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mikethemurse BSN, RN

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mikethemurse has 6 years experience as a BSN, RN.

Corrections R.N.

mikethemurse's Latest Activity

  1. mikethemurse

    ISO other chronic care RNs!

    OK, the Chronic Care Clinic...No not case management. You are monitoring inmates with Chronic health care issues. These would be, but are not limited to: HTN, DM, ID (HCV, HIV), CAD, Asthma, COPD and ect. You should check out NCCHC standards for Chronic Care. Lots of information there, and you will also be able to see some of the kinds of paperwork you will be doing. Or at least something close to it. Welcome to corrections. Good Luck!
  2. mikethemurse

    copy-cat" acts of self-harm

    First, Iam sorry you had a tough shift. How long have you been in corrections? The reason I ask is because, maybe this is a regional thing, but that type of thing was pretty much par for the coarse in most of the several county jails I have been in. Some nights (I worked nights) were MH nights with crazy or (crazy because it will maybe help my case) inmates doing all kinds of things to themselves and others. Some nights it was I'm going to try to die fromETOH/Opiate/whatever I can get my hands on withdrawal. Nature of the beast. Also human nature to want to vent, especially to anonymous strangers on the internet. I get, and have done it myself, and this reply is not a dig on you. Iwas just confused at your surprise at a pretty common thing. Inmates sometimes do stupid things in order to get what they want. At the end of the day, you did your job, and everyone lived! Good day all around.
  3. mikethemurse

    Pursue corrections right out of college or acute care first?

    First of all thank you for your interest in our specialty! Personally because of what Lilred said about the good assessment skills, and also the autonomy, I think that it is a good idea to get some acute care under your belt. In my state, they pay by experience. A new grad makes about as much as a med surg nurse does. for the state gigs there is a scale and where you fall on the scale is directly related to # of yrs, experience. I think it is something like 25-36 per/hr. then there are shift diffs and overtime. I love corrrections, as you may have read in some of my other posts. All that being said, in this market take the best paying job! You will learn a lot your first yr, but may be a bit overwhelmed in corrections as a new grad.
  4. mikethemurse

    Your advice for a new RN Intern

    Ok without knowing the type of internship, some general advise to a newbie...be open to constructive advise of your preceptors, just because someone is telling you that you have done something incorrect doesn't mean they are a bully, or eating young ect...just because school is over that doesn't mean you get to stop studying, you will make mistakes, learn from them!, at first you will be slow, and feel like you don't know what the heck you are doing, don't worry you are and you don't! But every one of us has had those exact feelings, it will come in time. do the work. be proactive, and helpful, even if its not your pt, help. answer a light, ect. well good luck, these are just a few ideas. you'll be fine.
  5. mikethemurse

    How did you decide on your specialty?

    I fell into corrections about 6 yrs ago, never learned a thing about it in school but use everthing and then some in this field...my advise is 1. find a job, 2. as stated above be open sometimes you will love something you never even thought about. Good luck!
  6. mikethemurse

    Do you carry around your stethoscope?

    WOW! I had to leave a comment on this one. I am a corrections nurse and depend on my assessment skills above everything. There are no mds on site ( i work overnight) and if I don't catch something, then people die. My stethoscope is another appendage I would sooner work without one of my legs than without it. This OP scares the heck outta me! I just hope they don't miss something and someone ends up dead. With the risk of beating an already dead horse, I can't even begin to understand a nurse who would rather let other people assess their pts. Or trust a machine to do a better job, or god forbid a first yr resident who can't even write for APAP without consulting some form of drug book while forgetting to check for an allergy. OK rant over. but darn that was some messed up post and like I said scary!
  7. mikethemurse

    Saving Lives, 1 cup of Gatorade at a Time!

    Again, like in any other situation you have to take the whole patient into account. As a rule I error on the side of caution. With the limited resources most of us have it is easy to mistake PE for MI or Bells for CVA or cellulitis for DVT. Our job is not to diagnose but to assess if our patients are in real distress and take action. The main reason why nurses get jammed up in law suits is negligence, being aware of a real danger for loss of life or limb and failing to act. That is why I see every complaint. I would rather waste 5 mins of my time than to be in front of a review board attempting to explain why I failed to act. (Please forgive spelling/ type... Now on 24th hour awake)
  8. mikethemurse

    Saving Lives, 1 cup of Gatorade at a Time!

