karbyr

I have been a nurse for 24 years now and remember how much I hated my first year as an actual nurse. Very intense and a lot of on the job training. Over the years, I have worked in various positions, some I loved, some I wouldn't have wished on an enemy. That's nursing

What a great informative article, thankyou!

Did you end up taking the Michigan job? What do you think?

They made my life a living hell for about 4 years. Was in the upper peninsula, might make a difference.....................maybe They were federally ordered to have a review due to inmates dying of neglect...........lots of problems, might want to read what the reviewers found.

I agree with you nurse 1989, this nurse did the right thing, although her methods may have been a little "off". I am wondering who stated her treatment was rough? The CMA who was angry about having her overpaid "play time" interrupted? The prison environment is just plain different and you run into situations that are at best appalling. One of the worst situations is the ho-hum attitude of other nurses who want to use the policies and regulations to AVOID doing their job, which includes patient advocacy. Even if it is stated that this nurse violated policy by not having an order to shower this patient, I believe she would have a great defense in "qualified immunity" showing that she really believed she was doing the right thing.

I had posted early last year about what is going on in Michigan's prisons and it isn't good. Michigan's Department of Corrections Health Care Services is under federal investigation for neglect and negligent practices. They were on "60 minutes" last February for this. From what I gather (they tell us nothing), the investigation is wrapping up and so far, all they have managed to do is blame their physician contract providers and not deal with their own issues, much of which are at the management levels. In my opinion, MDOC is a good place to lose your license right now, until they deal with their management issues.

I think I read somewhere that on average, the best nurses get fired between 2 and 4 times during their career. Having said that, I am in your shoes also. Including the small town bit. Just keep looking up as you look around, it will work out!!!!!

policy is every two hours removal. There is no real ability to check q 15 minutes, so would be foolish to write policy that way. He should have been treated, period, which he wasn't. IV fluids yes, but just plain attention would have sufficed and probably prevented his death

:uhoh21: Did anyone see the "Sixty Minutes" episode about the Michigan DOC and treatment of mentally ill prisoners? Any comments? Patients die, they fire the individual nurse and refuse to deal with a management structure that is totally unaccountable. So now the MDOC is under federal investigation. Any thoughts?

Nicely and firmly tell her she will need to take this up with the onsite doctor, then excuse yourself. as in, "excuse me, but I need to get on with my daily work, thank you for your concern". When she tries to go on, excuse yourself again..... and again, and if need be, tell her Excuse me Ms. ________, I am hanging up now, you have a nice day. and do so. sometimes these kind of people are sooooooooo hard to deal with, but polite and firm works, eventually.

another thought would be beefing up on the assertiveness training and the advocacy position of nurses. I see soooooo many nurses who act like co's and don't seem to understand that their licenses can be in jeapordy because they are NOT c.o's.

psych, psych, psych I see so many psych patients that are either undiagnosed or underdiagnosed in the system.....plus, psych training helps deal with the manipulativeness of the inmates.

Grrrrrrrrrrrrrrrrrrrrrrrrrrrr why don't we get better training on this????? There is a great book out called: The games criminals play...........you can get it at amazon..........it gives a great lookee see into how they think and run their cons..........recommend it for your friend

I wouldn't contact them about it, part of being a nurse is being able to "roll with the punches" and not let the 'little things' bother you...............this is a little thing. A funny little thing, but a little thing. I have done it too.......the most memorable time was when I noticed during an argument with my boss that my sweater was on inside out...........really made me feel like I was going to be taken seriously........not...........anyways, sounds like you need to work on your grades more than your wardrobe, that was their concern. Good luck to you!...........if its meant to be, you will get there, just keep plugging along at it.

My favorite tx for bowel incontinence is clear liquids for 24-48 hours. Obviously, if your stomach is THAT upset, it needs a rest. I don't think I've ever had a repeat performance with this tx protocol.

We pretty much only use food loaf when inmates are throwing or smearing food.............or feces.............

You might be better off looking for this information in the Mental Health forum; I can tell you what I know about Michigan, but it may vary state to state; In Michigan, the route to go would be to have a competency hearing scheduled, in order to show that the patient/client needed protection from himself as he is a danger to self and others. If he is found incompetent, a guardian would be appointed and it would be that person's responsibility to decide if he takes medications or not. If the guardian so decided, he could be given medication, including IM meds if he is not cooperative. This is, obviously, the short answer, but it is a direction you can pursue to see what the laws are in the state where you live; a portion of that research would include the rights of guardians of those deemed incompetent; GOOD LUCK!

