ocean.baby

Every unit has its ups and downs. You will learn time management skills that will benefit you in any job you do in the future. You will learn basics and have them out of the way and that will be a benefit to you when you move to a different unit. This is a great way for you to start out, in a year or so when you move to a different unit you will see the difference between you and new grads that are on that unit.

Each person has their own preference for shifts. I do not like days as they are more hectic and I hate the telephones. However, when I was younger I did not mind days. I am not a morning person so prefer evenings/nights. The bad thing about nights is you do not have as many staff available to help you or guide you when needed. Treat everyone equally, do not do ANY favors - no you can't give them a pencil, you can't mail their letter for them, you can't give someone a message, etc. Watch and learn, treat security like you want to be treated, they are your biggest asset and believe me, they can save your bacon! Good luck and have fun, corrections is a great field!

I work in a facility that has several group homes that house the developmentally disabled. We have two participants who have been prescribed Boost for a nutritional supplement due to difficulty maintaining their weight. Medicaid used to pay for this but no longer does. One of our participants is not able to afford it on her own. Do any of you have this issue? Who provides nutritional drinks at your facilities/homes? Thank you.

Rocephin I'm just flat out hurts, it hurts the patient and it hurts the heart of the nurse giving the injection.

OMG I hate cell phones and am glad they weren't around when I was young or I may be one of the people being complained about. Where I live all facilities are so short that they would not terminate anyone over anything but abuse/neglect, and that is iffy if they can get away with keeping them. I would love to work at a facility where cell phones were not allowed!

Unfortunately it is not working the cart occasionally. The less you complain about it the easier it is to say, 'oh the DON will do it' instead of truly trying to find coverage. A DON has far too much to do to also work the cart, even in an emergency. The thing is that you will work the cart one or two days per pay period, or more, and that is one or two days that you are not doing your job. Do your evaluations include how well you worked the cart? Nope. It includes how much of your work you did not get done, things you should have noticed but didn't, problem areas you didn't take care of in a timely manner all because you worked the cart too much. Nobody cares. Your job is to get your work done and prioritize your work. There goes your eval. How do I know? Been there done that because 'I didn't mind helping out'.

I have been a DON and an administrator. There is not enough money in the world to be a DON again. That is a position that nobody appreciates, who gets all the dirty work that nobody else wants to do and way too much of it. All you hear all day long is complaints whether it is about care, the schedule, the other employees, smoking, phones, the way someone talked to or fed a resident, etc. It is truly a thankless job and though I have seen a couple of DONs thrive in that job, most fail quickly through their own frustration or the corporation using them as the sacrificial lamb. A Unit Manager is still a thankless job but at least you aren't the DON. I absolutely love LTC but would only be a staff nurse or work MDS. If any LTC DON's read this and love their job then I give kudos to them as they are few and far between. I think DON is one of the hardest jobs there are - I wouldn't be a DON in any type of facility.

I am answering as a prior prison health administrator. You would have a period of orientation with a correctional provider, your orientation may be longer due to not having worked as an NP. You have a patient list to see each day plus respond to emergencies which may be physical or mental health. You should have an officer with you at all times. Minimum security does not always require an officer to be with you and that is more dangerous. I have almost 25 years of correctional experience starting with staff nurse, DON, administrator. I would never see inmates without an office present so keep that in mind when you are interviewing. No matter what their reasoning is for not having an office with you and the inmate, don't buy it. You don't have to live in fear but you do always have to be cautious and expect the unexpected. The hours are similar to an 8-5 job, there are times you are not seeing inmates as they are eating or locked down for count and you can get your paperwork caught up during those times. You will renew medications, see inmates for chronic clinics (HTN, DM, hepatitis, seizures, etc.). You will perform a lot of intake physicals. There are guidelines as to how often physicals and chronic clinics have to be performed. You will have to take call during nights and weekends - how often is usually dependent on how many providers there are. You will always have a physician and regional medical director to support you. There are limitations based on the patient being an inmate. If he broke his ankle 5 years ago running from the police or playing basketball, and did not ever have it looked at while he was not an inmate, we are not going to allow him to have surgery at our expense. If he breaks it while in prison that is a different story. It is essential to document well when you are doing the intake physical as they will tell you things like they broke it playing basketball, but a year later will say they injured it in prison. I have heard horror stories about inmates not getting proper medical care. I think this can be true based on the company that you work for, but mostly on the site administrator and overseeing physician. I have only seen poor medical care once, I had gone to help at a prison in another state and the HgbA1c's were out of control and been for some time. That provider was fired the day I got there, hours after I saw the A1c's. I think it would be a good idea to work in an Urgent Care first and get a little experience on dealing with patients on your own. Those skills that you learn there will be invaluable to you in corrections. Corrections is a great field, I loved it. Good luck to you no matter what your choice!

Corrections is a great field to work. You can advance in so many areas and the opportunities are great, especially if you can travel or move with the company. If you work for the state, there are always open positions that involve a raise. As a staff nurse - you need to have great assessment skills. You will see the inmate and decide if they need to see the doctor. You have a lot to learn, so don't act like a know-it all, ask questions and be open to learning from the other nurses and the providers, not to mention the officers. Develop a good working relationship with security - mutual respect. If you screw up, admit it and thank them for catching it. They are who will teach you how to stay safe, don't listen to them and it will be you who suffers. Prisons and jails are totally different, some nurses prefer jails, I prefer prisons. I don't like the fast revolving door of jails where I feel I am chasing my tail all of the time. I like the prisons where you actually get to know and help those that want it. Good luck to you!

