Quote from poopie
Hi everyone. I've worked in a local county jail for about one year now and I'm wondering how others deal with this type of situation. We have a new inmate who insists on many medical problems such as back pain, stomach problems, coughing up blood, etc.. and that he needs to go to the hospital immediately for untreated conditions. Apparently he's complained of the same for years and has some psyche issues. He insists he needs multiple tests and puts up a fuss every time he sees a nurse. He has even gone limp to the floor yelling and screaming that the officers hurt his back and he can't walk or get up. He has since been literally dragged back to his cell. Any ideas?? We can't just send him out for the full body scan he's probably looking for! Thanks.
After a while you will get to know the repeaters. I had one guy with a history of psuedo seizure and took depakote. He came from another jail and said " They stopped giving me my depakote 4 days ago because I was leaving soon and they didn't want to refill it". He was famous for faking seizures also. I ordered him moved to the rubber room which he hated but I advised this was for his saftey. I told him I would order his meds but they would not be in until the next day. So an hour later he goes into a full blown seizure, tonic clonic. He kept having seizures back to back. Following protocol, I gave him some valium to stop the seizure activity and sent him to ER for a Depakote level and evaluation. They brought his levels back up to therapeutic and sent him back to the jail. Well after that , when ever he didn't get his way he would say, " I'm gonna have a seizure right now", he would wait for the officers to lay a mat on the floor and would lay down and pull off the best fake I've ever seen. But, I knew his depakote levels were therapeutic and this was put on. So when he would threaten to have a seizure, I'd say "OK, go ahead, your mat is on the floor". And he would get really mad and call me all sorts of neat things. I had another inmate who was not very smart at all, and he kept denying any health problems, but his bunky insisted the guy was sick. I segregated him in r-cells and had him observed over night. He checked out good the next morning and begged to return to the block. That TV is a good motivator. He insisted he was just a little constipated and he had a dry bowel movement. He was provided the usual nursing advice for constipation.The doctor was coming in but the inmate said he didn't need to see the doctor, so I let him go back to the block. The next day there is a different crew working. They tell me this same guy's bunky is complaining the inmate is ill. So I pull the inmate out into the darkened hall and it was immediately obvious his abdomen was huge, I had seen him the day before and knew it was not that big. He still insisted he was not that sick.I took him up to the exam room and before we even reached the room I had already decided without further fuss he was going to the ER. As far as I was concerned, he had an acute abdomen. I was thinking maybe a bowel blockage or even a perforated bowel. He spent 2 weeks in the hospital, 10 of those days in ICU. He had a bowel blockage, a UTI and and got worse after he got there. The ER doctor found out this inmate had had numerous surgeries in the past due to bowel blockages but the inmate was not very forthcoming with the information. So, You never know. At my jail, they are either faking or definately dying. Sometimes the officers ask me why I spend any time assessing certain inmates, and I tell them " One out of 10 is telling the truth, You guess which one ". This population behaves and lives by different rules, they lack education and some of their fears are legitimate no matter how stupid it seems. You have to Scale your instructions way down to a 4th or 5th grade level. And yet not give away too much information. I have grown women come in and havent got a clue about normal female functions, basic female anatomy. They are hillbillies who have been raised on old wives tales and practice inbreading, or illegal aliens from Mexico who think a pimple is cancer because they don't get healthcare in their country and their uncle died from a pimple on his nose. Or so they thought. So, better safe than sorry. Make a real good assessment of the guy. Request his old medical records. If he checks out ok, put him on observation, and document his behavior. If he falls over and his face turns black, call 911 and get the AED. You don't have to treat symptoms that you can't find or test every inmate for every disease possible. One thing I tell them is "I am the nurse, I get to make the assessment, and I get to decide if you are having an emergency, and I get to make the decisions" . Just always be careful.