Clinicians, codes and coffee – a Night in the Life of a first watch Registered Nurse

California Medical Facility Registered Nurse Joselito Pascasio is one of many who work overnight to keep the prisons running with the rest of the world sleeps.

California Medical Facility Registered Nurse Joselito Pascasio is one of many who work overnight to keep the prisons running while the rest of the world sleeps.

By Dana Simas, CDCR Public Information Officer

It’s 10 p.m. at California Medical Facility (CMF) and there’s a stark contrast to the busy and bustling day hours when staff, visitors and other guests shuffle in and out of every part of the prison.

As those who work the second and third watch shifts go home to their beds, many California Department of Corrections and Rehabilitation (CDCR) staff are just beginning their work day.

Operating prisons is a 24-hour, 365-day a year job and at any given part of the day, there is chance something could go wrong.

First Watch begins at 10 p.m. and ends at 6 a.m. Even though activity is minimal during these hours, CDCR staff have to be ready for anything.

CMF Registered Nurse (RN) Joselito Pascasio is on the job ready to handle whatever comes his way.

Pascasio has worked First Watch for approximately five years and currently works in CMF’s B-1 Clinic which is shared with the emergency room, just one of several operating medical care units at CMF.

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The medical staff must work closely with the correctional staff to process inmates in and out of the clinic.

If all is quiet and routine, Pascasio and the other nurses in the unit pull inmates’ electronic health records to prepare the next day’s medication distribution.

This includes preparing for more than 100 insulin tests for inmates first thing in the morning and hundreds of individual medication needs.

It’s now 11:30 p.m. and the coffee aroma is becoming ever more present, a staple for those who pull the graveyard shift.

“Sometimes we get tired, but we work together as a team and everyone works to get the job done,” Pascasio said of working overnight hours.

Pascasio receives news an inmate has been discharged from an outside area hospital after receiving routine treatment and is headed back to the institution. Pascasio notifies the on-call doctor and starts preparing all of the necessary medical paperwork.

Once the inmate arrives, he is transported via wheelchair by CDCR custody staff to Pascasio’s unit for evaluation and intake.

The inmate is clearly agitated by the late night hospital discharge and says he just “wants to go to sleep,” but custody and medical staff work together to keep the inmate calm and to process him as quickly as possible.

 Registered Nurse Joselito Pascasio helps prepare medical records and tests for the following shift.


Registered Nurse Joselito Pascasio helps prepare medical records and tests for the following shift.

Once the team is able to process the inmate’s return, he is taken to his cell by custody staff.

As the night rolls on, the coffee continues to brew. Pascasio and his team resume preparing the next day’s inmate medications.

An infinite number of scenarios can happen at any moment inside a correctional facility and medical staff must be just as alert and responsive as CDCR’s custody staff.

Pascasio, and other medical staff, can be required to respond to a housing unit or yard to perform life-saving measures, if an in-cell fight occurs and one, or both, inmates sustain injuries they may be transported to CMF’s emergency room for treatment.

While RNs cannot prescribe medication to inmates, Pascasio says he always checks on inmates who call to be seen by a doctor or other medical staff, even if just to listen.

Processing inmates in and out of the B-1 Clinic requires cooperation between medical and CDCR custody staff. When asked about the most difficult part of his job, Pascasio said it is the unpredictable, and sometimes violent, outbursts by inmates.

“(Custody and medical staff) have to move together to get through difficult situations,” Pascasio said. “Mostly, everything is good.”

As the end of First Watch comes around at 6 a.m., the prison is already alive with movement. This time also tends to be one of the busiest for Pascasio and his crew.

If the night was quiet, Pascasio is confident the next day’s team is set up for success. If it was an eventful night, Pascasio will often stay to make sure the team is prepared.

It’s a tough job, and these are tough hours, but many are appreciative of staff like Pascasio, and the hundreds of other CDCR and medical staff who work the graveyard shift. They keep the prisons going when the sun goes down.

If you would like to nominate a CDCR employee who works First Watch to be highlighted in the “A Night in the Life” series, contact Dana Simas, Public Information Officer II, at (916) 445-4950 or dana.simas@cdcr.ca.gov.

The medical staff must be prepared for anything. Nights can range from quiet to busy. By 6 a.m., the facility becomes alive with activity once again.

The medical staff must be prepared for anything. Nights can range from quiet to busy. By 6 a.m., the facility becomes alive with activity once again.

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2 Responses

  1. J. Bargstadt, Sergeant Thursday, May 11, 2017 / 1:23 am

    Awesome work RN Pascasio! I had the pleasure to work with him at CHCF before he transferred to CMF. He always made sure custody staff was aware of what was going on in the institutions Standby Emergency Medical Services Dept. We definitely had some good times and lots of laughs. Glad to see they did an article on such a great nurse (other than my wife which is a correctional nurse. lol)

  2. J. Herrera Monday, September 15, 2014 / 1:19 am

    Well said! Not enough credit is given to those who maintain the grueling hours of first watch.

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