[nurseT]

OK, This Mother is driving me crazy. The inmate is a 23 YO male who has already spent time in prison for 2 counts of possession and theft. While out on parole he gets arrested for burglary. He likes to claim his mental problems cause him to misbehave. He is on Lithium and Celexa. He is quite intelligent and knows all the magic words to get attention. He wanted a Lithium level done because he wanted to up his lithium and add Straterra to his cocktail. After the Doctor sees him and his Lithium level is therapeutic, the jail doctor said no.the kid is still not satisfied. He wants his records to send to people on the outside who are waiting for this information. His Dad is a Vetrenarian and his Mom is calling all kinds of outside doctors trying to get them to visit the jail and give her kid more meds and someone to talk to about his problems. I told this kid and his mother that he could not get orders from outside doctors and bypass our medical department. She calls constantly and talks about how she wants him fixed so he can lead a normal life when he gets out. She has had 3 different doctors call me. They all say she told them that the kid has no doctor. The kid's family doctor told me the mother "doctor shops" and the kid was better off in jail. She will call me and try to tell me she wants another Lithium level done and blah blah blah. I have told this woman, and told this woman the rules. She does not listen. She is a high maintenance, high anxiety control freak and pesters everyone until she gets her way. She will even threaten to give prescriptions she has with doctors orders on them to her lawyer. Should I refuse her calls? I have warned the sheriff about her and told him she'll probably be calling him next since she has not got what she wanted from me. What would you say to her to shut her up? She will not take no for an answer, she calls prepared with an answer for anything you might say. You know, I never, and I mean never,,, get calls from the mothers of female inmates. What is up with that?

[karbyr]

Nicely and firmly tell her she will need to take this up with the onsite doctor, then excuse yourself. as in, "excuse me, but I need to get on with my daily work, thank you for your concern". When she tries to go on, excuse yourself again..... and again, and if need be, tell her Excuse me Ms. ________, I am hanging up now, you have a nice day. and do so. sometimes these kind of people are sooooooooo hard to deal with, but polite and firm works, eventually.

[**nurse**]

I have many times told moms/wives/sisters etc that due to HIPPA I can't even tell them if thier person is in the system, much less discuss thier health care with them. Assure her he has access to health care if he is an inmate there and that you can't discuss it further. If she is not his POA then you are telling the truth, HIPPA is federal and nationwide is it not? I'm sure a hospital would limit her involvement in his mental health care.

Sometimes I will discuss health care with a family member when it is THERAPUETIC to the inmate and with thier permission, but one of the major benefits of correctional nursing is that you give great health care, but you don't have to be nice for the sake of nice about it!!!!!

She, and his outside physicians, have no input in his care without a court order.

[charebec65]

Sounds like his parents are a bigger problem than the bipolar. The bipolar disorder is bad enough but parents that are enablers only escalate things. Unless he is actively psychotic, he can determine right from wrong and it doesn't sound at all psychotic. The bipolar disorder is not causing him to commit so may crimes. Nurse T is right. This guy is an adult, you don't have to talk to his parents at all unless there's a court order making them his guardians.

Good luck. You're being put in a bad situation....hope it works out for you.

[Mirth]

At the Penn where I worked, we didn't talk to any family about health care, period. The prison had people who talked to family.

If we found ourselves in the visiting room, handing out meds or whatever, then we might get into a conversation with family. But if you didn't want to talk to family, you didn't.

The only time I ever talked to an inmate's family, I sided with the inmate, so the family never talked to me again. They wanted him to be checked into the health care unit to live, and he wanted to be out in the cellhouse with his friends.

[nurseT]

Thanks for the suggestions. I really needed to hear from some other nurses. I am the only health care professional in the jail and sometimes just need the support. Yesterday the Commander told me he had a wedding to attend and it turns out this mother will be there too. Some mutual friend / family. He was dredding it. He knew she would try to corner him. I told him to blow it off on me and then when she called I would refuse her call. Thanks again.

