New to Correctional Nursing, any tips?

sjdoxies · Feb 18, 2012

I also just got a job as an LVN at my county jail which holds 1500 inmates. I'm a little freaked out myself. I've been looking online and got a few do's and don'ts...mostly don'ts: no make up, no necklaces, bracelets, anklets, don't turn your back on them, don't let them get between you and the door and the only do: do bring mace. I consider myself a pretty tough cookie and have had to deal with some scary situations while working in hospice (think 3 am, police escort, family popping pills) but I'm wondering if this jail nurse position is as scary as it seems?

ckbreathing · Feb 19, 2012

sjdoxies, it may not be as scary as we are making it in our heads. I'm use to patients being abusive and yelling at me that I'm late with their pain meds (when truly thats not the case). I've been hit, kicked, spit on, had patients throw things at me, call me every name in the book. Everyone keeps telling me..if I can handle that, I can handle inmates.

I'm up for the challenge! Good luck to you in your new job.

prison_nurse · Feb 20, 2012

You are allowed to take your own mace? That surprises me as that would be considered an unauthorized use of force. I would check before you bring something in that may get you into trouble.

ChuckeRN, BSN, RN · Feb 21, 2012

Agreed.

I seriously doubt any non-security staff is allowed to bring something like Mace. Heck, I have to have written permission to bring my own stethoscope in.

You are allowed to take your own mace? That surprises me as that would be considered an unauthorized use of force. I would check before you bring something in that may get you into trouble.

hopeful616 · Feb 22, 2012

Hi Everyone!

I am actually a Deputy Sheriff about to start Nursing School :)

I worked the jail for 2.5 years, and the best advice I can give you is to watch what you say. You never know who is listening, and the inmates have 24/7 to listen to you and try to "figure you out". They will push buttons you didn't even know you had, but if you are professional and consistent, you will be fine. Deputies are there to keep you safe, and they are right there with you, so if an inmates ever makes you uncomfortable you can let them know.

The biggest issue I've seen has been nurses who flirt with inmates. It's wrong and it causes problems and drama. It's just a different environment. You are there to take care of petients, but there is a heightened danger level just because of where you are.

As for the pepper spray- I would be highly surprised if you were allowed to carry any- too much liability. And since most facilities contract medical providers, it would be a nightmare to try to keep up with training for new Nurses.

Good luck in your new career! :) I'm sure you all will do well!

GalRN · Mar 19, 2012

Thought I'd throw my 2 cents in as someone who started working at a jail about 5 months ago. It was originally a 13 week assignment, but has been extended and I'm starting a position that has an opening. Last week I knew they were deciding whether they wanted to try and get me on board, and at one point someone said that I hadn't started as a corrections nurse, but I definitely have turned into one. That's good, since I plan on applying for the job. I started on the most acute men's inpt psych and now cover 3 less acute units in the mental health unit. In a few weeks I start days in acute women's.

If there is a radio, and you see other nurses carrying them, you may want to find out if you are supposed to carry one. I wasn't told a lot about my job responsibilities because the person who had vacated the job wasn't there to orient me and every one said they didn't know what she did. So, I found out I wasn't doing something after I didn't do it. I didn't think of the radio.Now I carry it and use it. Very useful to be able to say you are 10-6. In my case that means messing with my phone in my car on break.

The officers are with us anytime an inmate is out of his cell. Sometimes 2 officers depending on security level. It is their job to keep me safe and they do. In return, I communicate with them what I need to do and ask when it's a good time- they are sometimes a little bit short staffed. It may take a few minutes, but they don't make me wait unless they really can't help it because it's understood that we respect each others time.

Occasionally there is an officer working who doesn't get it, and it makes things really hard. You need to build a rapport with the officers, more so than with the patients in this case. You are in their house, it is your job to deliver non judgemental care to the patients so that they will not suffer from their illnesses while the judicial process does it's thing. Don't get me wrong- I judge. I have a patient that killed 2 little kids with a baseball bat. He's charged with capitol murder x2. I loathe what he did, but not him, because I don't know him. And I won't- I'll know his blood sugar though, and will do his blood draws and be non judgmental in my interactions. At least I've been able to so far.

I can't stress enough that you need to have a good working relationship with the officers, I've looked up and seen them writing down VS for me, one just put the cuff on them bc I hadn't mastered the art of putting it on an arm that was coming out of a slot. One called me last week to let me know that a pt was back from court and that he knew they had a stat lab, but were sorry- they had no staff until for a few hrs. Then called me when they did. He's actually in nursing school, but most ppl don't know that.