You have been watching too many prison movies. I have worked in corrections 25 years, and have never seen physical abuse from staff towards the inmates. I am not saying it hasn't happened, but I have not seen it. Verbal abuse - yes, but rarely, and not to the point I had to report it. Most officers are professional. They want to go to work, do their job, be safe, and go home at the end of the day to their family. Inmates treat medical staff far different than they do the officers, they want something from us and are usually nice. That is NOT how they treat security. Medical staff give inmates what they need, not what they want. You want an extra mattress because yours is too thin? That is a security issue, they assign mattresses. You need an extra mattress because the thin one makes your back hurt, and security told you to get a medical release? Well, we are not in the mattress business. There are strict guidelines as to who gets a second mattress and they are few and far between. You do not qualify. You need 5 packets of antibiotic ointment because you have cuts on your hands? Hmmmm, or do you really want it to masturbate with? You have a cut on your finger and need some bandaids? Well, bandaids can be used to make shanks, the cut isn't bad, just wash it with soap and water then keep it clean and dry. An inmate comes to pill call and looks like hell - pale, diaphoretic, weak. When questioned he says he isn't feeling good, his stomach really hurts. You have never heard him complain before in the 6 months you have seen him daily. You have the officer take him to the infirmary, or the nursing office on that unit, get his vitals and assess him. BP is low, pulse is high, can't get an O2 sat. You call the doctor and get orders to start an IV, put oxygen on him, and ship him to the ER. You might have saved his life. The best nurses only focus on medical care and issues. You need to have a good working relationship with security and develop mutual respect. When they tell you something, listen, they know what they are talking about. They will keep you from getting killed if you pay attention to them and do not take offense when they tell you that you did something stupid or out of line. Inmates do not receive the standard of care that a congressman with great insurance does. They have to receive the same as the community standard of care. If you are a single mom working at McDonalds, no insurance, and have a bad tooth - you can afford to get it pulled but not a crown. Same with inmates. You have a scar across your face from a car accident 5 years ago - but you can't afford to have plastic surgery. Same with inmates. You have cancer, you have a heart attack - you get the treatment you need. Same with inmates. Go into the facility wanting to give good care, not looking for any perceived problems. Please keep your mouth shut until you learn the system unless it is a life threatening situation. Watch and learn, you will do fine.

I have worked with many petite nurses in corrections that were great. It is dependent upon your attitude, setting and maintaining boundaries, and professionalism. Do NOT discuss your personal life under any circumstances. It is not their business if you are married, have or want kids, your education, likes and dislikes, etc. Go ahead and apply - it is a great career!

They go to the rehab unit at nursing homes, or to the rehab hospital, neither which is a good choice in the area where I live. Having worked at the nursing homes, I can tell you that the nurse has 20-25 patients regardless of the care that they need. Many of the nurses do not have hospital experience. Once a patient was admitted with TPN and not one person on that unit, or in administration, had a clue about checking the orders, hanging it, monitoring, etc. But you can bet that the admissions nurse got kudos for the money that patient brought in! This is not a slam to admissions staff everywhere, but 2 out of the 3 nursing homes in our area are owned by companies that want the money and to hell with the patient and the staff. Many nurses that work in nursing homes have also worked in the hospital. Some have gone straight from school to the nursing home. The problem here is they are being made to care for these acute patients with no additional education/training since they did their clinicals. Our rehab hospital is a joke. They are only concerned about the therapies. If you have medical issues such as complications from a recent surgery and are unable to do the 3 hours of therapy per day, you are non-compliant and they discharge you. So many of the patients that have been discharged go directly back to the hospital because they did not receive the follow-up medical care that was needed while at rehab.

It's a requirement for the RN programs; however, not all nursing schools require it prior to admission. No. It is not required for all ADN programs. They are still RNs.

As a health administrator, I have interviewed and hired a lot of staff. I always appreciated when the person being interviewed brought up planned time off during the interview. I like that up front honesty, and never one time held that against them. They always got this time off - people have lives and plans and some of those plans are very important and cannot be rescheduled. If they waited and told me when the offer was extended? It didn't sit as well with me. I felt they were putting me in a bind, that it was an ultimatum. Either I get this time off or I won't come on board. If they waited until orientation, or after orientation? They may not get it, depending on the time of the year and other staff that have already requested and been granted that time. If you plan on flying to another state for Christmas, or your dad's retirement party, or your 10th class reunion which is held over the 4th of July, you knew that at the interview. If you wait until or after orientation, I feel like you are telling me 'either I get this time off or I will quit'. Bye - I am not playing games with you.

I worked with a new nurse for four hours - first time I had worked with her, who had not charted that the blood sugars were done before dinner. I asked her if she had done them, and if not I would be happy to help her get them. She said that she got them. She then charted five blood sugars without having any kind of note to look at. Nothing written on a paper towel, tongue depressor, alcohol wipe packet, her hand, nothing. I could see the wheels turning as she made the numbers up. I then got the glucometer and checked the numbers. Not only had she not checked blood sugars at that time, she hadn't prior to lunch, she hadn't prior to dinner the day before, nor prior to lunch the day before. The numbers on the glucometer matched the blood sugars that the nurse working the opposite shift had documented for two days, he worked nights so had the bedtime and early AM blood sugars to do. However, those were the only blood sugars recorded on the glucometer. I notified my supervisor and was told to write a report (which I did). When the supervisors talked to the nurse, she said that she couldn't get our glucometer to work and borrowed one from next unit. Funny thing? Their glucometer was really not working so they borrowed ours in the rare instances that they needed to do blood sugars (they only had one weekly blood sugar to check)! This new nurse was turned into the Board of Nursing and rec'd disciplinary action. Wouldn't it have been much easier to just take the blood sugars?