Nursing skills needed?

[qimenglan]

I am starting a new job soon at Central Booking as a medical staff nurse after years of being a psychiatric nurse. Also most of my psychiatric nursing has been out patient for the past 7 years. I'm trying to refresh myself on some of the old dusty things I forgot about from med-surg nursing. I've always been a psych nurse; never did any sort of medical nursing really after school, and I'm curious at what nursing skills/typical medical issued are common in corrections? For instance, is there a need to run IVs, transfusions, wound vacs and the like in the jail or is that something that gets a routed out to a hospital setting? I know the Correctional nursing has a blend of all kinds of different things, some sort of like an outpatient clinic setting and then another will be the emergencies of A Sort, but I wasn't sure what level of care to expect?

I'd really appreciate any tips on certain medical conditions or techniques and skills I can focus on instead of basically studying for the NCLEX all over again after a decade working only in Psych? Also note, I'm well aware of the need to set boundaries and set limits and things like that, and as a psych nurse that's definitely my forte so I'm not talking about that stuff. I'm just talking about the typical medical stuff that, for me, has become extremely rusty and or forgotten.

[Hoozdo, ADN]

Your new job sounds very similar to my current job. I work for the intake department for one of the largest county jails in the country.

A large part of the job is triage. I assess the new prisoners/patients immediately after they are brought to jail and determine whether they are to ill to be in jail or should be seen in the ER first. Be very familiar with the criteria for accepting patients into jail at your facility. Also be familiar with what the level of care is at your facility. For example, is there an infirmary you can send them to or do they just service "normal" patients.

Your psych experience will serve you well. One of the main concerns is if a patient is suicidal and what kind of housing they will need after admit. I would venture that about 85% of my patients are mentally ill in some manner.

Know your drugs - generic and brand names. Particularly seizure medications, diabetic meds, and hypertension drugs. Google up the CIWA, COWS, and CIWA-B withdrawal scales and be familiar with them before you start.

I see a LOT of wounds, from interesting police dog bites, to gunshot wounds. I have had wound vac patients but those are usually direct admits to the infirmary.

I start IVs almost every day on pt's who have been in jail a short time that need to be emergently sent out via ambulance. I give a lot of Narcan IM.

I enjoy the job very much and hope you do too!

[RNchic]

Sounds like you might need some of the medical skills but it is facility and unit dependent. Where I work, we have an in-pt unit that runs like a mini hospital with sub-acute acuity. The other areas have out-pt clinics that run like primary care and urgent care clinics.