Thoughts on First Week

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Specializes in Emergency, Corrections, Adv Practice.

I have been working as an RN in the emergency department of a level 1 trauma center for 2 years. I started a new job at a max security prison in the clinic this week and would like to share some of my thoughts on it.

1) I'm really surprised by how polite/professional all of the inmates have been. I deal with more attitude in 2 hours in the emergency department than I have in a week in the prison. I have not yet dealt with any manipulative behavior, but am sure it will come. I've just tried to be nice without being too nice. I'm trying not to be too naive or trusting, but when I find out what some of the inmates have done I'm usually really surprised because they're so polite. I don't feel scared of them and I'm wondering if thats a bad thing or a good thing

2) I don't think I'll ever get used to going to seg. It's obnoxious and a little scary. The nurse I was training with would actually respond to the comments inmates would yell at her from seg. I feel like its probably best to just ignore it.

3) We do "insulin line" where the inmates come in 1 by 1 and you draw up their insulin and let them check their blood sugars and give themselves insulin. I feel like its a med error waiting to happen- giving the wrong amount or type of insulin or reading the wrong person's order. Is this how most prisons do it? I'm used to a hospital setting where you can't even give insulin without having a second nurse check your order.

4) There is not as much physical security presence as I expected. Officers come and go from the clinic, but are only constantly there during insulin line. Is this normal?

5) My husband is being a complete jerk about me working there. He gave me his blessing before I took the job, but now can't get over it. I think maybe he though I would spend a day there and hate it. I love my new job and am so frustrated he can't share my happiness.

6) I was not all that impressed with some of the nurses there and don't feel like I'll necessarily be "accepted" by them. I'm one of the only RNs working there and one of the more experienced there as well. I'm not sure why, but I feel that they don't like me. As this is only a PRN job, I really don't care. A couple of the nurses were downright nasty to the patients and others were waaaay overly friendly

7) Overall, I think I will really enjoy it and can make a difference there, I just need to get the hang of it. Thanks for listening to my thoughts!

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This is an excellent synopsis of some of the questions I have after exploring prison nursing. I agree on the insulin administration. It would be interesting to know what other facilities do to reduce errors. Are the prisons monitored by the same agencies as clinics and hospitals?

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Specializes in Occupational health, Corrections, PACU.

Kansas,

Excellent observations and well written. Everyone will have their opinion, but let's see if I can answer a few.

Re: insulin line, yes that is how it is done. You must be very careful, check and double check, because it is only you. However it is done thousands of times a day with just one nurse throughout the U.S. I never saw an insulin dose-related incident while working in corrections. However, I had my doubts about some of the reports from the inmates about feeling bad after insulin, etc. and the method of injection by the nurse. I saw many poor nursing skills in corrections by nurses who had nothing but contempt for inmates. I would watch them jab the needles straight in and sometimes I was certain that it was being given IM, but no one seemed to care, and I was "just agency". However, it was my experience that the inmates would watch you very closely and they would catch any mistakes before you could make them. It helps to identify one of the bottles by always making sure there is a recognizable difference. For instance, I always put a rubber band around the 70/30 bottle. You will do just fine, you just always have to be alert and precise.

Tell your husband that it is safer on a bad day than the ER is on a regular day. No tripped out, coked-up junkies breaking restraints and taking a swing at you. Bad boys come in, in full leg irons and cuffs. Or at least cuffs, and escorted. For the rest, there should always be a c/o within easy reach.

Seg is always weird, but you will habituate to it. If it doesn't feel weird, then I would worry.

Re: security-there was always a c/o presence at the clinic entrance, making sure that the inmates either had an appointment or a real reason for being there. They would not let just anyone walk in. Your situation may vary, are you behind glass, or is the desk open? I have to leave this to other posters for their opinion and experience.

Re: #6 Well...as I mentioned, I saw some really BAD nursing while I was working in corrections. I found that the bad nurses really don't like a good nurse, especially one that has more education and real skills to come in and make them look bad (which is easy to do, sometimes just by doing your job). The good nurses will applaud and welcome you. Get used to seeing inmates treated like dirt by some of the other nurses and staff. It goes with the territory, so all you can do is be professional.

Re: not feeling scared...I did not feel scared in all the units I worked in. I only had an inmate act as if she would hit me once, and the c/o quickly put her in her place. I dealt mostly with men though, and felt comfortable. You are right, some seem like SUCH nice guys, but we are seeing them drug-free and without the problems they had in the free world. Beware though, because it will shock you when that first really nice guy that you learn to "like" tries to steal a syringe, or something else. They will try to manipulate you, and at first you won't even know you are being played...but it is all part of the process.

Enjoy your job! You like it, and it seems good fit.

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I have been working in a state prison for just under a year and I really enjoy it (most days, anyway). I too was surprised at how pleasant the inmates are, especially after finding out what they were in for!

I had been working in an ED with no security at the door, which to me is just a disaster waiting to happen, so I agree that the prison environment is very safe.

Working in seg was a bit intimidating at first and I would hear all kinds af nasty comments coming out of the walls but I just ignored them and after a while I was just part of the furniture, so to speak.

For some reason, corrections seem to attract a type of nurse who may not find employment elsewhere (no offense to good nurses!), I think because the general population imagine it to be an awful place to work, so they are always short-staffed and must take nurses they wouldn't normally hire.

Personally I wish I had discovered it years ago! In my work place I have seen many nurses come and go in the short time I have been there. Alas our good ones go because they get sick of being mandated every week, or putting up with the nonsense from the bad nurses. I think many staff would be happier if there were 12 hour shifts, too.

I have seen nurses fired for stealing narcs, bringing in contraband, and having liasons with inmates. It astounds me every time how someone could be that foolish.

