jailDON

I have a lot of experience with borderlines. In order to deal with their need to consume of lot of your attention and time as a floor nurse with 8 patients this works: First accept that the borderline will get your attention one way or another. The borderline has that awful fear of abandonment and an agonizing empty feeling. At the beginning of your shift sit with this patient and give your undivided attention. Do your initial assessment and then make "appointments" with her every 2 hours or whatever you think is appropriate. If something comes up and you can't make an appointment go to her and say I have an emergency I'll be 15 minutes late. If she wants attention in between do not comply, stick with the appointment schedule. If the appointment time rolls around and she is in a meeting with the therapist approach her afterwards and say you were tied up at our appointment time, do you still need to talk? This really, really works. Also borderlines are great staff-splitters. This requires a lot of staff education and good communication to combat.

I am moderate on three of the things. The bad thing is that as a psych nurse, I knew what was the "right" answer and what was the "wrong" answer so I had to really try and be honest with myself.

Forgot to mention pay. It is comparable for the LVNs to the hospitals but a little low for the RNs.

Same here in Texas.........the 8 hour shifts mentioned above. We also have 16 hour shifts on the weekends for nurses who only want to work weekends. The company would like us to phase them out though. Also I agree with the others. Get a year or so of med-surg or ER experience first.

LOL, a pimple! You never know what you are going to see. That's why I tell my nurses to never triage over the phone. Maybe after everyone gets used to you and learns you are smart and know what you are doing, they will show more respect. Are you on-call 24/7 like I am? That DESERVES compensation!

LOL, a pimple! You never know what you are going to see. That's why I tell my nurses to never triage over the phone. Maybe after everyone gets used to you and learns you are smart and know what you are doing, they will show more respect. Are you on-call 24/7 like I am? That DESERVES compensation!

Brickman, I think you are right. Many times medications or certain treatments are part of a parole or probation agreement. My experience is that inmates do have the right to refuse. If they are incompetent to make their own medical decisions, we get a court order for forced medications if their refusal will lead to harm or death.

Brickman, I think you are right. Many times medications or certain treatments are part of a parole or probation agreement. My experience is that inmates do have the right to refuse. If they are incompetent to make their own medical decisions, we get a court order for forced medications if their refusal will lead to harm or death.

Just curious NurseT...........things still looking up for you?

Wow, I probably have many conversations with my supervisor that I should not have behind those walls. We don't really say anything wrong but we talk a lot about the relationship between security and medical.

Sounds like he jealous maybe and doesn't understand that there is a lot of responsibility that goes along with your profession. Great move to network with other nurses in your area.

In west Texas the pay is $16-$19/hour. The key is in negotiation IF your area is short nurses. Try this....Don't ask what the pay is but TELL them what pay you require.

Dixiedi - all true. You didn't comment on the bugging issue. Did they record phone calls in the institution you worked in? NurseT - on the labor laws....The only thing I can find out is that salaried people in my state are expected to work 40 hours IF they don't do call. In your case, doing call, a shorter work day helps make up for the inconvenience of being awakened in the middle of the night. At a local hospital the nurses don't get paid for call at all unless they have to go in THEN they are paid overtime.

What state are you in? I think the laws are different state by state but I could be wrong.

"I'm beginning to wonder if they've got me bugged." It's very possible. At my jail, every call that lasts over 3 minutes is recorded. Listening to the recordings is done randomly and only a small percentage is monitored UNLESS they suspect something or are out to get you. Once at my facility they caught a nurse having a relationship with a former inmate/felon that returned frequently. I wouldn't be surprised at all if they are listening to you. Over the years there are times when I have had to go to my car and talk on my cell phone rather than use the jail phone. It's a weird feeling when you have to do that. Their concerns are really ridiculous. You are your own department as Mattsmom suggested and the doctor could be the one that determines what hours you work. Which of you is considered the Health Services Administrator? In my facility it's an RN with that title and he is the supervisor over the MD, monitors contract compliance and ACA/NCCHC compliance.

