Mentoring

So something wonderful has happened at work.  We hired a couple new nurses.  For the purposes of this writing lets call them H and B.  They're both guys, they're both in their second career, and while I haven't asked their age I believe both are in their 40s.

Sound familiar?

First and foremost, it's wonderful having an almost fully staffed nursing service.  For too long now we've been short handed with people either out on long term sick leave, or recent transfers and retirees.  We're still missing one 'first' shift nurse as well as a third shift nurse... but neither of those positions really affect me (well, the third shift one does, but I'll talk about that and the end of this post).

Between me hiring in and these two new RNs, the prison has hired four other RNs.  All four of them came in with more experience than me.  One has worked in corrections for ten years or so (five at this very facility), one has worked in corrections for four years and been an RN for almost twenty.  One was still fairly new, but she had a years experience at this facility before leaving to have a baby.  The other one had no corrections experience, and in fact had no experience with nursing in America, but had worked as an RN for twenty or so years in eastern Europe.  But these two RNs... well their story matches up with mine a year ago.

By that I mean that they had careers before coming into nursing that didn't pay well enough.  They both decided to go into nursing and their first job is here at the prison.  And that lets me be something that I get a lot of satisfaction from... a mentor.

At first I didn't even realize that it was a role that I could play.  I mean lets face it... I only have a year's experience in both nursing and working at a correctional facility.  I just looked at them as new hires and tried to show them the ropes.  Nursing knowlege is one thing and I trusted them to know that, but every place a nurse works is going to be a little different.  When do you go to the doctor for help?  How do you document what you've done?  How do you tell people via your documenting what you believe (that this 'patient' is a fucking liar liar pants on fire), without putting something down that could be used in a court of law?  How do you deal with the bureaucracy?

But once they were both finished with their orientation, I got the chance to work with them on several occasions.  Just as various RNs were there for me... answering questions, guiding me on what to do and when to do it... I was there for them.

This past week I worked with H.  We were both in the south clinic and it was an overall 'easy' day.  A small handful of transfers, few call outs, and only a single urgent call.  As he was done with orientation and had been working on his own for a couple weeks I let H do his own thing, and only occasionally looked over his shoulder.  The only reason I felt that was necessary is that he works mainly in the north clinic and there are some distinct differences with how we operate.

At a particularly slow moment I started talking to him about how he handled a particularly troublesome transfer.  The main gist of this transfer is that he's been 'inside' for a long time and knows (or at least thinks he knows) how to manipulate the system into his favor.  For instance he doesn't like the wool blankets that the department of corrections issues inmates.  He also has a subtle ongoing skin 'condition'.   At previous facilities he's used the condition to get a medical detail that gives him a cotton blanket.  While the inmate was explaining to H why he needed the cotton blanket I was documenting on a previous transfer and listening in.  I could hear H pausing and looking into the computer and figured he could use a helping hand.  I slid over to the edge of my workstation so that I could see H.  The inmate was between us, looking at H.

Once I had H's eyes I turned my own eyes purposefully at the inmate, down to his wool blanket, then back up to H.  I then slowly and solemnly shook my head in the classic 'No' method.  H barely nodded his head at me and with far more confidence explained to the inmate that he didn't currently have a detail for that and that if he felt he needed one that he would need to request an appointment to discuss it.  They inmate tried to continue and agrue his point but with a slight smile and nod of my own H stopped him and continued on with the remainder of the transfer.

Later, when the inmate was sent on to his unit (with a wool blanket) H and I talked about it.  He explained that he was fairly sure that was the right course, but my simple shake of the head was exactly what he was looking for.  That's part of what I mean about being a mentor.  Just listening in and being there when a vote of confidence is needed.  We kept talking and I went off on some tangent on how I approach certain problematic inmates... ones that either have needs that go above and beyond the expected level of treatment, and ones that think they have those same needs but actually don't.  After going on for about five minutes I interupted myself and said something along the lines of "oh God, I'm just going on and on now.  Let me get out of the way and we can both get back to work."

H's response was "Oh don't worry, I'm learning more form this than I did through nursing school!"

That made my day.  In fact it made my whole week!  Through most of my jobs I've either moved up into management or at the very least been the 'Go To Guy' that could help everybody out.  I was even 'that guy' in nursing school.  I may not have gotten the best grades, but I best utilized the information and put it into practical use.  I then used that experience to help my fellow students.

