riverlands

Im a corrections nurse but I lurk in the school nurse forum, because there are SO_MANY_SIMILARITIES. This made me laugh. Because ice-pack-duty-making duty is real.

Depends on the environment! I am in the County Jail. Too much professional language is not always appreciated in the trenches. If you dont joke and you dont swear, you might be a robot or a snitch. We know the patient is being over the top behaviorally challenging when a medical provider starts cursing after rounds...thats like Christmas! Its hilarious! LOL.

You can do what I do as a new(er) nurse (15 months): I play a game in my head called Flip It with crabby pants like this Lead Rn. I flip it around: whatever behavior they are doing to you: backstabbing, overly constructive criticism, checking your charting, downplaying your knowledge to the doc? OK. I just ask myself: how can I suck all the learning out of this interaction? 1. what can I learn from this 2. did I really do something I should not do again and why 3. try not to repeat if # 2 is correct 4. every time, cheerfully thank the person for taking their time to "help" you whether it was passive aggressive or nasty or valid or whatever who cares? If I flip the script on them and use what they did/said etc to learn, they are wasting their time being a crabby pants and teaching me in the process even if they are not really trying to help me 5. Bounce back like a rubber ball or a whack-a-mole..I just pop back up and smile and totally pretend I didnt "get" that they were being nasty-ish. Its super annoying. Focus on the patient. 6. Some crabby pants co-workers get an endorphin hit from seeing a newbie in passive-aggressive-induced emotional pain. Give them nothing. Do not care personally about their nastiness. This means you win Flip It points. 7. Sure they know more, they have been doing it longer: experiential learning is empirically proven as the highest level for learning. Its like they have been in school for 20 years. Good for them, they sound dumb when they keep saying it like that. Really awesome experienced nurses dont run around saying "I know XZY I ve been a nurse for blah blah blah years" with every interaction. The awesome ones are just awesome, they dont need to tell everyone how awesome. And the awesome nurses are focused on the PATIENT not themselves. 8. Who cares if the doc thinks youre stupid sometimes. You are. I know I am. Just dont be dangerous! Be careful, thorough, and get your orders properly, practice in your license and keep the patient first. Thats all any of us can do, even super smarty pants experienced crabby pants nurses. 9. Crabby pants are often personally insecure. And no one is right all the time. We all have things to learn. 10. On the other side, I have found there are lots of awesome tenured nurses out there who love to teach. Treasure them and tell them politely how you look up to them if you mean it. I bring nice fresh Starbucks to them. They are a treasure. 11. One day I will be a old awesome # 10 and I will use my tenure and smartypantsness to troll the old crabbypants and have lots of time to support and encourage new nurses. This is my goal besides caring for the patient.

I took a corrections job because I had less than 1 year acute care experience and could not get hired in the hospital. But I totally love it in jail, although it is: tough, frustrating, and political, our provider relationships are wonderful and every shift I learn more and more. And it has forced me to be very independent.

I think all jails, prisons and facilities are different. Im in County Jail and its not perfect. But it is safe. Man down, all the deputies are running for that cell. Backup called (fight) they are on it. Blatant disrespect to Medical staff, inmate often receives discipline (seg). I trust my deputies and I have their back any time they want Medical for their inmate. Its the other Medical staff interpersonaly that can be challending. Im in a progressive Western state in a very, very progressive city, the county well funded and Medical are all county employees with a sprinkle of Agency. I find it safer than the hospital I worked at before, where we were expected to act like security to deal with behaviors in mentally competent patients ourselves.

Suggestions, yes!! Based on my personal experience...If you can get into an acute care new grad residency, take it. Your new graduate status has an expiration date of 6 to 9 months after which many hospital systems will not look at you without two years of experience. Rough estimate, about 50% of our patients in jail were seen in the hospital in the last 180 days, so basically the same population! I know many excellent nurses who have never worked in a hospital. But for me, it was infinitely valuable. If you really want to go straight to Corrections, I know several awesome nurses who did that too. Where I work, the jail medical department are county health department employees, jobs are posted on the County jobs website. Jails are run by the county sheriff. And if your state has unions, look for a Corrections job in a union environment. Regarding prisons, I have never worked in prison. If your county jail isnt directly hiring, check with local staffing agencies, they may hire via agency first. Good luck new grads!! You got this.

Hi Nurse Beth. Why did you phrase your response "sub acute, even Corrections?" As though Corrections nursing is the very last resort? Because that's what it sounds like you are trying to say. I'm a nurse in Corrections and proud of it. There is no nursing specialty of last resort. We all perform valuable work and each setting has it's own challenges.

