From ED to Correctional Nursing

[Nurse Beth, MSN]

Dear Nurse Beth,

I'm in a bit of a predicament, as I am burned out on acute care micromanagement but love what I do as an ER nurse. I have only experience in acute care but is is varied and covers a lot of specialty areas. I love my patients and coworkers and get along with most docs. I tend to hear I am a good nurse but I can be high strung and outspoken (mgmt).

I'm thinking this perception might be correct due to the stress levels; perhaps I love the aspects of the job but am lousy at coping well with stress.

I'm looking at maybe HD nursing or CCT nursing because maybe I need something outside the hospital. Mostly, I would like to try something where I have more autonomy where I can use my skills/experience. I know very little about these areas of nursing. Any suggestions would be so helpful. Thanks in advance.

Dear Burned Out in Acute Care,

Micromanagement is not just confined to acute care. I'm concerned you could go from the frying pan to the fire. HD is known for requiring a lot of overtime, but I'm sure that varies by area. CCT nursing is not for everyone, and you might miss the stimulation of the ED. There wouldn't be much autonomy in Corrections, and you wouldn't be practicing many ED skills.

This is not to say you don't need a change, as your feelings are telling you. Is there any way you could job shadow before you make a leap?

Since you love your patients and have a lot of experience, have you thought about home health? There is more autonomy and your assessment skills could really be utilized.

Wherever you go, make sure it is as much about going toward a new specialty as it is running away from your current situation.

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

[TAKOO01, BSN]

19 hours ago, Nurse Beth said:

Wherever you go, make sure it is as much about going toward a new specialty as it is running away from your current situation.

This line just about sums it up.

My experiences with home health and corrections were actually different. My HH cases were stable - mostly wound care and meds. No special emergency care experience needed.

On the other hand, the prison I worked in had enough beatings, stabbings and random health emergencies to keep a certain level of excitement going. As with everything, your experiences may depend upon variables such as location and size of the facility or town.

You may like corrections nursing. If nothing else, you will have great stories to tell.

[Forest2]

I hate to be dumb, but here goes. What is HD? I can't think of what it is. (Health Department?).

[cmac21, BSN, RN]

35 minutes ago, Forest2 said:

I hate to be dumb, but here goes. What is HD? I can't think of what it is. (Health Department?).

I had to google. All I could get to come up was dialysis because of HD lines, so I'm still confused

[Forest2]

15 minutes ago, cmac21 said:

I had to google. All I could get to come up was dialysis because of HD lines, so I'm still confused

?

[cmac21, BSN, RN]

2 hours ago, Forest2 said:

?

Health department seems way more right haha

[Nurse Beth, MSN]

Sorry, I hate when people do that and I can't figure it out. It's hemodialysis, as in working in a hemodialysis center.

[TriciaJ, RN]

I happen to think corrections would provide a nice transition for an ER nurse. Yes, you do have autonomy (I was quite often the only healthcare personnel in the building), depending on how a particular facility is run.

To work effectively in corrections you need: 1. Good assessment skills to sort the malingerers from the real deal and handle emergencies effectively 2. Good communication skills; you have to provide instructions and health teaching to people who have limited education and significant learning deficits 3. The ability to work with law enforcement personnel and the understanding that security is their first priority 4. The ability to effectively problem-solve and advocate for patients in a less than ideal environment 5. Astuteness and assertiveness. You will be lied to approximately 100 times per day (see #1). 6. You will need a brisk sense of humour and to not take yourself too seriously.

I think ER nursing skills are highly transferable to this challenging environment.

[Nurse Beth, MSN]

15 hours ago, TriciaJ said:

I happen to think corrections would provide a nice transition for an ER nurse. Yes, you do have autonomy (I was quite often the only healthcare personnel in the building), depending on how a particular facility is run.

To work effectively in corrections you need: 1. Good assessment skills to sort the malingerers from the real deal and handle emergencies effectively 2. Good communication skills; you have to provide instructions and health teaching to people who have limited education and significant learning deficits 3. The ability to work with law enforcement personnel and the understanding that security is their first priority 4. The ability to effectively problem-solve and advocate for patients in a less than ideal environment 5. Astuteness and assertiveness. You will be lied to approximately 100 times per day (see #1). 6. You will need a brisk sense of humour and to not take yourself too seriously.

I think ER nursing skills are highly transferable to this challenging environment.

Interesting! and fascinating to me as a nurse who has no correctional nursing experience. I always wonder if my self-care would include not becoming cynical or jaded.

Oh, wait!!! I'm in acute care and struggle with those! haha

[riverotter]

I would also like to recommend Correctional Nursing. I've worked in Corrections for 15+ yrs as both a staff RN and a Nurse Administrator, at both a medium and a max in NYS. There is a LOT of autonomy! Not only during off shifts when there are no providers, but even during sick call / triaging when it is full blast day shift. There are a lot of emergency situations. Drug overdoses (med and max), slashings (mostly max), chronic care issues, issues of the elderly, of youth, and many acute situations (stroke, heart attack, allergic reactions/anaphylaxis). Things you never imagined! How many times do I hear staff say, "you can't make this stuff up!" It is a place where you will use every assessment skill you have! I have found it a rewarding and exciting field. And yes, you definitely get stories to tell! I like to tell potential hires, "It's mostly low key, but when things happen, they are ALWAYS interesting!" It's a great place for an ER nurse to move on to. And Corrections needs experienced nurses with great assessment skills.

[lcmills, ADN, BSN, MSN]

I have to disagree with Nurse Beth. I used more of my skills in corrections then any other nursing job I have had. Depending on where you work you could be the only nurse. You will see everything in corrections just like the ER. Having strong triage skills is a must. You will either love corrections or hate it. I did it for 11 years but we had high turn over so I changed to occupational health nursing. I was usually the only nurse in corrections for about 700 inmates and now I am the only nurse for about 650 factory workers. I miss correctional nursing it was something new everyday but you really need supportive management and other staff to not get burnt out.

[Nurse Beth, MSN]

Good to know, all corrections nurses! And I stand corrected. Thanks for the feedback!