I recently, in the last 4 months, started working in the local jail infirmary as a nurse. My previous experience as a nurse has been mostly hospital but recently some nursing home experiences. Nursing is a rewarding but sometimes thankless and stressful profession. In the hospital, nursing is all about Care planning, coordination of care with doctors, ancillary services and families of the patient and doing all of that around your charting, pain management, basic waitressing, We generally address each and every problem a patient has whether or not that is the reason they came to the hospital or not. If they come to the hospital with a GI bleed we have to also address their chronic diseases and anything new that comes up up to and including nail fungus.
A nurse in the acute care setting (hospital) generally will juggle 5-6 patients in any one shift if they are a floor nurse, maybe 4 if they are a PCU nurse and 1 or 2 patients if they are an ICU nurse. Sometimes it is a 1:1 nurse to patient in cases like Recovery room and fresh open heart patients. It’s all about being nice, showing compassion and being competent to care for your patients. Meaning, know about their disease condition so you know how to care for them and what their unique needs may be- I’ve come across some ones I have never heard of and have had to educate myself with Doctor Google (that is using reputable websites, journals with detailed information regarding such diseases or a textbook that is almost certainly laying around the unit.)
Everything happens NOW. Emergencies come first whether it be on the floor or in the emergency room. The more in life threatening your condition the higher up on the priority list you go. That is why frequently there are long waits in emergency rooms because of actual emergencies that come in and take priority over someone coming in for a sinus infection.
It can be a dirty job, working with bodily fluids and waste products, seeing things you may not see anywhere else.
I’ve always felt safe in the hospital environment. In reality I am probably less safe working in a hospital environment than in the corrections environment. You hear all the time about how this doctor was shot or this nurse was chased by a wild patient with an IV pole.
Corrections nursing is all about maintaining. Maintaining the disease states that the inmate comes in with. When an arrested person comes in to the booking area they will be screened by a Nurse for suicidal ideation, perform a history and physical, interview them for drug and alcohol use, and decide if they need to be admitted to infirmary. Often we will see patients who are users of opiates, crack, cocaine, heroin (which is an opiate) Meth, and Alcohol. These people get a direct admission to the infirmary for detox protocol. Withdrawal is not a pretty picture, with sweats, chills, elevated heart rate, fevers, nausea and vomiting and these folks need to be monitored closely and treated appropriately. If they state or appear like they may be thinking about suicide we admit them for watch.
I have found that this job is an exercise in compassion for me. I was shocked by the amount of compassion I felt for these people. These people who do bad things or stupid things, addicted to drugs etc. I feel so much compassion for these people! So much so that I have to dial it back with wanting to help them as soon as humanly possible. Meaning see the doctor asap, give them something to stop the pain, etc. I found out the hard way with many tears that it’s not the way it works. We screen them, get their history, decide where they need to go (either infirmary or out to General population – the Sheriffs department takes care of GP placement) and add them to the list for the provider the next day. Everything is not so NOW, so to speak.
We also see more than our fair share of the mentally ill. It’s connected a lot of the time. Sometimes this is the only time these folks get the meds they need for one reason or another due to lack of insurance or lack of want to take the medications.
Believe it or not it is generally safer to work in the jail than in a hospital environment. People cannot come and go as they please. There are no family members coming into the infirmary. We rarely get calls from Family members and even if we did, we cannot confirm nor deny that their loved one is there for privacy reasons. We take the information they give us and direct it to the correct person or persons. We are ALWAYS with the CO’s or Corrections Officers when ever we attend to a patient. Things are tightly controlled. There are secure doors and “air lock” type in parts. You are very safe. But that is not to say you shouldn’t always be aware of your surroundings.
If you are considering Correctional nursing it’s a good choice and different than working in the hospital.