And now it seems that I can do that again.

With B there hasn't been as acute as a realization... but it's still there.  There have been several occasions where we are both working, but not at the same location.  I've been either in the north clinic or five block while he's been holding down the fort in the south clinic.  When he's come upon something that he didn't know how to deal with though... he called me.  Understand, there are more experienced nurses that he could call for help, but he called ME.  There's also been several occasions where we were to work in the south clinic together but I've been called away to some other location.  So now when we are to work together he'll ask me if I'm actually going to be there.  I'll tell him that yes, I'll be there but even if I did get called away that there is another nurse there for a few hours that can help him out.  He'd just laugh and say that it isn't the same thing.

Again, not as obvious, but he does look forward to working with me.

Both H and B have what it takes to be a good correctional nurse.  It will just take time for them to gain firsthand knowledge and experience.  And along the way I'll be there to not only help them out, but be there to offer my own reasoning.

There's another nurse that I'm kind of helping out too.  We recently had one of our three supervisors retire.  They opened up the position and one RN that had been working at the facility for years and years got it.   Shes incredibly knowledgeable not only about nursing in general but in correctional nursing and all the bureaucracy involved at our particular facility.  Even with all that knowledge though, she's never been in a supervisory or management position before.

On two occasions I've helped her out.  In one she had to discipline me for an error.  It was only a paperwork error in which no one got hurt, but it's an important paperwork error.  She seemed nervous and anxious as she described what I had done wrong and that she had to put me on a kind of probation for six months.  I did what comes naturally to me... I helped her out.  I explained that I was appreciate that my supervisors monitored my work and not only encouraged me to be better but would also be there to point out when I've done something wrong.  And not only point it out, but go through the motions of discipling me which, in my eye, will help me focus on not making the same mistake (or similar mistakes) ever again.

She was visibly relieved.  It seems that while I made the initial error, five other nurses had followed my mistake and not corrected it.  They all were getting the same discipline.  And all of them were howling mad at her for doing this.

The other occasion was far less formal.  I was working in five block and she had to come in and do a management count.  More or less it's looking over work that's been done there and confirm that all the nurses have been doing their job correctly.  I told her that I had no problem with her getting her job done and that instead of her staying out of my way (which is how she started working) that I would stay out of HER way.  We chatted as we both worked at our respective tasks and I told her how I had been a supervisor/manager in several jobs before and how there is always a distinct difference between being 'one of the guys' and 'one of the bosses'.  How some people could accept that difference and know that outside of work there is no change in relationship, while other people will now always look at her as 'the enemy'.

I mentioned that eventually I'd like to get into the management/supervisory position but felt that I needed far more experience before I even looked at open positions and she responded by saying that if I had thrown my hat in the ring for the job she currently holds, that I would have had as good a chance as anybody else in getting in.  In face, my previous supervisory experience would far outweigh my lack of direct nursing experience.  The more I think about it, the more that makes sense... her job, more or less, is supervisory.  She will only rarely get her 'hands dirty' and do actual nursing work now.  In fact, the nurse supervisor that retired had NO hands on nursing experience before he got that job.

That's something to consider in the future.  Maybe I can 'move up the chain' faster than I originally thought.



So I mentioned above that the third shift nurses position doesn't really affect me.  Well... this past weekend it DID affect me.  To be fully staffed we have to have three third shift nurses.  The minimal staffing on any night is a single nurse for the entire facility.  But realistically with our facility's size, we should have one on the north side and one on the south side.   Since I've started we've had two mainstay third shift nurses.  A few months ago another nurse moved into that position.  That nurse is now moving back into 'first' shift and they're in the process of hiring and training a new third shift nurse.

Well last Saturday found me working in five block.  It's not my favorite place to work, but I can get through the day without issue.   About two hours into the shift I was contacted and told to call one of our supervisors.  She was incredibly stressed and practically begging for forgiveness as she told me I was being mandated to cover the third shift that night.   The RN scheduled that night had called off and she had contacted everybody else with no help.... as I was on site (and couldn't exactly dodge her call) I was the only RN she could make stay.  Technically there were two other RNs on staff that day but one was a contract nurse whom she couldn't make stay, while the other one was on a 12 hour shift.  Our union rules say that they can't force an RN to work more than 16 hours in a row outside of an emergency.  So while technically I had more seniority than this RN, I could cover the entire shift while he could only cover the first four hours.  Since the supervisor couldn't find anybody to cover the shift, let alone a four hour block between 2 am and 6 am, I was the only choice.

