This is a very complex situation. This man likely has a case for neglect but an attorny will likely not take it - due to the man's hx. He just isn't a reliable plaintiff or witness.
Even if the man was not a prisoner, he could have a shower "forced" on him in the interest of health and safety, even without a psych consult. Healthcare workers "force" things like this all the time - when people come in the hospital or are in LTC facilities, we help them bathe. Even when some LOL is screaming her head off that she doesn't want her diaper changed, we still do it because we understand that the woman has poor judgement and is unable to make appropriate decisions and leaving her in a wet or dirty diaper would be harmful to her. Then you have issues of apparent consent. Even if consent is not expressly given, the persons actions may indicate the apparent consent, because their behavior indicated that they were going along with what was happening. Either way, if the man was deemed to be mentally ill, a "forced" shower would have been appropriate. If the man was AOx3, a "forced" shower could have been appropropriate either by his behavior that allowed the shower or by the fact that he could be endangering others. I don't agree however in the C.O.s hosing the guy down. The motive is ok but the method is not.
This man is in tight quarters with many other people. It would be a health and safety issue to allow him to remain filthy with sores,etc. Not just for himself but for the other people. MRSA and other infections can spread rampantly throughout close quarters such as prison. A person who is covered in urine, feces, and has open wounds that can be harboring infection is a safety concern of not only other inmates but of the C.O.s and staff in that facility.
There is a fine line between violating someone's civil rights and protecting others in this type of case. It would probably be much different if the man was in his own home vs being incarcerated. But many free world rules do not apply when someone is in prison.
In a perfect world, there would be a P&P book for everything. But hospitals are bad about not having good P&Ps and a prison is probably worse. The prison should probably write a policy regarding this for future use, since it has come up once.
should have P&P written regarding staff discipline and termination. Tirzo13 is correct that lots of employees do not get due process in these matters - that doesn't make it right. Just because an employee does not sue an employer for workplace violations does not mean that the employer should get away with terminating someone without cause, even though many employers reserve that right, especially in right to work states. My guess would be that the RN will get fired because to an outside observer, it looks like she is the bad guy here. And this would help to satisfy any family, advocate/ombudsmen that wanted to complain about the man's treatment. Termination is always the easy way out for an employer because an employer can be held liable for their employees actions. I still am more concerned about the fact that this man obviously has mental health issues and now physical issues that the doctor is not addressing them. I understand that there are many inmates who abuse the system but I really don't think this is the case here. I am also concerned that the staff are following doctors orders to NOT give basic hygiene to the man. If someone went to the trouble to put on a condom cath, then obviously there are issues of medical need here and the staff have a duty to the pt to provide care, regardless of the Med. Dir. orders. In this case, the Med. Dir. is wrong and a nurse that does not provide needed care is WRONG! In the free world, this doc would be looking at negligence charges, as well as any staff who followed his orders. Just because a doc writes an order, that does not mean that a nurse is covered when the nurse knows that the order is wrong. In addition, I am wondering why security and procedure is so lax that the CMA came to work on her day off so that she could play with her buddies at work. This is totally inappropriate and if I were the manager, we would be starting with verbal counseling, working up the ladder to termination. This is inappropriate in any work situation but even more so in a secure prison setting.
If they are looking to fire the RN, there probably isn't much she can do unless she is willing to put up a heck of a fight. And unless this is a private prison vs a state run, most states have limits about lawsuits against the government. Sounds like there are a lot of issues at this place, as there are in most prisons unfortunately, but they will use her as the scape goat because what she did seems more out in the open than the real issues of poor medical care.