Great job....you have some good people behind you. Keep the medical director involved. He can sign your job description. :) I've learned that respect starts at the top and trickles down. Officers that are disrespectful to nurses are allowed to be that way. They have no idea what it is like to be on call 24/7.

The jail I mentioned in which I had 3 employees, there were 120 inmates. You need more help really with 200 inmates. It's acceptable for "health-trained officers" to perform some duties such as Intake screenings and give meds if they have appropriate training. I wrote my own job description once! Everyone must have a job description. I agree with the last writer who said you are going to have to be assertive or they will run over you. I suggest communicating with written memos and attending meetings as a department head. Once, I was asked to leave a meeting in which I belonged and I refused and stayed!! You have a tough road ahead but you will be a stronger person because of it. You will make your jail safer for your community.

I work in a Texas jail. RN pay $22.50 to $24.00 ($5.00 less than hospital pay) LVN pay $15.00 to $19.50 (comparable to hospital pay) Measly shift differentials $1.00 for evening and $1.50 for nights. No weekend differential No sign-on bonuses. Hospitals are offering $3000 to $5000 for RNs. No matching of 401K contributions. Does offer life insurance, disability insurance and good medical plans.

Ok, I'm getting a clearer picture. You are in a very SMALL jail.......how many inmates are you responsible for? You are medicating and doing everything. How do your inmates get their HS meds? Who medicates on the weekends? I'm suspecting it is trained officers? Maybe I would start with a job description. Do you have one? Who supervises you? The jail commander should not have the ability to judge your nursing care. He's not qualified. I don't clock in but I work at least 40-50 hours/week AND I'm on call 24/7. Can you get comp time? You aren't being treated like the manager of a department at all. I ran a small-scale department of only 3 employees and now I have 20 employees but the responsibilities are the same and you deserve the same respect. I would demand it.

Because you are the manager of the unit and not a nurse assigned to accomplishing a peice of the puzzle (i.e. sick call) I am trying to outline the most basic services that your clinic should provide. It sounds like you are in a jail, not a prison. Offering the physical before the 14th day must be done and documented whether the patient allows the physical or refuses. Even the healthy ones need to be offered STD testing at the time of physical according to NCCHC standards. Intake screening must be done as soon as the inmate is booked. Chronic care patients should see the doctor within 30 days of booking and at least every 90 days after that. I'm not saying I have it all figured out!! We are constantly fighting the "squeekiest wheel gets the oil" situation. Sometimes the nurses are giving healthy drug-seekers all the attention when there is a 79-year-old sitting quietly with uncontrolled hypertension and diabetes.

Hysterical laughter, how rude. I recently went to an interview for a prn hospital position and I did not receive a warm welcome though since they are desperate for nurses, I was offered a position. Their concern: "Your current job involves clients who are a captive audience, no pun intended (smile) and we don't believe you don't have what it takes to make the paying customer happy."

Another idea: Instead of reinventing the wheel, why not borrow nurse protocols from another facility and have your doctor sign off on them?

We have nursing assessment protocols so that we can treat simple things without a telephone order. These include: colds, allergies, athlete's foot, withdrawal, rashes, etc. If the person has seen the nurse twice with no improvement, a doctor's appointment is required. There is a NCCHC standard that addresses how often you hold regularly scheduled sick call depending on the number of inmates you have. I don't have it right in front of me but I can post it later. Are you getting your intake screenings, physicals (by the 14th day for jails and 7th day for prisons) and chronic care clinics done? If not that would be a place to start as well as holding sick call.

Don't you have to have a special DEA license to handle Methadone? At our jail, we detox only unless it's a pregnant woman. It would threaten the pregnancy to detox.

No nothing too serious. I just found out I can work in the hospital as a staff nurse for $2 more an hour than I"m getting as DON pay that is salaried. I don't know if the pay is really behind just for PHS nurses or if it that way all over for corrections nurses.