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Orca ASN, RN

Corrections, psychiatry, rehab, LTC
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Orca has 25 years experience as a ASN, RN and specializes in Corrections, psychiatry, rehab, LTC.

Orca's Latest Activity

  1. I had a coworker years ago who "found" a fire in one of the women's restrooms, and she "saved" her coworkers by reporting it. Investigation eventually revealed that she had set the fire herself, then reported it to make herself out to be a hero. She was charged with arson. I never found out what happened to the charges because, as you might suspect, she was fired as soon as the results of the investigation came back. This was a large, older building that contained a lot of flammable material. It was also the administration building for a major state agency. Had her stunt gone wrong, she could easily have killed a bunch of us. I worked on the second floor, and the fire was set in the ceiling of a first floor rest room.
  2. You can find micromanagement and lack of autonomy in just about any specialty area. It largely depends upon management.
  3. Orca

    Ageism in Corrections?

    I manage a staff of about 50 people. Several of my nurses are petite females. They are among my most productive and effective staff. As others have said, it's about how you conduct yourself. Stature and appearance have nothing to do with how effective that you will be in this environment.
  4. I'm a DON and I have an ADN, so I'm guessing that the answer would be yes. The federal Bureau of Prisons may require a BSN (I know that VA does), but I don't know of any states that do.
  5. Orca

    Gender dysphoria

    I'm not sure how many of you are dealing with the issue of gender dysphoria, but it seems to be coming up with increasing frequency lately. Our current policy is that if an inmate is already on hormones for this condition at intake we will continue them, but we don't initiate or restart hormone therapy unless not doing so would be a medical risk (and this would be an extremely rare exception). I am wondering about the experiences of my colleagues, and how different agencies are dealing with this issue.
  6. Orca

    Ethical dilemmas of correctional nursing

    Inmates will also insist that they have all kinds of undiagnosed conditions, and that their rights are being violated because they aren't being treated. I was once sued by an inmate (I'm a DON, so I get sued every time that the medical department is named) because we weren't treating an obscure neurological condition that she claimed to have that was not diagnosed by anyone who we obtained medical records from. Our contract neurologist didn't find it either. I looked it up, and the main treatment for this condition is opioids. She is an opioid addict. She found a condition that few people knew about or understood that would feed her addiction, she claimed to have it, and she was hoping that we would treat it without verifying it. When we didn't, she sued us. She lost. Inmates will try to convince you that they aren't getting what they need, when in fact the issue is that they are not getting what they want. I was sued by another inmate over a different medication issue. He was insistent that two medications that we removed from our formulary because they have trade value on the yard and had created an underground economy were the only medications that worked for him. Neither drug was listed by any source that I could find as a treatment for his condition. We replaced the drugs with drugs in the same classes as the ones that he was on, but he was still insistent that they "don't work". Most likely we took away his income, and he was hoping that the court would force us to give it back to him. The court didn't bite. This is a work environment unlike any other. We have to consider issues that would never come up in a hospital setting. Our clientele is almost without exception manipulators. They weren't put here for their honesty. Behind that backdrop, we have to separate the legitimate issues from the fabricated ones, and it isn't for everyone. If you come in with the attitude that all inmates are neglected, they will eat you alive. They will have you twisted in so many different directions that you won't know which end is up. Welcome to my world.
  7. Orca

    My DON is harrassing me, can I save my job?

    I don't understand that advice at all. There is no legal issue here.
  8. Orca

    Constant Complaining

    If someone brings a complaint into my office, my first question is, "What do you suggest that we do to solve this?" After a while, staff realize that they aren't just going to walk in, dump a problem for me to solve and then leave without thinking through what they would like to see done. And no, "Hire more staff" is not a solution.
  9. Orca

    Ridiculous medical mistakes on TV

    But then there wouldn't have been anything for the DA to beg the judge for.
  10. Orca

    What do they teach these days in school?!

    I work in a prison. We had an inmate come in who most of you would know, a former pro football player. We had many instances of people looking up his information in the online record just out of curiosity. They were asked by the director to explain their reasons for going into the record (and most of this was not medical information, BTW). As for me, I wasn't star struck by this guy, and I didn't care what was in his record. He was another inmate with a number.
  11. Orca

    Do Psych Nurses Travel?

    With any travel assignment, there is usually a good reason that a given facility does not have permanent staff to fill the spots given to travelers.
  12. Orca

    Do you think I can get my job back?

    I can't imagine why you would want to get this job back. You would be working under the same conditions with the same people.
  13. Orca

    Unethical Former Boss- Advice?

    Impersonating a nurse is against the Nurse Practice Act in every state that I know of, and it is encoded in state law. It is a crime. The BON may decide not to pursue prosecution in her case if she did not engage in any direct patient care and she was instead only telling fabricated stories to appear to be one of the team. If she claimed to be an RN in order to get a license for her company, that is a different story. The forgery is far more problematic. That is a felony.
  14. Orca

    ADON position with Centurion?

    This is sound advice. I work for a state facility and we are not NCCHC accredited, but we frequently refer to NCCHC prison standards when developing policies and procedures. I have a copy of the prison standards on my bookshelf in the office.
  15. Orca

    Ridiculous medical mistakes on TV

    A couple of days ago I watched an episode of Everybody Loves Raymond entitled Sweet Charity. Ray was volunteering in a hospital, and he immediately expressed a phobia about blood. A nurse walks up to the counter, slaps down a bag of blood - with tubing attached - and says "This is for the fridge." Later Ray is assigned to a lonely older woman who won't take her pills. His job is to convince her to take them so that her health will improve. When he walks into the room, the pills are just sitting on the bedside table in a large soufflé cup (the kind usually used for water). I understand that it's a comedy and things are done for comic effect, but still.
  16. Orca

    Ridiculous medical mistakes on TV

    I realize that this is a comedy, and realism isn't paramount, but in Airplane, a woman with a guitar begins to sing to a child who has an IV hanging. As she swings the neck of the guitar, she knocks the IV out, and the child instantly begins crashing.
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