Corrections Nurse vs Psychiatric Nurse?

TAKOO01, BSN · May 18, 2022

I don't know about psych ER. It sounds like it would be stressful and I suppose it would still be physical if patients have co morbidities or if they become disruptive.

Corrections is a good fit for your background. You will have autonomy and will need to deal with some emergencies. There was no lifting in my experience. My experience was: two med passes per day, which includes methadone and insulin. There are days where you take sick call and inmates are brought in to be checked for various complaints. You have to be vigilant at all times, knowing where people are around you, securing all items near your person- pens, sharps, etcetera. Your keys and radio are more important than your stethoscope and thermometer. Safety is paramount.

HiddenAngels · May 24, 2022

On 5/17/2022 at 10:42 PM, TAKOO01 said:

Your keys and radio are more important than your stethoscope and thermometer. Safety is paramount.

I’ve always wondered about Corrections Nursing and wow your post was insightful. I was always scared and then after watching the Mayor of Kingstown, I just said forget it.

TAKOO01, BSN · May 24, 2022

If you are interested, Hidden Angels, try it out! It is actually enjoyable in many ways.

xbananachipsx, BSN, RN · May 28, 2022

I’ve had the opportunity of working in correctional health and acute psych.

I personally love psych nursing as I felt I have the flexibility to use my nursing practice/therapeutic communication to provide the care clients deserve. I have more opportunities to collaborate with others. I loved the work but hated the lack of support from my DoN that I left. I’m still in psych, but outpatient and with a very supportive boss. I can see myself retiring at my current facility.

With correctional health, I felt like it functioned more like a SNF. You do have a deputy with you at all times. You Don’t have time to chitchat, getting to know the clients/inmates is a difficult thing to do. You have to have a thick skin, deputies don’t have the patience to deal with your nursing stuff I’ll be honest. It’s a very “stay-in-your-lane” type of environment for me. I didn’t last long.

Based on your physical concerns, I think outpatient psych would be more up your alley. With correctional health there’s a ton of walking and pushing, going up and down stairs. It’s definitely not as labor-intensive as the ER. You’d also have to be creative at times when having to do certain tasks on the pod. I had to learn to pass meds on a second floor without my cart, but a basket while making sure meds are given properly. With outpatient psych, I feel like you’re able to do your nursing role with a lot more flexibility - seeing how to do your tasks while not killing your body in a sense.

feel free to email me if you have any questions: [email protected]

I struggle using the PM system here so emailing works better for me.

TAKOO01, BSN · May 28, 2022

5 hours ago, xbananachipsx said:

I'm still in psych, but outpatient and with a very supportive boss. I can see myself retiring at my current facility.

I love reading about nurses who love their jobs...gives me hope. Glad you found your nursing comfort zone.

Kooky Korky, BSN, RN · May 30, 2022

First off, get a proper diagnosis. Perhaps you don't have just osteoarthritis from age or wear and tear. Perhaps you might need med for gout, diet change, some kind of brace, osteopathic care, chiropractic care, or something other than whatever treatment you currently have. When a steroid injection did not help me, my doctor didn't care at all. His response when I reported no relief after 3 days post steroid was, "I don't give pain meds other than for surgical patients". Kicked me into the dirt, the rat did.

My primary, thank God, had suffered enough with his knees that he had understanding and compassion. He did a proper work-up (labs to r/o rheumatoid or psoriatic arthritis, etc.) and suggested we try gout med. I was greatly relieved within 24 hours of starting the med. I am not saying you have gout, but you should get diagnoses ruled out by someone who gives a hoot and is enough of a clinician that he or she has some real understanding. See specialists if need be.

Next - my correctional nursing jobs were nothing like ER. You give a million meds, you handle any emergencies, you work with the doctor when he is seeing patients, take off orders. You run a Sick Call and treat by Standing Protocol Orders or refer to doc, dentist, psychiatrist.

It is pretty calm and quiet most of the time - about 95 % of the time. Emergencies are mostly following up on inmates who have been in a fight, maybe have an injury from being punched or having punched someone else, maybe hit with a mop handle.

