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How can you crush wellbutrin? We have a heck of a time getting the rare order for not XR/SR?

Love the whistle trick! We find neurontin, tramadol, & of course narcs to be the most abused, but some I/m's will abuse anything. antihistamines, GERD meds, you name it. I make it a habit of letting i/m's know that if they take too much of ..whatever.. they can get very ill, and use vomiting as an example. It's a stretch, I know, but not impossible. And who likes to vomit? We crush & float all suspect meds.

Don't give up! It is not you, it is a horrible test written by those who have risen to the top of a field known for 'eating their young". Keep plugging away and don't even think that stupid number reflects one whit on your worth. Once you pass, and if you study and take it enough times you will, it just won't matter anymore. There's nothing there that made me a better nurse. As for prepping... have you gotten at least 2-3 different study guides with dvds? I took tests at home until I could scream, and then took them all again. You can find used copies on amazon. I also thought about taking those 2-3 day prep courses just before, but thankfully, I passed. Don't know how. I was sure I failed mine. Horrible questions. Horrible stress. Make sure the stress isn't sinking you. Practice your relaxation techniques. Breath!!!

Hi Biker nurse.. I can't seem to reply directly to your mail... I could transfer, even to the facility you mentioned but I do not think it would be any different. It's the way the system is set up. One is actually rewarded for finding other nurses mistakes. If it's your mistake you have to write up a couple of forms, often weeks later and oh boy do they threaten to "have you escorted off the grounds" if you show even the tiniest bit of spine. It's very punitive, not at all used for learning purposes. I have been written up so many times during the training process for things I had not yet been trained on and no one would show me how to do it so I had to guess. These are little things, little guesses, ie: how to note on a MAR that an inmate returned a med, or a med came in, not life or death things. I would never guess on serious things! But they treat me writing something, say "#42 rec'd 7/10" rather than "7/10, rec'd #42" like I just killed someone! When in fact inmates are often allowed to run out of very serious meds, or sometimes even given the wrong med outright. That is treated like it's the inmates fault. They didn't fill out the right form or they didn't do it in time, or they should have said something when they got a pink pill instead of a white one. Really! These guys are not in here cuz their brain surgeons or are comfortable with things like accountability or responsibility. We miss teaching opportunities every single day with these guys. Mention that and I am laughed at. Teach these guys they say, like it's a joke to even try. They want me to treat these guys badly, no matter at orientation they tell you that you are not here to punish them. The reality is very different. I have worked in some pretty high stress fields before. But no matter how bad it was at least you and your coworkers were in it together. Not where I am now. It's every man for themselves, and many, many of my coworkers just love to find other's mistakes, especially the new person. They brag on it, talk about it behind your back. It's really horrible some of the things I hear them say about other people, people they are supposed to be on the same team with and I am not popular for refusing to participate in what I consider to be gossip and darn unprofessional. There are 3 new people since I came and I really feel for them. My biggest beef would be that I put my nursing license on the line every day I go in, and no one cares. "Sign here" someone will day and don't you do it!! It may come back to bite you weeks, or I have heard, even years later. I am expected to supervise others who while they may have been on that job longer are still not nurses and still, don't really give a hoot if they pass the wrong med, borrow meds from other drawers, cut XRs in half, or just plain don't give them. Who is ultimately responsible in court of law, (and inmates do like to sue),.... we are. I am. And here they pay very well for that. Very, very well. Think about why. Is my licenses worth it? More to the point, is my peace of mind worth it? It's not. I have already given notice. I can't tell you how wonderful it feels. But maybe it will be different where you are. You never know. From the 3 interviews I have been on so far working at a prison & admitting that it just isn't the kind of nursing you want to do isn't exactly hurting me. The word "integrity" has come up. (My prison has a horrible reputation locally.) In fact, I just got a call back for a second interview at just the kind of place I had in mind when I went to nursing school. Wish me luck!

I gave notice and for the first night in a long time, I slept so well. What really surprised me was that some of the people who were the meanest to me came up to me on the side & said how much they wanted to quit. Thank god I quit before I became like that.

