Loving The Job, Poor Orientation

[Trampledunderfoot, LPN]

I have not been a nurse for very long, my back ground is SNF as a CNA and CMT. This job is my first out of school. I chose it because they told me they had good orientation that could last "however long you needed it too". This has turned out to be a lie. My orientation lasted three weeks (a few days a week) and consisted of mostly taking vital signs. I thought this was good at first, as I was not used to being around inmates, and felt that getting comfortable with hands-on care was a good thing to do before I was by myself. I felt that I would graduate to more difficult things for me, such as charting, after a bit. Instead, they decided they were too short for that, and threw me out there by myself, to struggle to learn the computer system and the protocols. They tell me they will be there to answer questions, and they are not. They tell me they will show me how to do something "tomorrow" and tomorrow never comes. I can feel my bare *** hanging out in the breeze. I'm too new to this and nursing in general to feel that I am appropriately covering my butt.

But I love this job! I find it exciting. I feel like I could be good at it. I feel like I am good at it, but worry that I am fooling myself because I'm having so much fun. I think I am just weird, but a couple weeks ago, the inmates were breaking sprinkler heads, and I was doing med pass behind a waterfall over the side of the top walk. I don't see how it can get much cooler than that. I feel like I am working in a zoo half the time, which is awesome to me. Please don't judge.?

I enjoy the crazy things they have to say, the stories I hear, I enjoy the work I do. The stress is hard on my family some times, and I wish I could be more confident in my charting and my butt covering skills.

I guess I need to be better about asking for help. I need to make sure I get enough sleep. I know my performance goes down because they expect crazy hours, and at the end of the day I feel like I am physically sick because I've just done four 16 hr shifts in a row, 3 hours of sleep each night, and am basically winging it because there is no one to help me. They have told me to read other nurses' charting, and I do sometimes, but the work load is so large that I usually can't find time to eat lunch, let alone stop to browse through people's charts.

I feel like I am stuck in a bad decision that I love and won't let go of.

Don't even know what I am looking for in posting this. Stories about waterfall med passes or mashed potatoes flying out of chuck holes would be fun. I found stories like that difficult to find when I was looking around before I took this job.

Thanks.

["nursy", RN]

I was an RN in corrections for 4 years. We were like 2 prisons in one; one complex was the levels 3,4,5, and 6, and the other complex was the level 2. I was hired for level 2. I was trained for 5 weeks in the other complex, then sent to the level 2 (where everything was different) for ONE day of training. Because corrections is SOOOO different from hospital (or any other kind of) nursing, there is a LOT to learn. I can honestly say it was at least 6 months before I was semi comfortable, and a year before I could say, yeah I got this. In the beginning I just muddled through as best as I could, and when I had a question that really needed a correct answer I just called the DON. But through it all, I loved it. Not a day went by where I didn't hear, "thank you ma'm, God bless you ma'm, appreciate you ma'm. You can really be yourself, do your job, not worry about patient satisfaction scores, and feel like you are making a difference. I don't have any stories that would compare to your broken sprinkler head waterfall story, but what I found that would crack me up on a daily basis, was the "sick call requests" that the inmates would fill out. Between the crazy spelling, the newly invented diagnosis that I never heard of before, and the random comments, they were the highlight of my day. I even thought about collecting all the funny ones (anonymousy of course) and putting them in a book, but I never kept up with it. I do know that the prison system is always short staffed, and will use and abuse you if you let them to cover extra shifts. I just refused to do it. I worked the shifts I was hired for, and once in awhile, in a true emergency I would stay late or cover an extra shift. But the more you do that, the less inclined they are to hire more help. So, don't burn yourself out. Good luck!

[Trampledunderfoot, LPN]

The sick call requests usually make me laugh, too.

I found that out the hard way about covering extra shifts. I have stopped helping, but they seem no more motivated to hire new people. They seem to scare all the new ones off.

Thanks for sharing!

[Kooky Korky, BSN, RN]

Did Corrections for about 10 years. Enjoyed it quite a bit, that is, I enjoyed not working in the hospital mostly, I think.

You have to be careful to keep the proper distance between yourself and the inmates, not only physically but socially. They will compromise you and get you in trouble if you let them. Not all inmates, of course, but some sociopath among them. One is all it takes.

Do NOT, do NOT, do NOT ever tell your personal business to them. They will use it against you in time.

You are letting your bosses use and abuse you, as you know already. Good luck.

[TAKOO01, BSN]

On 3/11/2019 at 11:25 AM, Trampledunderfoot said:

Stories about waterfall med passes or mashed potatoes flying out of chuck holes would be fun.

Careful.....there might be something else in that "waterfall" ?

Can hide a few things in mashed potatoes, too.

Just sayin'

[Noodle411, ADN, MSN, RN, NP]

Dear Trampledunderfoot, LPN,

My first job out of school was also in corrections at a state correctional facility in a long-term care unit. I was told the same thing about orientation -- and there were times I felt that I was thrown into it without ample preparation. I feel it's good to be challenged once in a while. My main concern during orientation and every day I was there was safety -- for myself first, then for my patients... after all, it is a correctional facility. As much as we're aware that inmates are a vulnerable population, we cannot take care of them unless we take care of ourselves first. [I ended up working there for nearly 2.5 years before I moved on to another nursing environment.]

I see that you're concerned about your charting skills. I had this same concern myself as a new nurse at the time. Charting is especially important in the correctional facility because inmates have a history of being known to be litigious. In some cases, they will go to court and surprisingly win their case.