Probably the hardest thing for me to get used to is how long everything takes - getting an appointment to see the provider, requests for things such as special shoes, or non-formulary meds to be approved, etc.

What I love the most is being able to do my job in a professional and courteous manner but not have to "suck up" to get good press ganey scores, which is all that hospitals seem concerned about these days. I recall so many instances in the ED where patients would be hurling abuse at me and I'm expected to smile and ask how I could make their day better! If an inmate has a hissy fit he gets hauled off to seg :D

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I enjoyed this post. I found it to be very helpful. I am a new RN and would like to work as a CF nurse in California. Half way through the nursing program I decided that this is what I wanted to do. I have a few questions that I'm hoping someone can answer.

1. I would like to know how much training a new grad would receive. Would they just leave me on my own immediately? If so, I would not feel comfortable with this.

2. Do the California prisons not have 12 hour shifts? Are they 8 hours and four days/week? (I'm not sure if there are any Californian's here). The prison that I would like to work at is in the middle of nowhere.

3. Would the nurses eat a new grad alive? Even if they do, I still want to work there. What would be the most professional way to handle this as a new grad and new employee? :D

Thanks!

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Specializes in corrections.

NewGradRN I had orientation on all shifts (as i was per diem) and it took about 6 weeks. No one ate me alive lol and I was a new nurse, there is some drama but I assume it happens wherever women work together. We work 8hr shifts. I really enjoy my job is not as crazy as the hospital (i have time to eat lunch and pee lol, sometimes it gets hectic but usually it's manageable)

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bymysoultosqueezrn - that's great to hear! 6 weeks would make for a great training period. i also love how you have time to pee - hehe. in our clinical rotations at school, it seemed that i never had time to pee or eat. i'm looking for something that is manageable yet challenging. i hope to learn a lot on the job. i submit my resume to 4 different california prisons. i haven't heard anything yet. it has been 4 days. i sort of have my heart set on corrections but should probably be applying elsewhere as well. how long did it take before you heard something after applying?

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Specializes in corrections.
bymysoultosqueezrn - that's great to hear! 6 weeks would make for a great training period. i also love how you have time to pee - hehe. in our clinical rotations at school, it seemed that i never had time to pee or eat. i'm looking for something that is manageable yet challenging. i hope to learn a lot on the job. i submit my resume to 4 different california prisons. i haven't heard anything yet. it has been 4 days. i sort of have my heart set on corrections but should probably be applying elsewhere as well. how long did it take before you heard something after applying?

it takes a long time to hear back from them (at least here in nj) i didnt even remember applying lol i got an interview in august and didnt start working until nov 2nd but the clearance process takes a while. i hope i dont discourage you, its worth the wait, i really like my job and yes you can learn a lot in a slower pace. and you cant beat all the pba cards you get from the officers hehe hello getting out of jail card ;);)

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I'm going to call the prison today to request a tour of the facility. I'm hoping that by meeting some of the nurses, they may put in a good word for me! What should I wear when I show up for the tour? A pant suit? In this situation, I'm not sure what would be most appropriate. I want to make the best impression possible. Also, should I ask questions or save them for a possible interview?

Thanks!!:D

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Specializes in Occupational health, Corrections, PACU.

Oh my....LOL...

Unless your state is VASTLY different than ours, you cannot just "call up and request a tour of the facility".

These are facilities with murderers and violent gang members, not to mention the other large group that are

sexual offenders/child molesters. You have to go through a stringent background check before they will

let you in, which is done post-offer. People cannot simply "drop in" for a visit. And when you do go in for an

interview, you will need to leave your purse, cell phone and most other things in the car (sorry, I do not know if you are male or female). And you will receive a pat-down search before entering. At our prisons, even permanent medical staff and all correctional officers are patted down and searched after going through a metal detector, each and every morning when reporting to work. It is part of the routine.

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Specializes in corrections.
Oh my....LOL...

Unless your state is VASTLY different than ours, you cannot just "call up and request a tour of the facility".

These are facilities with murderers and violent gang members, not to mention the other large group that are

sexual offenders/child molesters. You have to go through a stringent background check before they will

let you in, which is done post-offer. People cannot simply "drop in" for a visit. And when you do go in for an

interview, you will need to leave your purse, cell phone and most other things in the car (sorry, I do not know if you are male or female). And you will receive a pat-down search before entering. At our prisons, even permanent medical staff and all correctional officers are patted down and searched after going through a metal detector, each and every morning when reporting to work. It is part of the routine.

yea you cant just get a tour. you will probably get only to your place of interview, if you get one. wear nothing revealing, pant suit is fine. dont wear any metal because you wont clear the metal detector machine.

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Oh my....LOL...

Unless your state is VASTLY different than ours, you cannot just "call up and request a tour of the facility".

These are facilities with murderers and violent gang members, not to mention the other large group that are

sexual offenders/child molesters. You have to go through a stringent background check before they will

let you in, which is done post-offer. People cannot simply "drop in" for a visit. And when you do go in for an

interview, you will need to leave your purse, cell phone and most other things in the car (sorry, I do not know if you are male or female). And you will receive a pat-down search before entering. At our prisons, even permanent medical staff and all correctional officers are patted down and searched after going through a metal detector, each and every morning when reporting to work. It is part of the routine.

LOL...yes, your state must be VERY different. I've had two of the prison guards urge me to take a tour first. One is a family friend and has worked there for years. He said they have nurses who take tours there at least once per week. Most of them do not end up applying. I already spoke with the prison and they said I could take a tour but need to call the PIO to make an appointment. He was not in at the time. That's too bad your state does not allow tours for nurses. I think it's a good idea for a nurse to be able to tour a prison first before applying or accepting a job offer.

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