CCHP-RN

As "corporate management" (and RN) for the company I work for, I want all of you to know, some of us do care GREATLY. We are at a loss at how to operate units with no staff. We have tried everything in my specialty to recruit and retain nurses and all medical staff in general. We are willing to bring on agency nurses, however, those are also limited. Everyone is fighting for nurses in the same agency pool every week. We are paying agency nurses more than NPs. It's the oddest thing I've ever seen. Last week, in my weekly call with my regional directors, I literally broke down in tears as I know we haven't been able to find any relief for our staff. My specialty is a much better environment than hospitals. You'd think people would flock to it, but too many have preconceived notions as to what it entails, if they have ever even thought of it. My specialty is correctional healthcare (detention, jails, prisons). As much as I'd love to recruit you for our company, I won't. I'd rather recruit you to corrections overall. Thinking about all of our challenges minute by minute. Keep your head up and do your best. However, remember, there is only so much any one nurse can do.

I know all of you are feeling the staffing shortage as much as I am. I was just wondering what other correctional facilities are doing when medical staff are not staying and staffing is at critical levels. COVID has wreaked havoc on facilities. At what point do we move to the emergent, urgent, then routine clinic activities? I say we do what we have to do, but there is only so much we can expect from one employee. Anything you have implemented (procedures) to allow the staff to focus on the most essential duties?

I haven't worked as an employee for ICE. However, the company I work for provides healthcare in 5 private facilities solely housing ICE detainees. It's somewhat different in the way ICE provides services. However, it comes down to providing healthcare in detention/corrections. We do intakes, physicals, preventative care, CID, CC, routine and acute care (sick call), emergency care, pill call, etc. ICE publishes all of their standards online at https://www.ice.gov/detain/detention-management/2011 These standards were revised in 2016 and are performance based. All of the standards are essentially based on NCCHC and ACA/ALDF standards, but can be more stringent in some areas. The biggest challenge is communication with the various languages of the detainees. A facility with <500 beds, typically can have 60+ nationalities represented. Hope this helps. If you have other questions, let me know. Always willing to share experiences and any knowledge I may have after 25 years in corrections.?

I'm sure there are programs such as that. Of course, as with everything else, it cost's money. Typically, if my nurses are working 12 hour shifts, I work them 36 hrs one week, 48 hrs the next, with every other weekend 3 day weekend. Work Mon/Tues Off Wed/Thurs Work Fri/Sat/Sun The following week it's exactly opposite of that.

While the last 2 years have definitely added to the "regular nursing shortage", I've been told since 1988, at 18 years old starting nursing school, there was a major nursing shortage. At that time, the BSN program I entered only accepted 40 new students every year. It was the only BSN program in the Lubbock, Texas area, which probably had a 210+mile radius at that time. The salary for MSN nurses teaching the course (required) was less than a BSN in other areas. No wonder there was such a limit of students admitted to the program. I have had many thoughts about the nursing shortage since that time, however, most of you would not agree with me, so I'll just keep thinking them for the next 14 years until I retire. I hope all of you find the best RN or LPN fit for you. I have and it's NOT the hospital or "free world" as we call it.

I would quit the hospital again in a heart beat. I work as a director now in correctional healthcare. Lots of room for advancement, locations everywhere if you know where to look, many different types... Jails, State Jails, State Prisons, State Parole Violators, USMS, ICE, juveniles, males, females. Work for govt or private companies. Or do like me and be a director over 14 prisons and detention facilities (from California to Florida, and then North to Ohio). It's ambulatory care for a lot of them, some have infirmaries, some have hospitals/surgery centers onsite. It's totally different than the hospital. Most of the ones I work at are ambulator care, similar to a MD office. Pay is comparable or better than hospitals, nursing homes, and definitely ambulatory care. The inmates have never been a threat to me personally. It comes down to treating them with respect and recognizing boundaries. I've always called them Mr. or Ms. and that has gotten me a lot of respect over the years. At the Level 1 Trauma Center we had a lot of gang members with hits out on them, etc. I surely definitely did not feel safe there with the 1-2 security officers campus wide.

