Terminated!

[kukukajoo, LPN]

As a brand new grad nurse, I took a part-time job at a small facility right near my house. Received about 8-9 hours training that consisted of two med passes and set out on my own-as the only nurse on the shift. In the last two months I had been concerned as the Dept Head would not give me promised direction, training or even answer my questions, instead she got defensive and shut down. When I did not get answers there, I went to the Sgts. on duty, then to the Superintendent, who all referred me back to the Dept. Head, who would not respond to me! Been there abot 2 months and had grave concerns the whole time.

Despite feeling uncomfortable with duties, I continued, hoping it would change, and looking for education on my own to learn more. I had just begin gathering P&Ps from other facilities that did have in place (Chest pain, hypo/hyperglycemia, Withdrawal scales, suicide assessments, etc.). No Glucgon or any emergency kits for ANYTHING other than an AED. There was a lot wrong with this picture.

A LPN who also works there is very afraid for her license as well and we talked. She is working hard to learn corrections nursing standards and even attended a national conference on her dime. Has left books and talked to Head RN till blue in face, again just defenses go up, no actual changes oreven guidance.

Then Thursday two things happened- they didn't want to send out a pt with BG of 589 and very high BP, numbness on l side, rad pain 5/10..... Finally did after I interrupted a staff meeting.

THEN..... that night a pt who was severely psychotic and tearing the skin off his face, having hallucinations of tactile nature... trying to assess him since he isn't on meds the CO accompanying me gets mad because I won't just agree that yes, someone that is invisible is trying to continually give you an injection in your arm..... Thinks I am being condescending by asking standard assessment questions and trying to see how deep his psychosis is. Obviously no psych training there....

Had a long conversation to the Sgt on duty about the Head of Nsg being ineffective (his words) and does nothing (his words) and how change does need to happen, but nothing gets done. I told him how I was getting the info regrding others policies since with that in hand, maybe they will put

So I don't get any sleep and yesterday I went in and lo and behold, my termination letter awaits. THANK GOD was my first thought! I had discussed this issue at length with peers at my day job and decided to wait until boss came back from vacation to talk to her and if I was ignored again or no response, then I was tendering my notice.

Funny thing is the letter begins:

It goes on to outline that I was condescending to the inmate and also was unsafe by being in a unit alone. BTW the said unit is behind 3, yes THREE locked doors and the only way to get let in is by control on the radio, which I do not have. (Rounds are done with CO). CO was with me and wlked off with me in the unit.

What do you all think about this?

Should I fight termination just to not have it on my record?

[SuesquatchRN, BSN, RN]

I think you should fight it for the sake of the inmates.

[XB9S, BSN, MSN, EdD, RN, APN]

I have never worked in corrections so I am not sure what is normal practice, but what you have described sounds horrible.

I can't offer any advice really just really sorry you have had to go through this

[kukukajoo, LPN]

I think you should fight it for the sake of the inmates.

Thanks. This keeps going through my head. I feel like the changes I saw that needed to happen are important, and still do even though I don't work there anymore. The treatment of psych pts is almost inhumane. Basic policies and procedures that I found out ARE in place at other facilities such as this need to be instituted to protect both inmates and the remaining nursing staff.

I mean, this cardiac & diabetic patient was given a sign that said "Nitro" to hold up if he needed it, that they would see it on camera...... Nitro kept in bubble with COs not with nurses. NO policy regarding when to admin nitro or how to, when to call 911, etc. No way to start a line prior to nitro in case the pt tanked. There were not even any policies regarding insulin or any precautions or supplies for hypo/hyperglycemia.

I just don't know where to start- the BON, Labor Board, Atty General?

Who regulates corrections nursing anyhow as they have never had a visit by anyone to check up on them.

[SuesquatchRN, BSN, RN]

I have no idea. I'd start with the NH board of health.

[aknurs]

Is this a state run facility or privately owned one?

[morte, LPN, LVN]

i would try your state rep/senator.....even if this is a contracted (private) facility, there should still be some state oversight

[kukukajoo, LPN]

Well I have to say that I have learned a lot in this whole situation. I will NEVER take a position I don't feel comfortable with and if I ever am somewhere that does not want to give me the tools and trainng I need to do my job, there is NO WAY I will take on the assignment.

[azguyrn]

I've worked in corrections for 8 years, ED nursing for 15 years. I think you really need to fight this. You should start with the grievance process with HR at the facility. You should also be able to contact the agency that oversees the facility (state or county) and discuss your concerns. You just don't want this to reflect on your practice as a new nurse. Good luck and stay strong.

[aknurs]

You should have a Policy& Procedure book somewhere in your Department. But then again every place is different. Also you should, have been oriented , as to what your job description is, where security comes in, yada yada yada. If your supervisor can't give you the answers you need, who is his/her supervisor? Although Security comes first in my facility, I have the power in my lowly night position:wink2:..to deem where inmates need to be sent in an emergency, whether it be a medical segregation cell, or to the nearby hospital....But I have a great supervisor, a P.A.(whom gives us a good protocol to go by,) & a great staff of Correctional Officers, that I work well with. Something is definately wrong at your place. If you like your job, you may have to go higher up, than your supervisor to get the answers you are looking for.....

[pogo]

I think that you should fight the termination for the sake of the inmates and your professional reputation.

Let me tell you, when I was a Correctional Nurse I would write up letters upon letters about the unsafe conditions that I saw !!!!

It did little good at that time of my employ but at least there was documentation to the facts.

The main issue with Correctional Nursing is litigation.

When I was about to resign there was an investigation of a death of a inmate.

Although, I was not directly involved with the incident, but my notes were under scrutiny and I must assume that my complaints were also noted.

For your situation, it depends on what effect you want to have (Sledgehammer or Behind-the Scenes Maverick).

You could present your case to the Medical Director of the institution. Or you could notify the State Health Surveyor.

Maybe you could even threaten the Medical Director that you will go to the Surveyor.

I know after the death, policies were changed and crash carts were purchased. It's a shame that it took a life being lost to come to that. Those Correctional Health Institutions seem to skate on thin ice.

Good Luck:twocents:

[kukukajoo, LPN]

Not so sure I want my job back but I do feel strongly that changes need to be made. These are not costly changes or necessarily even time consuming changes. BUT something should be done for the sake of the prisoners.

I just keep seeing that poor soul who had ripped all the skin off his nose and part of his face, being left in solitary with no meds for days and days.

I keep thinking about all the times I tried to get in touch with the director of nursing and was rebuffed and blown off, and how when I went up the chain of command, got rebuffed every step of the way.

I keep thinking that I know I am idealistic as a new grad, but gosh, how on earth could they expect me to accept those conditons and not want to make improvements if I could?

I will be seeking some answers this week and next before I decide which road to travel.