Quick ? Better to quit or be fired. If I let them fire me I can collect unemployment.. but how to explain to next employer? Correctional nurses are not exactly in demand by the nice, quiet doctor's offices I really want to work in, so not being a successful one isn't exactly going to harm me, but staying more than 6 months will. (So I am told.) If you read my other posts you will see how impossible my situation is. It is making me physically ill & I can sure see the writing on the wall. Love this forum!

Thanks to you all for your honesty. It is quite refreshing in my life right now. :) I am getting out. I am trying to hang in for 6 more weeks. That's how long it takes to save enough $$ to live on for a while. Best to you all!

Very little lifting in my experience, unless you are on the 'code team'. Even then you can ask an officer to lift for you. One warning though: In my experience it is a very very negative environment. That's no just the inmates that my coworkers. Note that I work in a processing prison. If you work in prison that offers a higher level of care things may be different. Good luck.

Hi! I am still fairly new to correctional nursing.. and am on my way out just as fast as I can. I have been interviewing and have heard over and over that no one wants to hire a correctional nurse because they think we are all mean. I look at my coworkers and pretty much have to agree. So to answer your ? I would use this line: "It's not the kind of nursing I want to do" "I want a job where I can be nice to people". In my experience those two lines work wonders. You also need to detail out all your clinical skills. Make a list and hand it out. The general consensus seems to be that correctional nurses don't do a lot of skills and don't practice good nursing. And sorry to report, that is my experience and why I'm getting out. You may have to take a huge pay cut too. So be very vague about your expectations. Let them offer. I blew one interview by asking for half of what I am earning now & it was still more than they wanted to pay. In retrospect I would have gladly taken it. (things are that bad where I work.) Good luck!

Be bigger than that, no matter how hard it is. I have gotten the same thing. I just pause, answer the ?, then continue with my report. The pauses allow the rudeness to stand out. After a few days of this her own best bud was telling her to shut up. Sorry you have to endure this. And I am speaking from recent experience.

I started working for a local processing prison about 3 months ago & was determined to make it work. As a new grad, there were not a lot of jobs for me so I was thrilled and grateful to be offered what I saw as a great opportunity. You may find an earlier post of mine titled "mean coworkers". That was just the tip of the iceberg. Are all prisons this way? Med errors are a great example. We use paper mars.. plenty of room for error there. I don't get on the window passing DOT Meds often, but when I do I see meds checked off as given that we don't' have & never had, meds being given that are just the wrong meds. Being new, and slow cuz I actually do check all those 'rights' of med admin ever time, I usually have a supervisor looking over my shoulder, so those errors are caught and the people written up. Guess who gets the credit for finding errors? Yep, me. Imagine how popular I have become! Most people stop talking when I enter a room now.. a very bad sign, I know. I am pretending not to notice, and continue to chat about work stuff, compliment where I can & shut up when I can't, but it's getting harder and harder. The few really nice people avoid me now. I asked the most approachable why but he denied it but wouldn't look me in the eye. I can see the writing on the wall... Inmates are running out of meds every single day. Serious meds too. It makes me crazy to see heart patients going without meds for days on end. I can't even give out a bandaid or tylenol. Charts are everywhere. If I can find one in under 20 min. it's a rare event, and the charts themsvles seem to be more to CYA than actual health care. Everyone I work with goes on and on about how awful the inmates are, how they hate their jobs. I also am getting in trouble over talking to the inmates. I am not talking BS stuff, I am talking nursing stuff. What is the med Rx'd for, what are the side effects, how should it be taken. Isn't that what I am supposed to do? So maybe a few already do know and are just wanting to 'talk to a woman" as I hear over and over, how am I supposed to know this when no where is such documented? Am I reading my state scope of practice wrong? That seems to say that I HAVE TO have these 'talks". I make them as quick as possible, quicker than I am comfortable doing, but still am told to 'cut it short'. I have been written up for med errors on days I have not even been there. When I am not yet allowed to scribble out mars, how could that happen? And they won't say who wrote me up, which is the way I think it should be but generally they are quite free in the info that it was I who found your med error. Now they are changing my shifts. The reason given is that my regular shift is too busy to train me properly. Uh, wouldn't' they already know that? And it is, but after a couple of months, isn't it a bit late to be worrying about that? And this latest shift change is going to put me with a most unpleasant person. A friend of mine who works for corporate America says its the equivalent of putting an office in the closet & sadly, I see her point. I'm getting so worn out. It's a battle every day I come in. I thought the inmates would be the worst part, but it's my coworkers & a system that seems to be designed more to cover your you know what, by covering up mistakes, (except mine!). I had heard that 'nurses often eat their young" but man... does it have to be this way? I mean, I got in trouble for fixing an O2 tank for an inmate. I was told I didn't follow 'policy'. Isn't airway a priority? The guy's lips were blue & it was just a bad regulator. Took me 5 min. to fix & boy, did I get in trouble. His sats were in the low 80's! What else could I have done? I'd really like this to work, if it isn't already too late..or just outright impossible. They will have to fire me, cuz I won't quit without another job already lined up. (working on it but you know, the economy.) I'd like advice on how to either make this work, or how to exit without messing up future jobs. I just cannot continue with all these last minute shift changes. I can't ever remember being this tired & you all know, that will lead to a mistake. And I wonder if that isn't the point. Is it like this everywhere? Can anyone explain to me why? And how bad, how hard will it be to explain to my next employer why I left this job? I will welcome any and all comments.