AndrewCraigRN: I am a Corrections nurse and my entire patient population is incarcerated. Way beyond some racist comments and a Swastika tattoo and the patient assuming I share their racist beliefs. My patients on one level or another, have been charged or convicted with the commission of a legally and sometimes morally offensive act against an individual or against society. So, on a daily basis at work I care for persons who have committed rape, assault, serial murder, gang offences, violation of children, drug distribution. Much higher ratio of patients with a psychiatric diagnosis of antisocial personality disorder (sociopathy). I consider every shift a valuable education. It is an enormous challenge to practice nursing in such a hugely restrictive environment. Where a pen is a weapon. My access to my patients is restricted. All of my nursing is observed by a Corrections staff member. My patient is chained before they are transported by EMS. In fact, I have faced judgement FROM nursing and medical staff in other settings!!! When I call report to the ER they are rude to me. I have had several ER and OB nurses try to tell me that my patient doesnt need to come to their ER. EMS tries to get out of transporting our patients. I have had more ER charge nurse push back...Arguing with me regarding patients with critical low electrolytes, persistent hypoglycemia, lady partslly bleeding pregnant women. Patients whom if they walked through the door instead of came in chains they would triage appropriately. How is that for morally objectionable. I suspend judgement of my patients while I am working. My role is nurse, not judge. If I came to work with a bunch of moral objections I would have no way to practice nursing...what would I do? Refuse the assignment of a dormitory full of alleged and convicted rapists? If the patient displays inappropriate behavior to me in that moment, I apply psychiatric nursing interventions to interrupt that inappropriate behavior. If my interventions are unsuccessful, I work with the Corrections staff to ensure the safety of the patient and everyone in contact with them. I am becoming skilled at de-escalation, therapeutic listening. The only reason I would refuse to provide nursing care to a patient is if there was a physical threat to mine or my co-workers or the patient's personal safety. I have lost count of the offensive tattoos I have seen. The only part of the tattoo I care about is using it as a landmark for a PPD test placement. If I want to be a judge, I will attend law school. I find your poll to be successful clickbait. At first I didnt like it, but after thinking about it, anything that makes us examine ourselves professionally is valuable.

work in jail. It's a MRSA syphilis tinea GC/CT party over here. We have people with MRSA abscessed draining areas all the time. Other than some gluteal cellulitis outbreaks I'm always surprised there aren't more skin infections. I glove and handwash and bleach wipe all day long. Tip of the day the worst abscesses are when Someone shoots heroin in their gluteus muscle......

Im confused. Your very first job you were immediately charge nurse and your very first day of orientation you were given 15 total patients of your own with no preceptor?

Isn't the fluid draining from the chest tube coming from the pleural space between the lung and the lung cavity lining? So it's not coming from inside the actual lung itself. Which is where the TB bacteria would live. So I would think pleural fluid would not be a reliable source of material to culture. Need to cough up a nice fresh sputum sample from down deep where the bugs are hiding right?

OK so Ive been a jail nurse for 9 months now. Here are my tips I have learned: 1. are they on Bactrim or another sulfa drug, you might be seeing fixed drug eruptions...essentially an allergic reaction. I have seen this several times now as smallish blisters on palm of patients hands. We have lots of IVDU getting bactrim 2. diffuse rash on trunk: lots of little red spots evenly spaced, can be syphilis rash! 3. I see lots of Tinea Versicolor, its a good one to research 4. scabies 5. athletes foot can show as maceration and splits or cuts in the space between the toes 6. I always check first do they have any new meds...I go straight for allergies and try to rule that out 7. uptodate.com is a great resource 8. I dont give out hydrocortisone unless im pretty sure its contact dermatitis 9. dont underestimate the power of soap and water 10. If that wound/skin infection/whatever isnt improving on an antibiotic they have taken before get orders for a culture. Seen so many resistant infections. Happy hunting!!!!

You did the right thing in the end: never perform a procedure without a physician's order. If the patient is not in danger or acute distress, waiting for an order might be the safest thing for the patient. If the patient was catheterized for maintenence of incontinence vs for urinary retention for example, then just careplan them for Q2 urinary incontinence changes or whatever your policy is, and they are safe until the physician can make the decision. If it is just for incontinence then I would just use other nursing interventions to ensure they are safe from consequences of incontinence. Urinary rtn would be of urgent nature of course.

JC doesnt come to jail, oh darn. For Real Doe, I would sweetly call security and say there was a visitor playing tricks on staff members in the lobby and that I was concerned they were going to startle a little old lady and cause her to trip and fall :)

Stick it out!!! You can do this. The preceptor with 7 patients plus charge is completely ridiculous. If you can survive orientation on a floor like that you can survive anywhere. I know i survived orientation on a cardiac tele stepdown hell floor. Make your skin as thick as you can before you walk in every day and soak up whatever you can. Chart the minimum focus on the abnormals when you are charting and chart throughout the day as you can. If theres a code, run to it. Good luck new nurse you got this