Considering Correctional Nursing

K9lover, ASN, RN · Apr 19, 2017

Cannot speak for ICE or larger facilities but county jail where I work is as follows; IVS and abx drips are none; inmates are sent out for that as this facility does not have an infirmary. Chest pain; triage as you would anywhere else (always ensure it is safe for you.) ABCs, history, pain radiation, is inmate diaphoretic, what are VS, any history; are they currently on cardiac meds, what makes pain better or worse, when did they eat R/O gastric, EKG if you have one on site. Case by case basis, some of these guys have recurrent C/P and I would call provider see if we are on the same page as to monitoring. Love working with the guards; they absolutely protect us and are right on it if an inmate is exhibiting any threat toward the medical staff. I feel far safer than I ever did in the hospital.

Orca, ADN, ASN, RN · May 2, 2017

Can't really speak for ICE facilities. The only one in my state is operated by a private company under contract. I know some people who have worked there per diem, but that is about it.

I work in a state prison. A lot of measures are taken to ensure our safety. We still have to keep our heads about us, and consider things that would never occur to us working in a hospital. IVs are done, but not frequently. Sending inmates out to the hospital is the provider's call (either on site or on call, depending upon when it happens). Chest pain is a tough one. A lot of inmates fake it to try to get sent out. An EKG usually sorts out most of the pretenders.

Zigga zig ah · May 5, 2017

I work in a max security/death row state institution and most days love my job. Wanna know what it's like? You can message me and I'll answer as I can. I actually typed a whole long reply to this and lost it when my phone died and have no desire to retype it now but I'm happy to answer questions in the post or in messages

lauraebk1 · May 15, 2017

I can only speak to my experiences, but I was an ER nurse who went to corrections. I have been in correctional nursing for about 6 months. To be fair, my facility has a medical and mental health CTC, but no "hospital" and a TTA but no actual "ER."

For me, this truly is the "easiest job you will ever hate." We were told that at orientation and it is very true! The shifts are short and you will have literally 1-2 things to do during the entire shift. Going from ER (depending on the pace of your ER) to prison might give you whiplash. You will be stunned by the people who complain about how hard it is.

CONS

Now, it actually is hard. Not like being at the top of your game after running ragged for 11.5 hours is hard. Its hard like if you can't stand (literally) nothing do do for hours on end, not being allowed to read, look at the internet, etc. Also it's hard due to the constant mandates that turn your 8 hr shifts into 16 hrs (frankly that's why most people quit- there's a stress level to never knowing if you are going to be allowed to go home that wears on people). If you are single and have no outside responsibilities, it works great. If you have a sig. other to take care of the kids- that's great too. but trying to balance raising a family or caring for anyone or anything while working at the prison is very very stressful. However, along those lines, if you love overtime and want to make some major bucks- its the place to be.

Working in a prison will not enhance your nursing skills. If you work at a prison where there is a mental health facility, you may get to observe things and learn from that. However, that is about it. As an RN, I do almost nothing nursing related (besides charting) unless I am sent to the medical clinic a(once I got to draw blood). The LVNs and Psych techs pass meds, and unless you are one of the lucky few who get to be a first responder (and these posts are very coveted and you cannot get without years of seniority), you wont see any injuries, or traumas. Unless you are on the team that secures the patients for transport out of the facility, you wont even touch patients. Its possible to get maybe one dressing change a month or so, but that's rare too.

PROS

Now, the pay is good, the benefits are good, and lets face it, there is no such thing as retirement anywhere else. You can get lots of overtime! Frankly I feel very safe at my prison, the correctional officers are great, you really aren't at risk if you follow some very basic guidelines- and I am far safer here than I was in the ER.

Ultimately, I think it comes down to what kind of person you are- do you want stability, lots of income and hours? Or do you want a fast pace, where you are learning and growing? And (as for me) Where you are in your life- Can you work a job with mandatory overtime? Do you need a break from the hard physical work and mental stress of the ER? What are your long-term retirement, financial planning goals...

Remember, you can always try out the environment through a registry if you are interested in a trial run.

Hope that helped. I really miss starting IVs, thinking on my feet and learning all the time- but right now, for various boring reasons, this makes the most sense for me and my family. I am 100% sure I will get back to doing fun stuff eventually in the outside world. :)

Oh, and as for your final questions: Due to the large amount of lawsuits, almost anything potentially life threatening is sent out. Once verified stable, inmates are returned to the prison. My prison has a medical CTC, which basically takes guys with broken jaws who are totally stable but need crushed pain pills for a while. Sometimes we get IVs there (already started elsewhere)-again it will depend on what facilities your institution has.

Basically you aren't going to keep much in-house. When there is an MD on site: M-F 8am-5pm, they have assigned rounds/clinics etc to do, so they aren't going to be there to figure out whats wrong with a sudden chest pain, etc. And most anything after hours will be sent out. The response center has protocols for the nurses for until the ambulance arrives.

(At the last ER I was out, the rule was to keep all inmates overnight, cause if we sent them back to prison and they still complained of chest pain, we got dinged for the visit. So you see almost everything is built around lawsuits and medicare payments in and out of the prison.)

Correctional officers come in two flavors: Fan-freaking-tastic, great people with a head on their shoulders, a kind word, and a great attitude towards the job and their coworkers - I'd say this is the majority of them. Type 2 are those with "Little Rooster syndrome" who have to push everything too far, get the inmates riled up, cause problems whenever they perceive that their manhood/power status is threatened. They can make for a long day. But the nature of the profession appeals to them, you know- like nurses and control freaks

Everline · May 16, 2017

As a nurse (RN) working in corrections, I do dressing changes (a few of them) every shift I work. I also see inmates who declare medical emergencies and who need evaluation before going to confinement or after altercations or uses of force. I give out medication (including insulin and IM injections), do patient education, chart, call the physician for orders, triage sick calls, etc. The nurses at our facility do sick call and therefore see patients daily. There are opportunities for overtime, but I don't have 16 hour shifts! I get out of work within a half an hour of the scheduled end of my shift.

I will say that starting an IV is not a common thing. Having said that, it does happen from time to time. We have an infirmary at our facility, so the nurse working there would probably do that more often. Our facility tries NOT to send inmates out unless absolutely necessary. In the case of chest pain, we will do an ECG and if it is abnormal, we send them out. We will also send out inmates who have multiple stab wounds or head trauma. But anything that isn't major, we do try to treat in house.

I feel safer in corrections than I did in a hospital. There certainly are pros and cons to the environment and I do not like every single thing about my job. For the most part, however, I feel content. I am not and never have or will be an ER nurse, however. That's not my thing. I would imagine coming from an ER, you might dislike the level of action or the type of interaction you have with patients. I don't know.

Psych77 · May 16, 2017

I may see 5 people with chest pain in a day. Most are fake; for us we need a doctor on site to do an EKG; so at night, we just have to go by vitals, our assessment, age, IM's history, and bulls*** meter. If everything looks good, they are young, and bs meter is high, we give them mylanta, send them back to their unit, and tell them to contact us again if symptoms don't go away or worsen. Our inmates are charged for each visit 5 dollars, but some of our nurses forget to have them fill out the paperwork that ensures they get charged the money. Oftentimes, just by handing them the paperwork to fill out, their chest pain goes away. I think every facility is different; if a doctor is on site, we do ekg, then if needed aspirin, o2....and/or ship them out to ER. It really depends. Some prisons have an infirmary also, so they may be sent there, but that's usually if they are stable.