Thank you for the references. For reasons I don't quite understand I do like this job, so thank you for the opportunity to improve & your insight/experience. It was time well spent. Blessings!

Min. wage? So freakin far from it... The guards, opps, "correctional officers" maybe, but they pay nurses better than anyone else.. at least around here. I love Rob72's comments about blowing their good thing. That really hit the nail on the head. God forbid I learn a task faster than someone else did. And now that you mention it about the controls.... Ding! Ding! I will keep a better watch. I already CYA more than I ever have had to in any other job. & I love the Maslow reference. I had already applied it to the inmates, but GREAT INSIGHT rel. to the coworkers. So.. what do you do when you see outright negligence/malfeasance? I can cover my own tail... but for example I strongly suspect an IM was given asa instead of phenobarb cuz the med was "lost". I wanted to compare the 'found' one with a known & I was, as my dad used to say, 'given the bum's rush'. I refused to sign for it, but they had no trouble getting another nurse to. I see IM"s marked as being checked here, but I know for a fact they are somewhere else. And this happens every single day. Honestly, as one of the newest hires, what can I do beyond CYA? My supervisors don't really seem to care beyond keeping a lid on the worst of the interpersonal BS. Where is quality IM care in this equation? You'll love this comment: "Ya know, just because you are a nurse doesn't mean you have to be a ... rhymes with witch". Maybe not, maybe so...

Hello! I am new to correctional nursing.. and to my great surprise/relief I find I really like it... except for this one thing I don't understand. Why are so many of my co workers in medical so mean? They treat the inmates... not just like children though I see a bit more of that than appears necessary... but downright mean.... and they do it to each other to! There is so much backstabbing.. god help you if you work together with someone else & assume they did their end of the task. I learned real fast not to! The gossips is horrible, never a nice word to say about anyone. Not everyone is like this.. thank god or I'd be gone already.. but probably 2/3 are. I have actually gotten grief from someone... (under me, actually)... that I am 'too nice", as in she said to me "You think you are so much better than me just because you are nice to everyone". I was speechless, said only, "excuse me" so I could get by her to ..duh...do my job & even that was taken as an insult. And I'm not "nice to everyone", I'm nice to people until I have reason to be otherwise. It has gotten to the point, very quickly, that I just do my job & shut the you know what up. I pretend not to hear some of the awful things they say to each other about anyone who isn't there to defend themselves.. if I can't just walk away, but it is hard & I just hate it. But now the real mean ones are coming after me. One made me walk back in from the parking lot after shift because she found a piece of paper on the floor & she wanted me to pick it up. I told her "no" & left. I'll bet that first paycheck she wrote me up. Another set me up sure as I am sitting here. Were I a little less streetwise not only would I have gotten in trouble but lots of meds would have come up missing. No way that was anything but intentional. They were found stuffed in an disused corner. Come on! What kind of sick game is this? Suggestions? I have never had trouble getting along with people before. The guards like me well enough. I have had many compliments on how I handle the inmates, you know, with respect but take no BS. Guess how well those compliments go over with the meanies? The saving grace is the supervisors are NOT that way. They drop hints that lead me to believe they know & understand but otherwise seem to do little about it so long as it does not endanger anyone. (Though moral is surely dying..) It seems the lower the level of training, the worst they act. I am open to suggestions, comments... anything. I like this job & want to stay there. Thank god my shift is the.. uh...dare I say "Nicest"?

