new grad with first rn job at correctional facility... advice on what to study?

delilas · Nov 24, 2013

Ohhh, I got lots of it. Correctional Nursing is definitely a niche. I loved it and hated it at the same time. I've moved on to hospital work since then, but I continue to PRN at the prison to keep my emergency skills sharp.

Be ready to get a thick skin, and to be pretty autonomous. I'm c/p a post I made a long time ago about correctional nursing, and adding a little here and there.

Stand your ground on your assessments. When I first went corrections, other seasonsed/jaded nurses butted in a lot and would insist an inmate was malingering or faking. Don't let others second guess your own assessments. The inmate in question would have died of a blown appendix if I hadn't insisted.

There are a few good websites about pitfalls, traps, and other parts of correctional nursing. One of my favorites was Correctional Nurse . Net - read up! There is a lot of information on security vs medical, which is an issue that may plague you till the end of your days in corrections.

Never enter an area if you don't feel safe. Just today, I refused to enter the holding room of a new intake who was high on god-knows-what. It is not worth your safety!

Get to know your officers and what their "areas" are. For example, I know which ones are okay with me making my life easier (like letting my infirmary patients bathe instead of shower when I ask) and which ones will stick very strictly to protocol every time. I also know who truly has my back if a situation were to become dangerous.

Talk to your COs about everything! I learned a ton of information about the prison and security measures just by talking to them when things were slow.

We're there to help inmates - physically and mentally. But never let it slip your mind that a large portion of the population is manipulative and/or malingering. Never let an inmate "use" you for extras - even an extra band-aid to them can be establishing a broken rule that they'll use to manipulate you further. Know your protocols and follow them accordingly! A nurse got walked here (aka fired) 3 weeks ago for giving out too much OTC allergy medications to some inmates.

Learn what meds they can abuse. You'd be surprised! IE -albuterol inhalers? They can be sprayed on a surface, and when dried, they scratch it up and snort it. Advair diskus is similar (but worse, because they can remove all the parts of the diskus, but it appears intact). Allergy meds are very popular here to get high on (so much so our formulary only allows even benadryl to be written once every two weeks, and it can NEVER be given OTC anymore).

If you're expected to respond to emergencies, bone up on your anticipated actions for seizures, chest pains, drug withdrawal, overdoses, stabbings, hangings, and anaphylaxis. ACLS is never a bad idea if you're expected to be a responder without a doctor. We don't have a crash cart in my prison, but we carry an AED and suction machine to all emergencies, along with an assortment of other equipment, epipens, etc. Know the signs, how to treat, and how to call for help.

Know tattoos! Know the signs of a fresh one, the signs of an infected one, and what your prison's policies are on new tattoos. For example, our requires an exam form filled out, captains office to be notified, and blood to be draw for HIV/Hepc testing. Then the inmate is usually put in segregation as punishment.

Ditto for fights, accidents, and use of force. There is usually a different form versus what you may use in Infirmary or Nurse Sick Call.

I could probably go on forever - Correctional Nursing is definitely a horse of another color! I'll stop there. You're always free to ask me any questions or PM me!

Novo · Nov 24, 2013

Delilas, very informative but what did you hate about it?

delilas · Nov 25, 2013

I hated wearing 60 pounds of gear and running alone to emergencies across a 3/4 mile wide spanse. My facility was built in 1918 and now consists of 11 different buildings, any of which I could be called to at any moment.

COs were cut a lot lately so I never felt as safe. It wasnt uncommon to have an emergency in the dining hall or a bunk house with 300+ inmates milling about with only one guard anywhere nearby.

I realize my facility is a specialty, as most prisons are mostly enclosed besides an exercise yard.

I hated doing chest compressions alone while waiting for my 2nd responder to show because a dirty guard was slipping girls enough benzos to overdose. Alternately, I feel way overcrowded now during a code in the hospital.

I hated hangings and attempted hangings. And inmates swallowing things, namely razor blades, but I also saw eyeglasses, a fork, batteries, you name it. But then, I have excellent stories :)

I loved dealing with the aftermath of break out fights. Your assessment skills can be a thing of art as you sketch diagrams of injuries and take statements and try to get some semblance of the truth.

I 'hated' a lot of things but some of them are also what made me love it. You wont find a lot of this anywhere else in nursing.

The only thing that truly made me hate it were mandatories. We were constantly short staffed, so you would be held for a 16 hour period some times for them to meet staffing. There were some weeks when this happened four or five times. You literally dont have a life outside of the job, and you certainly arent functioning anywhere near the level you should be at to deal with the danger and emergencies you're attending. But, again, my facility was kinda unique. So I hope others have better luck!

Ozzarozz · Nov 26, 2013

Thanks so much for the advice!