The nurses that have been there for a long time will help you, but they will decide to accept you as a real peer when you show that you aren't going to do something dumb like flirt with a patient. They've seen other nurses do that, and some are pretty stand offish for a while- not saying that's a great thing, but it's how they are where I work. Overall I've been really impressed with the care that the patients receive. It is like being on a different planet. Getting used to it. Still asking questions when I don't know how they do it at their facility.

mobstfeld · Aug 27, 2015

This was probably the most helpful advice of all. Thank you for sharing.

Orca, ADN, ASN, RN · Sep 2, 2015

I have been an RN for 20 years, the last 14 of it in corrections, with eight as a DON. I will try to give you some information that you can use.

1. Stick to your policies and procedures. Deviation from them is the road to compromise, and that is a place where you don't want to be.

2. Be courteous and pleasant, but not overly friendly. Don't share any details of your personal life with inmates. They don't need to know that you're dating, that you have two daughters, that you went clubbing last night or that you're going on vacation in two weeks. Many inmates are experts at taking tidbits of personal information and using them to gain your confidence. This is another avenue to compromise. You start to feel comfortable around a particular inmate and you begin to confide in him. He will "understand" what you are going through. Before you know it, you're in over your head. I have seen even experienced correctional medical staff fall into this particular trap.

3. Spare the terms of endearment and excessive hands-on treatment. Inmates are not "sweetie", "honey" or anything other than their names. I normally refer to them as Mr. or Ms. No first names, because that implies familiarity. No way to get in trouble with that. Confine any hands-on treatment to only what is necessary to get the job done. No physical comforting, no hugs. Any of this can be misinterpreted as romantic interest. You are not working with people who are skilled at maintaining appropriate interpersonal boundaries. Keep it professional.

4. You will be in an environment where you will hear a lot of profanity and slang. Keep these out of your dealings with inmates. Be professional and you will be respected.

5. Don't go into an area with an inmate alone, or turn your back to an inmate when you are working. Keep sharps secure (scissors, needles, etc.). These have value on the yard, and inmates will steal them at any opportunity.

6. Set limits. If an inmate starts cursing or yelling or is discourteous or threatening, conclude your business and hand the matter over to custody. This isn't a hospital, where you have to placate angry people because they are customers. If an inmate started yelling or arguing with me, I told the officer "We're done here. He can go now." Word will get out that you won't be intimdated or take verbal abuse.

7. The information network on the yard is large and word gets around quickly. If you just broke up with your husband or boyfriend, or you got totally wasted last weekend, it will be all over the yard in short order if you mention it to or around an inmate. I never mention family, the area of town where I live or anything that I have planned or have done around an inmate. There are no pictures of family or hobbies or travels in my office. That is deliberate. The less that I share with inmates, the better.

8. Do not do any favors for inmates. Don't take anything out or bring anything in for them, or do for one what you would not do for all. This snowballs quickly, as one of our dental assistants soon learned when she started bringing in CDs for her "favorite" inmate. He used the threat of reporting her to coerce her into more and more "favors", including sexual ones.

9. If you tell an inmate that you are going to do something, follow through. This mainly applies to things like referrals, ordering medications and the like.

10. Remember that inmates live in a world with a lot of sameness and monotony. Your interaction with them, whether it is positive or negative, will be a bigger part of their day than it would be were they on the outside. Things stick with them.

11. Keep your conversation guarded if inmates are in the area. They are expert eavesdroppers.

12. If an inmate says something inappropriate to you, call him on it immediately. Ignoring it is allowing it.

WCSU1987 · Sep 5, 2015

I figure it be similar to psych just with patients having a higher rate of transmitted diseases. I am hoping to work in corrections once I finish nursing school. Have about 4 year's experience in the psych field and a bachelor's degree in criminal justice.

Can always remember a good friend who was a traveling nurse tell me about the poop bomb on a nurse the inmates didn't like. Basically this dude collected his poop saved it put it in a diaper or bag of some sorts. Heard the nurse coming slid it under the crack at the bottom of the door or something like that so when the nurse opened the door poop everywhere on this nurse.

I mean I figure some are going to hate you, but probably not as bad as the C.O.'s. They are probably going to try to manipulate you and try to split you, but just always have each other's backs trust your team/staff. Kind of how it is with psych.

rowanspring · Oct 13, 2015

in the couple of months that I have worked in the county jail I have learned a lot! In some ways it is psychological. Always set your boundaries and don't waiver. Don't add up your "chump change" as it was coined in an inservice I was just at. In other words don't let the inmates manipulate you into doing "favors" that only leads to trouble. Orca had several great pointers. Remember inmates are always trying to manipulate something out of you weather its meds, or what have you. always double check and research what ever they tell you because these people will lie and sell their own mother. Sorry to sound so negative but I have been in situations that it could have burnt me if I had done the request and not checked it out first. Always ask the staff questions because everyday is something new! â€‹

deltoid_chevron · Nov 29, 2015

Thank you, Orca! This is very helpful.