Protocols on Medication Administration

[EASTCOASTRN]

What a great forum to discuss important issues surrounding correctional nursing - thanks for the opportunity. As background, I got started in a juvenile correctional facility doing pyshciatric nursing (group therapy) about 6 years ago. I have worked in other places along the way and am now doing some consulting.

I was hoping some of you on this board might be able to comment on policies at your facilities regarding medication administration to inmates going to court. We had an incident where a prisoner was not given asthma medication at court when he asked for it, and we realized we didn't have a good policy regarding this in place. Any thoughts? (To note, this prisoner wasn' in our custody at any point... he had yet to be processed or whatever downtown... so we didn't have anything to do with this... but we want to make sure we create protocols because this has become a big issue).

Thanks

[Orca, ADN, ASN, RN]

Generally, we administer medication for that morning, and nothing more. Our inmates are usually held in the county jail where the court matter is taking place, and further meds are the responsibility of the county.

[jmallenwood]

The policy at our jail is that controlled substances are not given before court because there maybe a perception on the judge's part of altered consciousness and therefore impaired understanding/judgement/decision making that would put the I/M at a disadvantage. Of course an I/M's anxiety could do the same!

I wonder why asthma was not treated, though. Of course,asthmatics who have anxiety interpret it as dyspnea. Was rescue med that was witheld or inhaled anti inflammatory?

I am currently trying to get Peak Flow Rate seen as a vital sign in I/M that give a history of asthma - much in the same way one would automatically take a blood pressure in a person with hypertension.

[EASTCOASTRN]

Thanks for your replies. In this case, his Prednisone was withheld from the point of arrest (about one day) until his arraignment. Then, when he demanded his rescue inhaler it was refused. Pretty grim.

Again, this wasn't our people as we had never seen the inmate before... but was the court.