You will encounter the occasional chest pain, appendicitis or other surgical abdomen, a toothache, drug or alcohol withdrawal or even OD, as some inmates manage to do drugs while locked up.

I loved working in Corrections. Perhaps that is your cup of tea, too. There is probably room to get promoted, become a Supervisor/Manager.

I did not have to do steps. I guess each facility is laid out differently. Actually in one jail the inmates would carry my cart up a couple of steps now that I think about it, but in other facilities there were no steps.

You do have to use much caution, follow the rules (must have a deputy or CO corrections officer with you whenever there is an inmate present, do not ever give even the appearance of having an improper relationship with an inmate. One nurse baked a birthday cake for our trustee. She was a sweet, friendly person but you can't do stuff like that. Why didn't the Sup intervene???
She got in big trouble for that, was investigated. Came out OK but who needs that?

Don't be cruel but watch your step. Learn to think like a deputy). Remember that Medical comes after Security, after getting inmates to Court, after everything else. It's not a hospital, it's a jail/prison. Priorities are different.

Never cross the deputies. Do what they want you to do if you possibly can. You could be in danger if you don't. While Medical is SUPPOSED to make medical decisions, the Custody personnel sometimes do it. They want someone sent to a hospital or to a jail where there is a doctor 24/7. You know you can get an order for an antibiotic, warm soaks for the infected hand, and admission to the Infirmary, where the inmate will get his med and soak around the clock and have his temp checked through the night by nursing staff there and that he will see the doc in the morning. You have been trained not to send anyone on the transport to the main jail because Receiving will usually just turn him around and send him right back without him seeing a doc but the Captain wants you to do that. Admit him to the Infirmary instead, start the soaks and AB and hope you don't catch the Cap's wrath. Good communication is key, not to mention support from your Sup.

NEVER c/o about a CO. NEVER.

Inpatient forensic psych (each patient had killed someone) was OK but I loved the jail work. You will encounter plenty of psych in the jail. But there is plenty of medical, too. It's rather like working in a Clinic or Doc's office.

There could also be an inpatient infirmary for inmates with a cast, post-op, infectious illness, pregnant on bedrest, or post delivery like a C Section, for example.

I wish you all the best.

Kooky Korky, BSN, RN · May 30, 2022

18 minutes ago, Kooky Korky said:

First off, get a proper diagnosis. Perhaps you don't have just osteoarthritis from age or wear and tear. Perhaps you might need med for gout, diet change, some kind of brace, osteopathic care, chiropractic care, or something other than whatever treatment you currently have. When a steroid injection did not help me, my doctor didn't care at all. His response when I reported no relief after 3 days post steroid was, "I don't give pain meds other than for surgical patients". Kicked me into the dirt, the rat did.

My primary, thank God, had suffered enough with his knees that he had understanding and compassion. He did a proper work-up (labs to r/o rheumatoid or psoriatic arthritis, etc.) and suggested we try gout med. I was greatly relieved within 24 hours of starting the med. I am not saying you have gout, but you should get diagnoses ruled out by someone who gives a hoot and is enough of a clinician that he or she has some real understanding. See specialists if need be. (like maybe a Rheumatologist)

Next - my correctional nursing jobs were nothing like ER. You give a million meds, you handle any emergencies, you work with the doctor when he is seeing patients, take off orders. You run a Sick Call and treat by Standing Protocol Orders or refer to doc, dentist, psychiatrist.

It is pretty calm and quiet most of the time - about 95 % of the time. Day shift is busiest usually.

You can work with juveniles or adults. A small jail might have both. There can be one gender or both. You might have what they used to call cross dressers (queens; men who dressed and behaved like women, some of whom were on female hormones, which the taxpayers paid for. I am not looking for an argument, I guess this is controversial. People have different opinions about it. Just telling you what things you might experience in a jail). They were in a separate pod in the 80's through the early 2000's. Not sure what they do now.

Emergencies are mostly following up on inmates who have been in a fight, maybe have an injury from being punched or having punched someone else, maybe hit with a mop handle.

