Please give advice!

[LisaLPN7]

I just started a new job as an LPN in a small county jail of about 200 inmates at any time. Approved for 170. I was told during my interview that there would always be a CO at sick call and walking with me on pill call. After three days there has been no CO at sick call, and essentially none on pill call. They are too busy flirting with the females and teasing the males and hold the cell and pod doors open so that the inmates can flood out and gather around me and the cart. I don't feel safe at all.

Another issue is I am telling inmates who ask for Tylenol or Motrin that they need to submit for a sick call, which is what I was told to do. The other nurse, who is the site director and who told me to do that, hands it out to some and not to others. She is trying to get us to have special training so we can walk around on pill call without "bothering the COs". That thought terrifies me!!!!

Should I give up and leave at this point? I am genuinely afraid for my safety there.

[OrganizedChaos, LVN]

If your boss & CO's aren't helped call rank (ie: Sgt., Lt, etc.). If that doesn't work leave. There's always a riff between corrections & medical. Good luck!

[djules]

Happy Holiday Lisa,

I ran into the same situation as you when I first starting working in the jail. I refused to see any inmates without an officer present. I went to the Lt and expressed my concerns and just flat out said "Nope, not gonna happen. No officer=no sick call" They were able to find the time to provide an officer. Understand that it is written in the standards not to mention other memos that corrections can not deter inmates from seeing medical. As far as the med cart goes I would inform the block officer and the inmates on the block that I will have one inmate approach at a time for meds or we will all just stand there and wait until distance is provided. Maybe Im wrong but Corrections has their job and I have mine. I dont tell them how to do their job and they dont dictate how I do mine. I do know that the officers are responsible for the safety and security of the facility and those in it, (i know this because they tell me this), so I hold them to it. It has worked out well for us and I believe we have a good relationship. Good luck to you.

[Orca, ADN, ASN, RN]

This is not a safe situation. You should not be left alone with inmates, nor should inmates be allowed to congregate around the med cart in large numbers. The inconsistency of PRN pain medications being handed out to some inmates and not to others is also asking for trouble. This facility is being run in a very lax fashion, and I would be concerned about my personal safety in this kind of setup.

[Kooky Korky, BSN, RN]

What kind of "special training"? Ju jitsu?

You might need to just go to the CO, stand right by him with your cart, and tell him you need the men lined up. If you're new and want to keep the job, you have to find a way to non-offensively get him to achieve and maintain order. You must let him know, nicely buy truly, that you don't want to give the wrong meds to anyone, you would feel much safer if he would take care of safety and security so you could concentrate on the meds and med issues at hand.

If you don't want the job, just tell the nurse in charge that you quit.

Before that, though, ask this Site Director to clarify stuff for you, the stuff you said in your post.

Good luck.

[floridaRN38]

Can u talk to ur boss?? Safely for the NURSE IS MOST IMPORTANT

[OfficerRNBSN]

We issue all medications through "the bean hole" or a flap that opens in doors so a jailer isn't really needed. As it stands, jailers issue meds 20 out of the 28 med passes each week anyway. Inmates aren't allowed around the med cart. They initial the MAR saying they received the med, they get a small cup of water, their pills, they swallow, and they're done. Most of the jailers seem to have trouble performing these actions.

I've cut out PRN meds. We still have some unit dose ointments like bacitracin, orajel, etc., but once that's over then it's the end of it. I quit purchasing OTC pills for the clinic months ago, and I'll likely only keep bandages, Bandaids, etc around for use. Anything they need in that respect is actually available on commissary for them to order and keep with them anyway.

A problem I have with "pill call" is that inmates want to talk and ask questions ad nauseum about their health issues, etc. This particular characteristic of jail work has really starting getting under my skin over the last month or so. I really couldn't care less and tell them if they have problems they'll have to see a doctor for a prescription thus write a sick call and show up. Fortunately, for the general population, who gets charged copays for their visits and meds, is really conscientious about doing anything medical. Unfortunately, the federal population of inmates has everything free so they abuse it, malinger, and get meds just to have something.

[Giveback]

Rule # 1 is Safety First. You have to follow your chain of command. If the response is not in line with safety, go to the next level. Someone there will recognize it as a safety (translate - potential lawsuit or workman's comp) issue and address it appropriately. Good Luck!