I was mandated.

Now I fully accept that getting mandated occasionally is part of the job.  I've called off sick before and know that the result of that may very well be an RN getting mandated to cover my shift.  Fair's fair.  But man that made for a rough weekend.   Thank GOD it was the weekend and I was in five block.

The first thing to make it rough was the fact that I had only got about three hours of sleep the night before.  That's not a problem as I can work quite effectively on three hours sleep.  That is I can work effectively for eight or so hours.  Not sixteen hours.  So merely staying awake was going to be a challenge.  The second thing to make it rough was the fact that I've never worked overnight before.  I haven't even been orientated on that shift.  So a whole host of questions came up... what keys do I need to have?  What counts do I need to do?  What meds need to get passed?  What radio do I use?  What tasks cannot be passed over?  Sadly the supervisor was really no help in answering many of these questions as she hadn't worked overnight for years.  She did say that I'm mainly there in case of emergencies and that beyond any required tasks, I didn't have to do anything.  Counts were not necessary (but appreciated if I could get to them), filing away health care requests (kites... yes they're actually called kites) was not necessary (but appreciated if I could get to them).  Restraint checks (checking on inmates that were in restraints for proper fit and skin damage) WAS required every four hours... but the lieutenant on staff would contact me when she did them and I could simply follow along.

So I got through the night.  I did have to take several walks just to keep my eyelids open, but I never fell asleep.

The next thing to make it rough was the fact that I had to work the next day.  After getting out and driving home I would have about four hours to sleep.  That would allow me just enough time to wake up, shit/shower/shave, and head back into work.  I said earlier that I could work just fine off of three hours of sleep... but that's a singular phenomenon.  Two days in a row?  Umm.... no.  Not really.

I was dead dog tired on my Sunday shift.  My mind was slow to start and not all that effective once I got it going.  That's why I was actually grateful for being in five block.  Five block doesn't have any call outs on the weekend and only rarely has actual urgent or emergency scenarios.  For the most part, working in five block is more like working in a med room.  Get the meds set, do the diabetics (there are three in five block), pass the meds, clean up after the med pass.

At one point my gas tank ran to empty.  I couldn't for the life of me keep my eyes open.  I actually stood up and tried walking around the med room (the med room is only 7 feet by 8 feet), and I almost fell asleep WHILE walking.  So I did what I needed to do.  I sat down at the computer, positioned the med cart between me and the door and nodded off.  Technically I can get in trouble for literally sleeping on the job.  So I had a screen up on the computer that I could say I was studying (hence me sitting there quietly).  With the med cart in place no one could see me without actually opening the door and walking in... that noise itself should be enough to wake me up and ensure that they wouldn't actually see me with my eyes closed.

Technically I should have called my supervisor and told them that I was unfit to cover my shift.  But just how lame is that... I'd be calling off tired.  I'm sure they would understand... they had after all just forced me to work overnight.  But my ego just couldn't take it.  Plus my ego was so sleep deprived that I'm not sure I gave it proper consideration.  I had to sleep, therefore I slept.  As it turned out I woke up about an hour later... just in time to finish my shift without issue.  So long as I wasn't snoring loudly, I doubt that anybody even realized what was going on.

I should also add that even though I was sleeping in a prison, I did so in as safe a way as possible.  The med room is directly across the lobby from the officers station.  Five block, being what it is, has a lot of officers on duty at any given time and at least one is required to be at the officers station at all times.  No inmate is allowed to approach the med room without an officer, let alone open the door.  If such a thing were to happen the officer would immediately step in to either encourage the inmate to step back from the door or force the inmate away from the door.  With one shouted word the officer would both wake me up AND call all the other officers (I believe there were five on duty that day) to the scene.

So was I taking a risk?  Yes. Was it a minimal risk?  Yes.

I don't think I'll share what I did with the new nurses.