New job challenges---advise?

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Hi,

I'm an LVN in California. I accepted a position at my local county jail (300 inmates) about 6 weeks ago. I'm a recent grad and my first job was in LTC. I really like correctional nursing. I feel like I'm doing well, but sometimes the volume of work is overwhelming. We've been without management for several months, so everything is pretty disorganized right now. We have a new manager starting next week.

To top it off our regular medical officer is out on medical leave so misc CO's are randomly assigned, sometimes to their dismay. My biggest challenge is the custody staff. Most are nice and supportive, but others are very passive resistant--ie, when I go out to find an officer to assist me, they all suddenly get busy, pick up the phone, turn toward a computer screen. One young woman, my son's age treats me like an inmate. This disrespect makes my blood boil. In addition, I meet major resistance if I decide to send an inmate out for a "fit for"...I'm pretty strong and manage to stand my ground, but it sure is hard to work in a unsupportive environment. Advise?

Otherwise, this job is a trip. I've learned so much, and my 12 hour days fly by.

Thanks, T

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Sounds pretty standard. I wish I had good advice. Well, I do have good advice, but can't follow it myself. Don't let the disrespectful, surly, uncooperative guards make your blood boil. They are stupid, ignorant and insecure. What are you going to do? You can't change them so you have to change your reaction to them.

Most situations in correctional health care are not an emergency and do not really require speed --- so try to chill out. I think the words "lawsuit" and "liability" can be useful when you do need a swift response and follow-through.

But I would be very interested in advice from others who do not get themselves tied in knots over those stupid guards! Or -- in the California prison system -- those infernal MTAs.

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Specializes in ER, ICU, Corrections.

In the Oregon Correctional setting we have a few officers that are like that but for the most part they treat me with the utmost respect and are willing to help me whenever they can. I have worked at many facilities in the state and it seems to be that way all over. Sometimes they do things to make me mad but the rest of the time they are totally professional and good to work with.

I have had some of the officers in charge that wasn't going to let me send an inmate out to the hospital. I looked at him and told him "do you want to support me for the rest of my life when I get sued by this inmates family, cause I will come back and get you.."" He got the inmate out of here on the double and I never had trouble with that officer again..

I have been in corrections for 15 years and it is a great job and I have not had a lot of problems with the officers.

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I work at the county jail and have 200 inmates to myself. I'm the management and the task nurse so to speak. Thank god they're not all on meds. The officers pass the meds. Our Commander does not feel the nurse is safe in that situation and feels it poses a security risk. I train the officers to pass. We only have a few PO's, and the inmates have to do their own topicals and treatments. I have one or two lazy officers who do not want to pass meds and look at it as another task. And it only takes them 30 minutes to do it. I tell them, "Well, if I do it, 2 officers are going with me and it will take alot longer, most likely 2 hrs, as when they see the nurse coming they will all be needing PRNs" if you know what I mean. Besides. I would be scared with the way our jail is set up. Most of the officers and myself work together as a team when our jobs overlap and if they even think an inmate looks like he's going to disrespect me..... It's take down time. In fact I have even warned some of the inmates that "if they upset the officers, they get nothing from me", I have also made inmates apologize to an officer after being a behavior problem. The officers really like that. It really helps to present a united front to the inmates and they learn very quickly not to upset the only person in the jail that would help them....Me. We have finacial issues too, as far as sometimes the officers don't want to send the inmate to the ER. I just remind them that if I give the order to send, (and I use the word order) and they don't send... it's considered "Deliberate Indifference" and my responsibility ends after the order is given.

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I work at the county jail and have 200 inmates to myself. I'm the management and the task nurse so to speak. Thank god they're not all on meds. The officers pass the meds. Our Commander does not feel the nurse is safe in that situation and feels it poses a security risk. I train the officers to pass. We only have a few PO's, and the inmates have to do their own topicals and treatments. I have one or two lazy officers who do not want to pass meds and look at it as another task. And it only takes them 30 minutes to do it. I tell them, "Well, if I do it, 2 officers are going with me and it will take alot longer, most likely 2 hrs, as when they see the nurse coming they will all be needing PRNs" if you know what I mean. Besides. I would be scared with the way our jail is set up. Most of the officers and myself work together as a team when our jobs overlap and if they even think an inmate looks like he's going to disrespect me..... It's take down time. In fact I have even warned some of the inmates that "if they upset the officers, they get nothing from me", I have also made inmates apologize to an officer after being a behavior problem. The officers really like that. It really helps to present a united front to the inmates and they learn very quickly not to upset the only person in the jail that would help them....Me. We have finacial issues too, as far as sometimes the officers don't want to send the inmate to the ER. I just remind them that if I give the order to send, (and I use the word order) and they don't send... it's considered "Deliberate Indifference" and my responsibility ends after the order is given.

Thanks for your replies! I'm starting to become more assertive with the CO's. There are only a few that make my blood boil. One in particular...a young buff, arrogant, cock butthead. For example, last night after med pass there were a couple of IM's that I had to assess. One has HTN, c/o a severe HA and the other had c/o chest pain earlier in the day (his EKG was a little questiobale, but he was not having a heart attack). Anyway, I called these IM's up to assess them and this CO said, if you have anyone else to see do it RIGHT NOW! I want them all here RIGHT NOW! I said, "hey, the night nurse needs to call a few up for meds they missed on med pass when they are out of church, visits etc. If you don't want to stand by, find someone else to do it or I'll just document that you refused to stand by. He huffed and puffed and yelled some more." There is a real "us vs them" attitude right now because we are questioning how a psychotic IM ended up in a restraint chair. I told them NOT to put her in the shower, and they did it anyway. Long story.

I really kind of like this job, I just need not to take the Co's attitude personally and be very, very assertive. Does anyone know of any classes/inservices that I could sign up for specifically centered around physical assessment in a correctional setting?

Thanks again, T

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If You Get On Google And Type In Correctional Nursing Numerous Sites Come Up. Try There. As Far As The Officers Go, You Are Above Them. You Are Providing A Service That Is Required By The State. Get Ahold Of Your State Regulations And Look At The Medical Section. It's Small But Very Precise On Who Is Responsible For What. The Officers Are Responsible For Their Own Actions. You Are Not Responsible For The Actions Of The Jail Staff. Not Like In A Healthcare Setting. If You Give An Order And It Is Ignored, The Officer Or Anyone Else Will Be Committing " Deliberate Indifference". In Other Words, They Had A Medical Proffessional Advise Them And Deliberately Ignored The Advice. If You Quote That And Say" I'm Just Helping You With A Little Cya They Soon Get The Picture And Are More Cooperative.

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