR OLD. ONE NICE THING IS, IF YOU HATE BEING NICE AND DOING EVERYTHING YOU CAN FOR A PATIENT WHO JUST CAN'T BE SATISFIED, YOU CAN TELL AN INMATE,,,,"NO" "I'M HERE FOR SICK PEOPLE". AND FAKING AN ILLNESS FOR ATTENTION IN JAIL IS A CRIME. COULD GO ON AND ON.

crjnursewarrior · Dec 19, 2005

Other examples of WANT vs. NEED:

WANT antibiotics for my "horrible" acne...NEED to shower daily and drink plenty of H2O and the couple of zits you have will go away...

WANT dandruff shampoo from medical so I don't have to spend my $$$ purchasing it from commissary...NEED to forget it...I only see a few flakes..no open sores...it is cosmetic and you aren't going to the prom anytime soon! No one to impress! Your shirt is orange anyway...white flakes will never show!

WANT triple antibiotic ointment so I can put it on my new tattoo (made with new tattoo gun I managed to build out of a buch of contraband I collected) or need to use the ointment for "other things" (you can imagine I am sure!)...NEED to realize you will catch Hep. using your fancy new tattoo gun you are sharing with everyone in section...as for the "other things"...NEED to GET A LIFE!!

WANT an extra mattress and some oxycontin or Xanax for my "back pain" R/T "bulging disks"...NEED some Tylenol and to realize this is not Holiday Inn...extra mattress DENIED!!!

WANT all my "nerve medication" for my anxiety and "panic attacks"...NEED to get over it and realize you are NOT going to get a bunch of meds to knock you out so you can sleep away your sentence and not have to deal with the fact that you are paying the consequenses for your actions!

These are but a few of the things you will see...you will also get calls from family members who have the same reality problems as the inmate they are calling about..."My poor son/daughter is not getting his oxycontin..."

As NurseT said, most of these people do not decide to become health conscious until they get to jail/prison. On a more serious note, regarding the examples I gave, you will typically not see a lot of narcotics Rx'd. IBU 800mg is about as strong as it gets. Inmates really will try to get ANYTHING they think they can get for free. Why should we have to treat things, such as acne, that are NOT acute medical problems? You cannot possibly give them something EVERY time they fill out a nurse sick call form with some whiny whimpery NON-EXISTENT complaint. Again, as I have said, if there are actual symptoms of an illness/injury present, by all means, treatment must be given...but when there are NO symptoms...tell them so and SEND them back to the pod!:angryfire

military spouse · Dec 19, 2005

Thanks for those great replies. Definately see the difference between wants and needs. I'm just nervous because the pay is so low, but they are willing to let me pick my hours (out of available shifts) and maybe that is worth more. Thanks again!

uraqt2 · Mar 26, 2007

I worked for CMS for about 2 years and then I got sooooo fed up with all the crap that I had to quit. :banghead: After I quit it was only about 7 months before the state came in and took over, I then re-applied for the state and went back to correctional nursing (my true calling). I won't go into detail about why I quit, my only advice is things aren't always what they seem and do your research. Correctional nursing is definatly unique and it's not for everyone and sometimes the pay just isn't worth it. Do what feels right inside not what seems right for the money.

nomadicV · Mar 31, 2007

Having worked County and then Federal corrections (3 different facilities) for about 12 years I can share my own experiences as they've differed from working in the private sector: It all depends on the facility. County and state corrections IMHO is more political and less protective of it's staff. I saw more abuses in those systems. Federal was different--I loved it. Saw more interesting cases than in hospitals and other private sectors; security and esprit de corp is much higher in the federal system as is promotional opportunities. The only time I felt like I might be assaulted was in a hospital. In corrections you know what you're dealing with--in the private sector you don't.

Dixiecup · Apr 4, 2007

I worked for CMS for about 2 years and then I got sooooo fed up with all the crap that I had to quit. After I quit it was only about 7 months before the state came in and took over, I then re-applied for the state and went back to correctional nursing (my true calling). I won't go into detail about why I quit, my only advice is things aren't always what they seem and do your research. Correctional nursing is definatly unique and it's not for everyone and sometimes the pay just isn't worth it. Do what feels right inside not what seems right for the money.