I did the same. NA to NT while in nursing school, then 5 years as a RN, a total of 8 years at the same hospital. At age 27, they would not promote me beyond charge nurse due to not having admin experience. You can only imagine how I felt about that. I left the hospital and went to a prison to get my 1 year experience as a "Health Services Administrator". That was 25 years ago, and I'm still working for prisons, jails, and detention. You get in, you never leave! LOL, well not everybody, but it does get in your blood. 5 years in, I went to a the Corporate Director of Nursing, then Director of CQI/Training. I am now the Sr. Director for my current company, which I love. I have been given the chance to succeed since I started! BTW, depending on the type of facility, most are ambulatory care departments, not requiring bedside care as such. The pay is comparable to hospitals and nursing homes (pre-COVID) with a much better workload and more autonomy. I love it!

I'm working on rewriting all of the policies and procedures for my employer and need suggestions how to reference inmates throughout the policy. I was going to go with "patient" but that doesn't sound right in many of the regular policies. I don't like inmate, detainee, or offender. These are corporate policies and include jail offenders, detainees and inmates. Therefore, I need a good reference for all of them. How are they referenced in your policies? Any ideas/suggestions? Any help is greatly appreciated!!

Any updates to pay in Laredo? Someone told me that starting pay for RNs at Doctors Hospital is $35-39/hr... That just blows me away! (December 2012)

I think all of the medical departments are looking to save money on meds among other things. The best thing you can do is create and LIVE BY a good formulary and only go off formulary in extinuating circumstances. I went to the NCCHC conference in Nashville a couple of weeks ago and found a great pharmacy system that controls your costs significantlly. I loved it. However, if your doc's continue to order off formulary, it wouldn't help either. I don't have any affiliation with this company but so far it is the best I've seen in the 13 years I have worked in corrections (no blister packs -dispensing from bulk stock - similar to the use of a pyxis in the hospital). The cost was comparable to what our company spends on blister packs from the regular pharmacy but it cut out all of the extensive paperwork, paper MARs, reordering issues, etc. But again it comes down to formulary management. If you are interested let me know and I'll share the company contact info with you.

I am trying to find a 12 hour shift template that will allow me to schedule my staff 24/7/365, with no built in overtime. I had seen an awesome schedule at some point which had no overtime and allowed the staff 7 days off in a row each month. However, I can't seem to find this schedule now. Does anybody have a template they use for 12 hour shifts and no overtime? Please share if you will

I have worked in federal, state, jail, etc... I have to agree that the attitude you get from the federal BOP inmates is a lot worse than general inmates. Many feel they are entitled to EVERYTHING and unfortunately the US govt gives them tons more than state or local inmates - thus the feeling like they are staying at a luxury hotel. You may want to try a different level of inmate. In all of my environments I have always called the inmates "MR" or "MRS" and treated them fair and consistent and they have been much more appreciative than when my coworkers treated them as "inmates". Sounds strange - but will work 9 out of 10 times (if not more).

I took a minimal self defense class when I started corrections 12 years ago. I enjoyed the pressure points, not sure if it would actually work if I had to use it though. In these 12 years, I have only gotten into it with 2 inmates. Both times, other inmates told the aggressive inmate to back off and later in the day both inmates apologized to me. I think this is due to me being fair and consistent with the inmates at all times. The inmates always have my respect as long as they respect me. Once they disrespect me, then the other inmates know it. It can be as simple as me calling inmates Mr. so and so... then when they disrespect me, then I call them by their last name only (so and so). Inmates tend to appreciate nursing/medical staff unless you are just cold hearted and treat them like trash. We are some of the only staff in the prison that are not there to punish them, but are there to help them. Cristi

I had an inmate drink bleach/water that he was cleaning with ... to prove to the officers that it was too diluted. Evidently he was right. It did absolutely nothing to him. Regardless any sane person would not prove it with that method!

I have never done school nursing, but I have always thought Correctional nursing would be similar to it as well as military nursing. Believe it or not, our inmates are just like kids a lot of the time... always trying to get out of class or have an excuse to not do something or get special attention. The focus is triaging them and finding out if they have a valid medical need or not. Cristi - TX, NM, AZ (BOP, State, Juvy, Community Corrections, etc. - multi facility)