Just Hired!!! ? THANKS to ALL here. I read every thread & post here & without you all I may have turned down a job I am now thrilled to be starting. As for my interview.... I was asked to read from a sheet of paper with 10 scenarios & give my reply. As best as I can remember: 1. When is it/ when would you d/c cpr. A: SAFETY!!!! Obvious mortal injury, triage considerations, fatigue.. 2. Couple of ? re: TB... how to test.. know your procedure, what to do/how to treat a pt who is + TB... I said meds, ensuring compliance, diet, rest, fluids, probably put a mask on them cuz the air/droplet transmission, isolation. 3. You find an inmate who cut his wrists... I swear this exact ? is here somewhere... bleeding to death what do you do. ... this is a prison... you don't do jack until your scene is safe. Answer is to get a guard first. 4. Something about diabetes education.....Diet, testing, etc. EZ... 5. Two ? about inappropriate relationships with inmates.. I was helped here by a huge poster in the lobby. I didn't see anything about that here. Pretty obvious stuff though: A coworker who has a special inmate, bringing them treats, contacting their family, volunteering for OT, being found where you shouldn't be with inmate. What would you do? Hello! The answer is to tattle on them, even if in reality you might want to talk to them one on one first. 6. One ? asked about having to lift something too heavy for you & this was a trick ? if ever I saw one. The job description says you have to be able to lift 25 pounds, period. (I just had back & knee surgery, so this is a rather sensitive issue for me). The answer was related to the weight listed & job description. I said that it would depend on how much over the weight, what kind of lift is was, the urgency of the need, & of course, always #1, SAFETY. They seemed satisfied. 7. You just discovered you gave a whole tab to a patient when you were only supposed to give half, what do you do. #1 is always SAFETY. I answered that I would first review, quickly, the drug & other Rx's the patient had & their overall medical condition. Then tell my supervisor, document, & monitor patient for adverse reactions and lastly, make sure it never happens again. That's all I can remember for the ? They also asked why I thought I'd be a good fit. That was EZ for me. I have a background in psych, 12 years in EMS, & many years volunteering at free clinics. I think everyone deserves health care & hey, what a great opportunity to make an impact on a, uh, captive audience. At least here I can be sure they are really taking their Rxs! When it was my turn to ask ? I was well prepared, thanks to all nurse.com!! What kind of training will I get? They loved that & it's great, just great. I also asked the usual: what is their time frame, what are my perceived weaknesses, what can I do to get the job.. etc... I was halfway to my car when I heard my name over the loudspeaker asking me to come back. I was HIRED!!! ? ? It was a week later before the actual dollar offer came in. It is hands down the highest salary I could get in this area as a new grad. And.. state benefits!! Wow am I blessed! One more thing: this is what they call a transfer facility. Our inmates are either going to anther prison or home. I am told that this makes it a "cream puff' of a correctional nursing job. I'd welcome any comments on that. I start 5/2. 2 weeks of training. Good Luck!!! I studied for my interview & was very, very glad.