How does prison nursing compare to med-surg & other hospital environments?

[frenchxtoast]

Hi, I am a "new grad" RN (graduated BSN Spring 16, got my license May 17), looking to build a solid skill base for my career. I'm curious how prisons work: do they have an ED, med surg, ICU etc floor like a hospital would, or how does it work?

I live in CA and the job market for new grads is tough right now, I've been applying for jobs in the prison and jail system and the descriptions of the jobs themselves seem vague to me, like I can't tell if I'm applying for an ICU job, a med surg job, etc or if that's even relevant.

It is very important to me to build a strong, broad skill base transferable to many environments, would I get this at a prison or jail or would it be something highly specific to that environment?

Thanks so much for your opinions ahead of time!

[Orca, ADN, ASN, RN]

It depends upon where you work. Some prison systems have dedicated medical units that resemble hospitals. In other facilities, you will mainly be doing sick call, which consists of evaluating signs and symptoms and referring to medical providers if necessary. In the facility where I work, we see a lot of different things, but usually not a lot of any one thing. Our infirmary does IVs and pump feedings, and we have used wound vacs. We don't do any transfusions or chemotherapy on site.

[Oldmahubbard]

There are several different settings within the correctional environment. In my state, many of the maximum security facilities have designated mental health units.

Primary care is handled on-site, and anything more serious goes out to the community, or to one of the long term care facilities, mostly for inmates who are approaching death.

The medical care is, generally speaking, not great. You will learn a lot and either love it or hate it. Most important will be your working relationships with other employees and your ability to adjust to the politics.

Many states also have a forensic psychiatric hospital, which is where I worked for nearly 13 years.

I would interview, get a tour if possible and try to talk with other nurses or employees to understand the specifics of each unit.

Needless to say, you have to be careful, but most of my interactions over the years with inmates were respectful. I only left for a better paying job.

[frenchxtoast]

Thank you very much! Any idea how I should go about finding out which prisons have more hospital like settings?

[frenchxtoast]

Thank you! I'll try to get a tour of the prisons if I can.

[Oldmahubbard]

try googling forensic medical facility in such and such state. If you can get an interview, they will know more.

in my state, inmates are not sent there until it is a hospice type situation.

acute care is done in local hospitals, pt chained to the bed, with 2 corrections officers present.

I liked it but it probably isn't for everyone:)

[Orca, ADN, ASN, RN]

Thank you very much! Any idea how I should go about finding out which prisons have more hospital like settings?

Usually the major medical units are standalone or separate within a major institution. Ours is the latter, inside the fences of one of our major medium security facilities.

If we knew where you were planning on working location-wise, it might help us in answering that question.

[Neats, BSN]

Getting a feel for what it is like behind the bars is a great start. Movement from Sally Ports to general populations can be eye opening. You can contact whom every your dealing with in HR to contact the Health Service Administrator to come and take a look around. I have gotten approval of some nurses who are not sure if they can do it, some cases this was all it took once the sally port doors closed they were wanting out so fast we could not open the doors fast enough to get them out. Even if you only get as far as visitation room when they are visiting families it is different. This would be my first step. With no experience I would not be worried. What I want is to see is how you handle yourself in snarky situations...much like a bartender or waitress/server. These skills will take you very far and difficult to teach, the nursing I can teach reinforce and grow on what you have learned. When I hire I like to look for people who have had a background in food service, in bartending because you will verbally spar with offenders and staff more than you realize. It is this gift of words that will take you far in the prison working environment.

Lastly where you work in the prison depends on what medical they have to offer. Some prisons have hospitals (much like critical care rural hospital), some have infirmaries where basic IV to same day surgery to dressing changes can be completed, most have clinic like settings. Remember inmates are someone's daughter, son, brother, sister, mother, father they just want good medical care like us all.

[frenchxtoast]

I was considering any prison in CA where I could get a solid med surg experience and build strong skills.

In particular, Folsom prison, or Salinas Valley Correctional, or Soledad.

[frenchxtoast]

I have years of food service experience, as well as 4 years of CNA experience in long term care. I'm well acquainted with the unreasonableness of people.

[Orca, ADN, ASN, RN]

I was considering any prison in CA where I could get a solid med surg experience and build strong skills.

In particular, Folsom prison, or Salinas Valley Correctional, or Soledad.

If you want hands-on medical stuff and a lot of it, maybe the California Medical Facility at Vacaville.

[Orca, ADN, ASN, RN]

I have gotten approval of some nurses who are not sure if they can do it, some cases this was all it took once the sally port doors closed they were wanting out so fast we could not open the doors fast enough to get them out.

A former boss told me about a nurse who came out for an interview. As soon as the yard gate closed, she said "I can't do this", and she left. This was one of the smallest facilities in the system, and one of the quietest yards. This line of work isn't for everybody, and our normal routine isn't in what most would consider a normal work environment.