delilas

I worked corrections, albeit prison and not jail. In my prison, opiate users don't get any special treatment for detox except for perhaps an infirmary stay for a couple days through the worst of it. The first 2-3 days (in my experience) are the hardest, but the withdrawal symptoms do last for 7-14 days. If she was one of the very very very very few that seizes or has other issues from opiate withdrawal (usually caused by them also being benzo addicted and not bothering to tell us, not actually from opiates), she would be transferred to a hospital. People die from benzo withdrawal and alcohol withdrawal. An opiate user will feel like they got hit with a six ton bag of bricks, food poisoning, and swine flu all at the same time, but they won't die from it. That's why most states/most hospitals do not consider opiate withdrawal an appropriate admitting diagnosis unless there are obvious complications.

I'm going to ignore all the backbiting about taxes and post to the original topic. I'm union, and while ours go by seniority, our managers weigh in, also. Everyone gets to make two requests for "prime time" summer vacation (May through September). While naturally the seniority gets their first choices, management works hard to make sure nearly everyone gets at least one of their choices. If you take vacation in the "off season" its not difficult to get usually. The thing is, it was more or less like this everywhere I have worked, union or not. If you have a new grad and someone who has been there for 5 years attempting to vacation the same week of June, the senior person is going to get it. Even though I am absolutely low man on the totem pole since I recently got this new union job, I prefer this over "first come first served" wherein it is just a race to see who can submit faster on the scheduling thing at 12:01 am the day vacation sign ups begin.

Yes. Even so, they had a relatively good rep until the last few years, apparently. They were purchased by a large national for-profit at some point.

I just hired in to be a full time faculty member in a school of nursing. I am on my second day of orientation and already wondering if I should be looking to jump ship. My first big red flag was that after long discussions in my interview about my seeking work/life balance. I discussed that I was okay with the paycut I had to take to work there, because I would no longer be working crazy hours and weekends. The ADON I interviewed with agreed. I was given a sample schedule that was M-F. On my first day, it was casually mentioned that I would be taking on a Saturday/Sunday clinical group. They want me to work more weekends than I ever did as a bedside nurse. Second, this school has gone through multiple DONs/Deans in the last 5 years. The most recent left after less than a year. The current assistant DON is extremely new and attempting to do the job of several people. On top of that, several teachers have recently left, leaving them with very serious holes in their program. I oriented to the site of one of their clinicals today, and discovered that the school is on extremely tenuous standing with the hospital. In fact, the students are barred from passing medications on site, and are on their last legs and close to being removed from the site entirely. In attempting to talk to the interim DON and clinical manager about these issues, I was told that all schools have such problems, and that teaching shortages are an issue everywhere and that none of this should bother me. Is this true? Are these not red flags waving in my face?

Yes, I've tried reaching out to a few, as well as a couple of traveling outreach clinics, and I'm not getting replies. When I call, I tend to hear that "So and so will call you back if there's anything" and I never get a call.

I am working on finishing my RN-BSN, and to do so, I need to find a BSN prepared preceptor in a "community health" setting - more or less any setting but inpatient hospital care qualifies. I moved here 5 years ago and immediately went to nursing school and beyond my work, I don't really know anyone or have the contacts (at least BSN prepared ones) to find a preceptor who is willing to let me follow them and sign off on 60 hours of shadowing. I'm an experienced charge nurse who has worked in corrections, emergency, and currently, ICU stepdown. I would be happy for an opportunity anywhere, and I'll be happy to fetch your coffee, sit quietly, or do whatever you need in order to get through these clinical requirements. Please PM me if you have any questions or are potentially interested. I wouldn't ask here, but I've been hunting for 3 months with no results except a "maybe" with the coroners office, and my term starts in April.

I float system-wide for four hospitals. I don't have to work weekends, holidays, or essentially any day I don't want to work, and I get a higher base rate, but I don't get benefits or PTO!

That isn't an excuse to make it up. I just admitted a patient today who still hasn't recovered from taking her labetalol and having a major hypotensive episode. We're talking about the potential to cut off adequate blood supply to organs because you think it's okay to rationalize fake vitals. That's no better than nurses who fake giving medications.

Geographic location: Central Ohio Pay rate: 40/hour In which area / specialty do you work?I flex for Stepdown units across 4 different hospitals in one health system. What type of license do you have (RN or LPN)? RN What type of degree and/or certification do you have? BSN How many years of experience do you have? 5 Are you full-time, part-time, or casual / per diem / PRN status?I am technically PRN or Per Diem, but I can work up to and exceeding full time if I choose. What shift do you work? Day shift. Do you receive any shift differential? If I worked nights or weekends, I'd receive an additional 3 dollars per hour. Are you a manager or supervisor? ​Nope.

+ If you think you'll ever be too good to scrub down a patient in a good old fashioned bed bath. + If rectal foleys don't make you happy. + If you can't treat nursing school like a full time job. + If you can't own up to mistakes. + If you have no humility. + If you think it's a lot of codes, dramatic lifesaving, and you don't like repetitive, mundane tasks. + If you aren't damn sure being exposed to every bodily fluid you know of and a couple you don't is in your life plan for every work day for the rest of your life.