I totally agree! Won't go into detail but CMS sucks! Only it took me 13 years of being brow beat to finally have enough and leave.:angryfire

Mudwoman · Apr 12, 2007

I work for CMS. I don't think much of them. Recently, a guard who had the hots for one of our nurses (she refused his constant come-ons and she is engaged to be married) made false allegations that she was doing drugs. The prison took his side and strip searched her. Found nothing. Then the prison we are at was going to haul her to the local hospital for drug testing. She said that she would not go unless our DON/HSA went. DON couldn't go until the next day. The head of the prison said that since she had refused the drug test when they wanted to do it, she was to be fired. The nurse accused said that she works for CMS and that she would do any test CMS wanted her to do. CMS refused to do a drug test stating that they had no cause to suspect she was doing drugs. But because the prison wanted her fired, she was fired. CMS took the position that there was nothing they could do, their hands were tied.

THe prison system is corrupt and dangerous. It is not a hard job physically, but it is very hard mentally. There is no amount of money that could keep me working there if I find another job. A lot of the guards are just as dangerous as the inmates.

If you decide to work for CMS. Be careful.

Mudwoman · Apr 12, 2007

Hello Military Spouse,
I WORK IN A COUNTY JAIL AND AM THE ONLY NURSE AS WE ONLY HOLD 225 INMATES. I HAVE A SALARY 38,000.00/YR. THAT WORKS OUT TO 5.00/HR LESS THAN WHAT I MADE BEFORE, BUT THE TRADE OFF IS NO WEEKENDS, NO HOLIDAYS. SOMETIMES I'M SWAMPED IF I HAVE SEVERAL GET SICK AT ONCE AND OTHER TIMES I AM BORED TO TEARS SO I SIT IN BOOKING FOR ENTERTAINMENT. YOU REALLY DO HAVE TO BE SHARP AS THEY ALL ARE FAKING A HEART ATTACK OR SEIZURE ETC. WANTS VS NEED? THESE ARE DRUG ABUSERS AND CHILD MOLESTERS WHO NEVER TAKE CARE OF THEIR TEETH. SO, AS SOON AS THEY ARE IN JAIL THEY KNOW THAT THE COUNTY IS NOW RESPONSIBLE FOR THEM SO, RIGHT AWAY THEY REQUEST TO GO TO THE DENTIST AND HAVE THAT CHIPPED TOOTH CAPPED. THAT IS A WANT. THE COUNTY NOR STATE WILL PERFORM RESTORATIVE DENTAL WORK LIKE CAPS, CROWNS, SELDOM A FILLING, NEVER CLEANINGS. YOU MAY SEE TEETH ROTTED TO THE GUM LINE. THAT WOULD BE A NEED AS THE NERVE IS EXPOSED, BUT IF THEY ARE GOING TO GET RELEASED SOON, YOU MAY NOT WANT TO SCHEDUAL THEM FOR AN APPT. SOME WILL SAY, I NEED TO GO TO AN ORTHOPEDIC SURGEON CAUSE I NEVER GOT MY BROKEN WRIST FIXED AND YOU FIND OUT THE BREAK IS A YEAR OLD. ONE NICE THING IS, IF YOU HATE BEING NICE AND DOING EVERYTHING YOU CAN FOR A PATIENT WHO JUST CAN'T BE SATISFIED, YOU CAN TELL AN INMATE,,,,"NO" "I'M HERE FOR SICK PEOPLE". AND FAKING AN ILLNESS FOR ATTENTION IN JAIL IS A CRIME. COULD GO ON AND ON.

Had one the other day file a grievance because we were not getting him his dilantin and we were going to cause him to have a seizure and get hurt. He had been there just 3 days. Come to find out after many phone calls, the last time he took dilantin was 5 years ago.