Back to charting: The most I can help you with right now is to refer you to a couple of websites and encourage you to read books and other web pages on the Dos and Don'ts of charting.

Check these out (be warned that if you're reading this way in the future of this writing, the web link may no longer exist):

• Charting Tips for Correctional Nurses - https://correctionalnurse.net/charting-tips-for-correctional-nurses/
• 5 Ways Correctional Nurses Can Land in Court - https://correctionalnurse.net/5-ways-correctional-nurses-can-land-in-court/
• Risk and Documentation in the Correctional Setting - https://www.pedagogyeducation.com/Class-Catalog/Correctional-Nursing/Risk-and-Documentation-in-the-Correctional-Setting.aspx?cmp=F1.AP12
• Corrections Nurse LPN Job Details - This one describes Typical Duties of a Corrections Nurse LPN.https://www.governmentjobs.com/jobs/2350315-0/corrections-nurse-lpn
  • Typical Duties - Duties include, but are not limited to the following
  • Accurate and thorough chart documentation. SOAP nursing notes are clear, concise and thorough reflecting:
    • Signs and symptoms observed
    • Nursing assessment
    • Plan of actions – per standing order protocol, RN on-call, RN
    • Education of inmate
    • Expected or observed outcome
    • Noted Changes
    • Unusual occurrences
    • Outside communications
    • Explanation of refusal for treatment
    • Discharge summary – completed on clients transferred to other facilities

It sounds like you have the right personality to take on the correctional setting. I can't say I have had similar experiences as you with all the "waterfall and mashed potatoes" excitement, but I have had the pleasure of being the recipient of gratitude and respect, in spite of having had some very grumpy or scary and sometimes sad patients.

As you said, you need to be better at asking for help - hence your post here. You're already aware that you need to be taking care of yourself better, so I would suggest being your own best advocate and take some time to reflect on what you physically need first (remember Maslow's hierarchy of needs) -- get enough sleep, you'll be doing yourself and your family a favor. Then, get the tools you need professionally to feel more confident in your career.

Thank you for sharing your story. If you were looking for support, I hope I provided some for you. Wishing you the best.

[Goodmom2]

Alwaya

Be sure to ask till clear.Document very carefully.Don't ever show fear-firm fair and consistent. Left corrections nursing 5 years ago after 20 + years at 2 different facilities in Indiana/Time for a breather from doc.

[PDmetwo]

Funny sick calls are the best. I usually snort at least once a day from them.

Sounds like your post is about boundaries, you may need to set some for yourself. Hard to feel confident without food and sleep. Guard your free/ me time, as a way to stay sane, this includes sleep.

I had crummy training too, but now am confident I can manage anything that sores my way, and there is always new things happening. Hang in there.

[Trampledunderfoot, LPN]

Thanks. I'm still hanging in, feel much more confident than I started out.

I also have no support from my family, which makes this even more difficult. They absolutely hate my job. I can't even talk about it, dread bringing up the smallest things, like my schedule.

I do love this job though. Not ready to give up yet!

[Orca, ADN, ASN, RN]

On ‎3‎/‎11‎/‎2019 at 8:25 AM, Trampledunderfoot said:

But I love this job! I find it exciting. I feel like I could be good at it. I feel like I am good at it, but worry that I am fooling myself because I'm having so much fun. I think I am just weird, but a couple weeks ago, the inmates were breaking sprinkler heads, and I was doing med pass behind a waterfall over the side of the top walk. I don't see how it can get much cooler than that. I feel like I am working in a zoo half the time, which is awesome to me. Please don't judge.?

You sound perfectly suited to this crazy world behind the fences that we work in. I went into the administrative segregation unit for pill call one night, and there was about two inches of water on the floor. The inmates had decided to plug up the plumbing and flood the tier. I told the unit officer, "If I had known that the pool was going to be open tonight, I would have come better prepared."

I can't make up stories as good as the stuff that I have seen and heard on the inside. Where we work is definitely not most people's idea of a normal work environment, because it isn't. We work with society's worst, and what they do to cope with the environment that they are in baffles the mind. One way to deal with the boredom is apparently to keep a poisonous snake as a pet.

It's a shame that your employer doesn't put more effort into orientation. We realized several years ago that ours wasn't adequate, and we were losing new employees because they felt overwhelmed and they often resigned after a short time on the job. We completely overhauled our orientation process, and I believe that it's in pretty good shape now. We have also spaced out the coverage of our supervisors, to give employees better access to them. One of the biggest changes, and one that I pushed heavily for, was to put a supervisor on nights. We tend to assign our newest employees to night shift, and they had no on-site guidance during the shift. Their primary source of information was coworkers who weren't trained any better than they were, and they had frankly learned many bad habits which they gladly passed on to their new coworkers. While there is an administrator on call, they had no one to turn to for immediate answers to minor questions. I have also altered my own hours (I'm a DON) to include some overlap with our night crew so that I can keep track of what is going on and maintain direct contact with our night supervisor.

[bryanleo9]

On 3/12/2019 at 10:42 PM, Kooky Korky said:

Did Corrections for about 10 years. Enjoyed it quite a bit, that is, I enjoyed not working in the hospital mostly, I think.

You have to be careful to keep the proper distance between yourself and the inmates, not only physically but socially. They will compromise you and get you in trouble if you let them. Not all inmates, of course, but some sociopath among them. One is all it takes.

Do NOT, do NOT, do NOT ever tell your personal business to them. They will use it against you in time.

You are letting your bosses use and abuse you, as you know already. Good luck.

Yes so true. I have seen so many co-workers get fired and some arrested for getting too close with the inmates.