You will encounter the occasional chest pain, appendicitis or other surgical abdomen, a toothache, drug or alcohol withdrawal or even OD, as some inmates manage to do drugs while locked up.

I loved working in Corrections. Perhaps that is your cup of tea, too. There is probably room to get promoted, become a Supervisor/Manager.

I did not have to do steps. I guess each facility is laid out differently. Actually in one jail the inmates would carry my cart up a few steps now that I think about it, but in other facilities there were no steps. I have worked in 5 facilities, in 3 counties. In some state prisons that I know of, nurses are trained to handle a gun in case of riots.

Your safety is not necessarily a priority in case of a riot. That was really quite a shock to me when I realized that during a tense situation. These don't happen often but they do happen.

Do not carry much into the jail. You and your belongings are subject to search. I was never searched in the 2 decades I worked Corrections, but I don't guess it would be too pleasant.

You do have to use much caution, follow the rules (must have a deputy or CO corrections officer with you whenever there is an inmate present, do not ever give even the appearance of having an improper relationship with an inmate. One nurse baked a birthday cake for our trustee. She was a sweet, friendly person but you can't do stuff like that. Why didn't the Nursing Sup intervene???
She got in big trouble for that, was investigated. Came out OK but who needs that?

Don't be cruel to inmates but watch your step. Be courteous and respectful but firm. Learn to think like a deputy). Remember that Medical comes after Safety and Security, after getting inmates to Court, after feeding them, after processing them in, after everything else. It's not a hospital, it's a jail/prison. Priorities are different.

Never cross the deputies. Do what they want you to do if you possibly can. You could be in danger if you don't, sorry to say.

While Medical is SUPPOSED to make medical decisions, the Custody personnel sometimes do it. example: They want someone sent to a jail where there is a doctor 24/7. You know you can get an order for an antibiotic, warm soaks for the infected hand, and admission to the Infirmary, where the inmate will get his med and soak around the clock and have his temp checked through the night by nursing staff there and that he will see the doc in the morning. (if it's a weekend, you might have to take a different approach, like send him to the local hospital where your employer likely has a contract to get inmates seen there).

You have been trained not to send anyone on the transport to the main jail because Receiving will usually just turn him around and send him right back without him seeing a doc, but the Captain wants you to do that. Admit him to the Infirmary instead, start the soaks and AB and hope you don't catch the Cap's wrath. Good communication is key, not to mention support from your Sup. before you do what I said above. Really great if you can get your Sup to talk to the Cap.

NEVER c/o about a CO. NEVER.

Inpatient forensic psych (each patient had killed someone) was OK but I loved the jail work. You will encounter enough psych in the jail. But there is plenty of medical, too. It's rather like working in a Clinic or Doc's office.

There could also be an inpatient infirmary for inmates with, for example, a cast, post-op, infectious illness, pregnant on bedrest, or post delivery like a C Section, for example.

I wish you all the best.

Kooky Korky, BSN, RN · Jun 2, 2022

On 5/12/2022 at 6:07 AM, MercyMia said:

Hello Nurses! I just signed up for this, I need help! I am SO TORN and I am desperate for a change in my life. I have been a nurse in the ER for 8 years and I am SO BURNT OUT! I recently got diagnosed with arthritis and it’s hard for me to stand and run around the ER for 12 hours. I can’t transport patients in gurneys anymore, I can’t lift people in bed anymore, my back won’t tolerate it anymore. So I need to figure out what I am going to do. As I am typing I am dreading going to work in a few hours because my knees are killing me. So… I am considering transferring to the county jail as they need RN’s right now. Does anyone know what the work style is?? How does it compare to ER? I have no idea what the corrections nurse job duties are or what a typical day is like?

I am also considering transferring to a emergency psychiatric facility for suicide patients we transfer to from my current ER. It’s a county facility and they need a nurse.

My long term goal is to be a forensics nurse but I’m going back to school once I get a job where I can physically tolerate my work. Right now, I just can’t handle it it’s so physically demanding and painful.

I am desperate for guidance. Please anything helps!

Any and all suggestions would be so much appreciated!! THANK YOU!

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