[Sunshine22]

Course when you let them know that they are over the age of 18 and the law prohibits us from speaking to anyone other than the actual i/m about his healthcare, this does sometimes work. Then you can let them know that you weill be happy to speak to them if they have power of attorney over then person that they are talking about. I had one lady to tell me that "Oh, by the way, I do have power of attorney over him." I told her that was wonderful, and when she came to the jail and produced the POA and proper ID for herself, that I would be more than happy to discuss anything that she wanted to. Her answer to this was, very sarcastically, was, "Well you are just a piece of work, aren't you??" I told her that I was just CMA so that I didn't have to worry about lawsuits or having to find a new job.

My nursing staff knows that the stock answer is, "Ma'am, you need to call M-F from 8-5 and speak to my supervisor concerning this patient." This gets them out of the picture and then, depending on how the phone call goes, we can chat, or I can hang up!!

[shell911rn]

My impression of working in a state prison over the past year is that WE as in CUSTODY and MEDICAL are the guardians over the inmates, not their mothers or fathers. The inmate can appeal and if he doesn't like the answers, he can get a lawyer as is his right, but I still don't think a POA will hold much water while the inmate is incarcerated. Even when an inmate goes out for consultation on the outside, when he returns, it is up to the physician in our facility to decide whether the inmate will receive the medication the consult physician "prescribed." They use consult physicians to try to get narcotics and controlled meds that the prison physicians won't prescribe. Inmates always want me to call their parents or wives about their meds to verify they are taking a narcotic or some other controlled substance, but I don't take them up on the offer. I don't want to speak with their family or be harassed by their family. This woman shouldn't be harassing you when you need to be focused on other inmates, not just her son. Be firm with her and set boundaries just like you have had to do with her son. Consult with supervision and even custody about your right not to be harassed on the phone. Their could be legal ramnifications for her behavior if she continues. Good luck to you! That's one thing I love about working in prison compared to the outside hospital--don't have to deal with harassment from families. You have a right not to be harassed!

[Sunshine22]

Shell, You are correct in what you say, but there are several things to take into conscideration when dealing with i/ms. I do not have to speak to anyone about anything unless I choose to do so. That was the whole point that I was getting to. Basically, I was having fun with one of the mothers because I knew where the conversation was going. I could have just did the old Ma'm we can't discuss this, and hung up, but she had already crossed over the friendly point, and that is where you can let them know just exactly what you can and cannot do and why you can and cannot do it. I have not heard another word out of this women. Lots of times when you just hang up or get into a shouting match, you just end up having more phone calls. When you let them know exactly what the deal is, you don't have any problems at all. I have been doing this job for 10 years, and it does help sometimes to get creative in ways that you handle things.

Sometimes it is better to prove the i/ms wrong in Mama's eyes by letting them get caught lying to Mama about something. That works out great as well. I have even pulled i/ms to be brought up so that Mama can see that he is lying to prove my point.

This is why I have the rule for my staff to refer the calls to me during the work week, and then, my nursing staff can do their jobs and not have to worry with the mamas.

We are trying to get a dedicated line set up for concerned mamas to leave messages so that we don't have to speak to anyone. They will be told to record their concerns and that the matter will be looked into, but they will not receive a response from us. This will take care of everything.

[JailRN]

Being the only medical person in a level one jail, (there's 1 RN/shift),I get the phone calls from the front desk, trying to transfer calls from parents, grandparents, spouses of IM's. First, I have told the front desk NOT to transfer calls to me. IF the loved one wants to leave a list of the IM meds with the front desk, I will attach it to their files, but that's it. The IM is over 18 and, unless they have a conservator, I will not even acknowledge their presence here, and refer them to HIPPA regs. If, by some fluke, they get my direct line, I very politely repeat the same thing, "Under HIPPA policies, I can't even say that your darling son (daughter, etc)is here. Thank you for calling." and I hang up. Liability, liability, liability and CMNL (cover my nursing license) are the 2 priorities. Now, IF they can produce conservatorship paperwork (and some of them do), I will move heaven and earth to accommodate them (unless they become a PIA, like it sounds like this one is) She's trying to find an excuse for his bad behavior--too bad, the kid will never grow up. I feel sorry for him. Don't worry, the boss will handle it well, I'm sure. Good luck and let us know how it turns out.