On a unit I was a charge nurse for, we'd occasionally pull people aside as we checked our crash carts each morning and run them through it. "How do you pace? how do you change the joules?" etc, and have them flip the switches and show me. It's not necessarily as useful as a good mock code, but even just running through what buttons to push a couple times a week keeps things fresh. HERE is a link to the mock codes Zoll uses, with some useful diagrams on a couple different defibs. I don't know how useful it will be, but might be better than nothing.

It's a million times easier to understand in practice than in the classroom. The classroom tends to be rote memorization of signs/symptoms and normal levels. While thats certainly necessary to some extent, it's not until you've really completed all your pathophys courses and begun to treat patients for these imbalances that it really all comes together.

I hated wearing 60 pounds of gear and running alone to emergencies across a 3/4 mile wide spanse. My facility was built in 1918 and now consists of 11 different buildings, any of which I could be called to at any moment. COs were cut a lot lately so I never felt as safe. It wasnt uncommon to have an emergency in the dining hall or a bunk house with 300+ inmates milling about with only one guard anywhere nearby. I realize my facility is a specialty, as most prisons are mostly enclosed besides an exercise yard. I hated doing chest compressions alone while waiting for my 2nd responder to show because a dirty guard was slipping girls enough benzos to overdose. Alternately, I feel way overcrowded now during a code in the hospital. I hated hangings and attempted hangings. And inmates swallowing things, namely razor blades, but I also saw eyeglasses, a fork, batteries, you name it. But then, I have excellent stories :) I loved dealing with the aftermath of break out fights. Your assessment skills can be a thing of art as you sketch diagrams of injuries and take statements and try to get some semblance of the truth. I 'hated' a lot of things but some of them are also what made me love it. You wont find a lot of this anywhere else in nursing. The only thing that truly made me hate it were mandatories. We were constantly short staffed, so you would be held for a 16 hour period some times for them to meet staffing. There were some weeks when this happened four or five times. You literally dont have a life outside of the job, and you certainly arent functioning anywhere near the level you should be at to deal with the danger and emergencies you're attending. But, again, my facility was kinda unique. So I hope others have better luck!

I've seen plenty of obs units that are extensions of the ED - usually patients who may not meet criteria for admission but the doc doesnt want discharged yet (often chest pains, SOB, etc). I've never heard of an obs unit that is an extension of an ICU, however.

Ohhh, I got lots of it. Correctional Nursing is definitely a niche. I loved it and hated it at the same time. I've moved on to hospital work since then, but I continue to PRN at the prison to keep my emergency skills sharp. Be ready to get a thick skin, and to be pretty autonomous. I'm c/p a post I made a long time ago about correctional nursing, and adding a little here and there. Stand your ground on your assessments. When I first went corrections, other seasonsed/jaded nurses butted in a lot and would insist an inmate was malingering or faking. Don't let others second guess your own assessments. The inmate in question would have died of a blown appendix if I hadn't insisted. There are a few good websites about pitfalls, traps, and other parts of correctional nursing. One of my favorites was Correctional Nurse . Net - read up! There is a lot of information on security vs medical, which is an issue that may plague you till the end of your days in corrections. Never enter an area if you don't feel safe. Just today, I refused to enter the holding room of a new intake who was high on god-knows-what. It is not worth your safety! Get to know your officers and what their "areas" are. For example, I know which ones are okay with me making my life easier (like letting my infirmary patients bathe instead of shower when I ask) and which ones will stick very strictly to protocol every time. I also know who truly has my back if a situation were to become dangerous. Talk to your COs about everything! I learned a ton of information about the prison and security measures just by talking to them when things were slow. We're there to help inmates - physically and mentally. But never let it slip your mind that a large portion of the population is manipulative and/or malingering. Never let an inmate "use" you for extras - even an extra band-aid to them can be establishing a broken rule that they'll use to manipulate you further. Know your protocols and follow them accordingly! A nurse got walked here (aka fired) 3 weeks ago for giving out too much OTC allergy medications to some inmates. Learn what meds they can abuse. You'd be surprised! IE -albuterol inhalers? They can be sprayed on a surface, and when dried, they scratch it up and snort it. Advair diskus is similar (but worse, because they can remove all the parts of the diskus, but it appears intact). Allergy meds are very popular here to get high on (so much so our formulary only allows even benadryl to be written once every two weeks, and it can NEVER be given OTC anymore). If you're expected to respond to emergencies, bone up on your anticipated actions for seizures, chest pains, drug withdrawal, overdoses, stabbings, hangings, and anaphylaxis. ACLS is never a bad idea if you're expected to be a responder without a doctor. We don't have a crash cart in my prison, but we carry an AED and suction machine to all emergencies, along with an assortment of other equipment, epipens, etc. Know the signs, how to treat, and how to call for help. Know tattoos! Know the signs of a fresh one, the signs of an infected one, and what your prison's policies are on new tattoos. For example, our requires an exam form filled out, captains office to be notified, and blood to be draw for HIV/Hepc testing. Then the inmate is usually put in segregation as punishment. Ditto for fights, accidents, and use of force. There is usually a different form versus what you may use in Infirmary or Nurse Sick Call. I could probably go on forever - Correctional Nursing is definitely a horse of another color! I'll stop there. You're always free to ask me any questions or PM me!