I frequently remind prisoners for little offenses, i.e. "your hair looks nice down" or calling me dear or hon, that that is not the way to speak to a DOC female employee. It's a little way of reminding them that yes, I may be friendly, but I am not interested and the whole DOC is behind me in my disinterest. Sometimes it is innocent on their part and sometimes it is not, they are testing to see what I will 'let slide' in the familiarity department. I have had threats made, etc. I report them immediately. I want the guys to know that I am there to help them, but not interested in any other type of relationship with them besides that of care giver. I work in a 1000 male level 2 prison. I also believe in my job as my mission and trust God to watch my back! Having said that, I also believe it is my responsibility to follow the appropriate safety procedures, no matter who is advocating relaxing them. One of the key areas that this involves, for me, is refusing to see prisoners alone, no matter how 'short' custody is, or how bad the problem is. This has been a real sticky-wicket with shift command on a couple of occasions, but I stick to my guns.

I would also be very interested in a company who offered this option, please tell! Thanks!

Is or has anyone received any training regarding the PREA laws enacted in 2003? It was described during our general training day this year, but no healthcare indications or guidelines..........is anyone else really doing anything with PREA?

I agree, go with your gut And, you are not doing well without medication, why not give it a try? May have to try several different anti-depressants before find the one for you......anti-depressants work by changing the brains chemicals, either dopamine, norepinephrine or seratonin. There are no blood tests to detect which one is off, so they have to do a trial and error approach to find which one works..........and each trial can take four to six weeks...........however, once found, it can make a tremendous difference in your life. And remember, God loves you, even the depressed you, but wants better for you.

My first question would be, what state do you work in...........also, remember, a lot of employers will act like they can just go ahead and do something and count on you not knowing labor law to correct them. Make a point of making yourself familiar with the national labor laws and those in your particular state before accepting your employers report of 'their rights'.

Am so sorry you are going through this, it can be so difficult. Think the email idea was GREAT!!!! also think you are right about some of the issues, ie. depression, lack of confidence in his intelligence, etc. Also makes me wonder what other wonderful things his parents taught him ???? and how they went about it??? Counseling is the best step, glad you are already headed there and glad he is willing Is he able to verbalize that he is insecure?? That is always a good starting point. Also, are you able to tell him that looks are a very small part of why you fell in love with him..........and list other charms? that may help............. I am a big believer in cognitive emotional type counseling........ ie...........him taking responsibility to recognize when his thinking is 'insecure' and redirecting his thoughts in a more functional pattern. also, remind him that he ain't getting any younger (like all of us:chuckle) and will have to find something besides his looks to base his self concept on just some thoughts, but counseling is best good luck!

yes, contact the authorities at the prison..........the response address from the prisoner should give you a clue, sometimes you can look up locations/addresses from your states web site under dept of corrections or similar. Any health related matter could help..........some of the biggest problems we have on a recurring basis are 1. Overuse and overdosing themselves with OTC medications (if a little works, more will be better) 2. Noncompliance with prescribed medications ..............I don't feel bad today, why should I take pills 3. Poor understanding of basic health concepts.......hygiene, germs, etc. Good Luck!

I am heading towards my 20th year as a nurse and I agree, it ain't what it used to be (sorta like the old gray mare)..........I graduated the same year that DRG's came out.......they weren't real evident as yet at that time. I believe that throughout the eighties, health care was commandeered by the lawyers...........when they got done with us, the accountants stepped in...............I can't really decide which has been worse for us or our patients...........so, lets see, health care in the U.S. is now being run by groups informally known as sharks and bean counters..........and the public is just becoming aware that there's a crisis????? One of the few strategies that I have actually come to appreciate (slowly)..............are the docs who don't accept insurance. They bill the patient direct and the patient bills the insurance. Let enough of the public get burned with that and maybe they will start putting some pressure on their insurance companies..............unfortunately, nursing is so damn dependant in so many ways, that its only when the docs do something drastic like that that we may see some side benefits..........eventually.