    rnforlongtime, I didn't think CVA b/c no other symptoms present, and no other risk factors, aside from the decreased control over facial muscles, no droop, no slurred speech, 26 y/o with no hx drug use, vitals stable. I did speek with an MD who independantly stated the prob dx of bells. Actually my first thought was that the pt took another i/m meds, and was having some type of dystonia. the important thing is that i saw a neurological change cva, bells, or what it turned out to be, and took action in order for him to be taken care of, I didn't just send him back which was the point of this thread, to list stories that had good outcomes because of strong assessments of corrections nurses. especially because of all of the negative stories in the media about corrections nurses dropping the ball in pt care, I thought it would be good to improve the moral for all of those unsung heros working in a very difficult area of nursing. not sure if that answers the question let me know.
  9. So I just came across this thread, and had to tell this story, by far and above my father's best nursing come back...(I may have mentioned in other threads, my dad also an nurse x 38+ years started out in the Navy, and takes little crap from anyone. Not that he is a bad guy, he is actually the go to guy in the hospital for most things, and a wealth of knowledge.) Anyway...in July of one year, a very cocky resident began to straight up yell at my father, about a patient (not under my father's care). After about a min of this my father just looked at him, interrupting his rant and said in a clam voice..."you know what the difference between doctors and nurses is, doctors only think they are god." then he walked away leaving the newbie md to ponder this. I love it!
  10. mikethemurse

    Nursing Behind the Wall

    Good luck Tommo!
  11. mikethemurse

    Question About Proper Process

    Anytime, and good luck!
  12. mikethemurse

    Question About Proper Process

    hi, wow...that is not how it works! First, I have worked in several facilities during my time in corrections, and what I am used to is having a protocol book with standing orders for nursing sick call, anything above that the md must write. now depending on the medication I have seen chronic care meds renewed with a "verbal order" as above, but I don't do it personally, I leave the chart to the md and a note asking for him to write the order. At my main job we can print out a list from the pharmacy of meds about to end and then we pull those charts and ask the md to reorder the chroinc care/mental health meds and so on. As far as the messing with charts thing...all I can say is run far run fast and don't look back, because that type of practice is big time bad news bears! Documentation is so important in this area of nursing, and I would be very afraid of stuff like that. Sorry you are dealing with that, but NO it is not the norm nor should it happen ever! be careful, and good luck. please don't let this one company/jail turn you off from what is really a great area of nursing.
  13. mikethemurse

    what age did you decide to become a nurse

    I grew up with nursing, my father has been a bed side RN for 38 years, so I pretty much always wanted to go into the field. I had I guess what you would call a rebellious period right out of highschool and totally went the other way and got a B.A. in English Lit and Tech Theatre, and spent most of my 20s working all over the country doing profesional lighting, set design, and sound for live preformance. Then I met my future wife, and right away being on the road 10 months out of the year no longer interested me so at 27 yrs old I went back to school and got my R.N. Funny how life takes you in a great big circle to get back to where you belong sometimes. Most people think that my change from the arts to nursing was a big jump but not really. I use many of the same skills in nursing as I did in Theatre, thinking quickly on my feet, making choices and making the show go on no matter what.
  14. mikethemurse

    Nursing Behind the Wall

    Good luck CEO! I didn't really have time in an already long article to touch on safety. I am safer than any hospital nurse! In the hospital I have been spit at, yelled at, and even had a little old lady s/p spine sx try to punch me out! In the jail I never go anywhere without a CO, the bad guys are in cuffs, and I have a panic button behind the desk if things get out of hand. You do have to be aware of where you are, and always keep safety in mind, but all in all I feel very safe at work.
  15. mikethemurse

    Sick Call costs

    Sick call: Doctor, Dentist, Nurse, ect... $10.00 OTC meds: $3.00 Rx meds: $5.00 Chronic Care: NC Indigent: get charged and have a negative balance on their account until it is paid. No soups till you pay for medical. The charge is a non issue for me. My attitude is, this is sick call this is the charge, the fact that you are going to be charged is clearly written on the request slip that you filled out to be here, so yes you pay, or you sign a refusal and keep it moving. (get out of my infirmary) I see way too many people in way to short a time to discuss this point. Have the officers escort the ones still yelling about the charge out of the area, and watch the rest either toe the line, or sign the refusal slip. Either way, I let them know that there are plenty of others waiting who actually want to be seen, and they calm down. Or they don't and they get upset. But I am way past the point of caring if they don't like being charged for sick call especially when I loose half my check between taxes to pay for their health care on the street and in jail, and my own overpriced medical insurance. Not trying to get snarky here at all but...don't sweat the small stuff. Hope this helps.
  16. mikethemurse

    Miss Manners for Nurses

    Reason # 256 why I love being a corrections nurse...no darn satisfaction score cards! Almost as good as # 26 NO CALL LIGHTS!!!