Would like your help

Reigen · Oct 3, 2006

I'm soliciting your input in order to highlight this field:

1. Why do nurses leave corrections? Have you?

2. What should be taught?

I left correctional nursing for several reasons... first was the fact that I had to drive over 90 miles one way to get to the facillity and then do the return drive home after each shift. Since there were several nurses who made a drive of at least 90 miles, we tried to get a "home away from home" so that the nursing staff could have a place to stay after a 12 hour shift. This was not approved for the nursing staff, we were told that having this living arrangement would make us more likely to be contacted by inmates, and that our security would be at risk. The department of corrections could not approve us getting a place for staff to live at during our work times. We did not ask DOC to pay for this palce, only to allow staff to make sure that we could have a place so that we didn't have a 3 hour round trip drive with a 12 hour shift in between. After 2 years of making this drive and not seeing my family, I felt I needed to try to get employment closer to to my primary home.

The second reason for leaving was no raises for any medical staff after a year. This was a private run prision, yet we saw that the correctional officers were given a raise; "across the board/cost of living" while none of us in the medical department was even given a cost of living raise. I could and do make more money working for the temporry agency that staffs the prision, for me this was a $13.00 per hour raise in pay.

The third reason I left was the rotation in "charge nurses". Each day it could be a different nurse, no consistancy in charge, making each day uncertain of where we would be assigned to work, IE clinci, segreation, med line ect.. Some days the LPNs would make the nurse's assignments, while policy clearly stated RNs only were to do this. The inconsistancy of charge and assignments clearly left the medical/nursing staff open to breaches in security.

I would love to return to working in corrections, however the same drive time of at least one hour each way exsits. The supervision would need to be clearly a nurse with at least 5 years in correctional nursing and a RN not an LPN.

What should be taught-- I would have benefitted from having a clear idea of what a medical correctional officers duties were. Sometimes I was given a different list than what the officer the day before had. Again not having the knowledge of what their duties are/were placed the nursing staff in a posistion of not being able to provide the best care.

Learning more of the subtle ways an inmate tries to manipulate nursing staff, and how to to put a stop to this would have been of help.

How security makes arrangements when an inmate needs to leave the correctional facillity in order to go to and "outside" medical appointment and what is needed for security.

Documentation-- it seems that a few times a year the state would require a different kind of charting and/or the chart in a different order... no inservice was ever given on how to put a chart together in the correct order. More inservices on nursing items special to correctional nursing would have been of help, these couldhave been on simple how to chart/document to inservices on the stockholm syndrome... any inservice that would have made us better correctional nurses, would have been beneficial I think.

Thank you for the opportunity to participate in your survey...

Reigen

gw6 · Oct 3, 2006

Does it matter which system you are talking about? I stil work in the satae prison system in CA

karbyr · Oct 6, 2006

psych, psych, psych

I see so many psych patients that are either undiagnosed or underdiagnosed in the system.....plus, psych training helps deal with the manipulativeness of the inmates.

karbyr · Oct 6, 2006

another thought would be beefing up on the assertiveness training and the advocacy position of nurses. I see soooooo many nurses who act like co's and don't seem to understand that their licenses can be in jeapordy because they are NOT c.o's.

gw6 · Oct 6, 2006

In the state system (CA), all contact with psych IMs are made with psych pesonal. If an IM presents to a nurse with issues that are emergent in nature, the nurse makes a urgent referal to the psych MD.

gw6 · Oct 6, 2006

The aspect of a nurse acting like a CO is blunted by the protocols that govern inmate contact. If the inmate states his back hurts, there is an encounter form to follow, likewise if he has a cough...If there is a question that you cant deal with or there is no protocol for it, refer to the MD. We are medical, they are custody. I dont tell them how to do their job and they dont tell me how to do mine.

nomadicV · Oct 7, 2006

Any correctional system: jails, prisons, detention etc

nomadicV · Oct 9, 2006

You guys have been great. My thoughts were that the most prevalent concerns were

1. Security

2. Medical vs Correctional

3. Correctional training and

4. Personality conflicts

I see that I wasn't too far off target. Outside of Federal Bureau of Prisons training, NCCHC (and the pending ACA) certification; correctional training is largely OJT.

Mudwoman · Oct 10, 2006

We have lots of turnover.

#1 reason is lack of PRN nurses available to cover when we need off for illness or vacation. We are constantly having to change schedules to cover. What good does it do me to get a vacation if I have to work someone else's schedule to get it?

#2 reason is the correction officers that play us against the prisoners for their own power trip.

#3 reason is the psychotics that are there for lack of any other place to put them. The correctional system has become the solution for the mentally ill.

#4 reason is that it gets old putting up with some of the stuff you have to put up with from the prisoners.

#5 reason is lack of support and appreciation from management.

#6 reason is the doctors. Called Dr the other day for prisoner with gout and lower leg edema with leg warm to touch and fever of 101.5. He asked me "so, what do you want me to do about it?" That gets old and it happens all the time.

nomadicV · Nov 11, 2006

Great response. I'd had some of the same issues. I'd worked County and then Federal and by far; Federal is better, the docs there don't dare get flippant when it comes to responding to a call from staff: there is too much oversight. However, things do happen that place nurses in vulnerable situations.

Regarding CO's power plays: Sadly professionalism can be taught but internalizing the instruction is up to the individuals. More than once I'd have to say the IM are there AS punishment, not to BE punished.

I think that anyone that's spent any amount of time working behind the fence as a medical provider will agree with you that many mental patients are being warehoused, especially since the closure of government psych hospitals (which are inching back into existance)