Could use some input

Nurses General Nursing

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I have an interesting dilemma at my current job. I'm a jail officer for our police department here in Indiana. I'm currently taking my prereqs for nursing school at the community college.

Here's the deal. Our jail is just a 72 hr holding area for midemeanor prisoners untill they can go to court. If they have any medical problems or things like that, we send them to the county jail where they have nurses always on duty. If it's an emergency they go to the hospital. Pretty much common sense so far.

Part of the booking process is a medical screening, which includes asking if they take medication. Well, here's the problem. Our assistant Chief, in his infinite wisdom, has decided that now, if a prisoner has medication and asks for them, we're now to give it to them.

This naturally made all us jail officers hit the roof. We all go to a 40 hr jail officer's course put on by the state when we get hired. Part of that tells us how to handle medical situations, and they make it clear, we are NOT to give medications.

I even called the Nursing Manager at the county jail and asked what the laws and rules are on that. She said that at the county, no matter WHAT the meds are, they don't give them anything for 12 to 24 hrs since they don't even know what could be in their system. But she made it clear that it is illegal for non-medical personnel to give medication unless they're a CMA, LPN, or RN. I went back and explained this to my supervisor who talked to the chief. The chief gave a "I'll look into it" answer. In the meantime, I told my supervisor I will absolutely NOT do it.

Besides the liability involved if something were to happen, I could also jeopordize getting my nursing license when I get done with school. Does anyone have any input or experience with this kind of thing? Or any idea what would possess our dept. to make such a rule without checking into anything?

Thank you in advance. I've lurked on this board for a few months now and have enjoyed the discussions.

Tim

Specializes in Med-Surg.

Well, I don't know what the answer to the problem is, but I think the current system is a real problem.

They are without meds for 12-24 hours?? What if they are diabetic or have a seizure disorder--or any of a couple hundred other things? They just go without? That's crazy and asking for a lawsuit.

Well, the county nurse told me that if it's an emergency, or a chronic problem, they go to the hospital.

They don't give them anything for 12-24 hrs because 90% of the people who get arrested have cocaine, alcohol, or God-knows what else in their system, and giving them medication will make them worse. The jail has a very limited medical facility, so if they have any doubts, they take them to the hospital. But most people who come in who are prescribed painkillers or something don't HAVE to have them right away from what she told me.

I just know I'm currently NOT trained or certified to give out meds, but our dept. says we now have to. That's the bigger lawsuit waiting to happen if you ask me.

W/o dr orders, I give nothing to nobody. Not even aspirin. A sure way to get tagged for practicing med w/o a license. You are correct to refuse. The chief may know law enforcement, but he should leave medical issues to medical people.

I talked to my union rep, and told her if they don't change the rule, I'm going to file a union grievance. If I were to get sued, the state has on file that I went through their training course, so in court, the answer of, "My chief told me to" won't cut it LOL...thanks Todd, I'm glad someone doesn't think I'm over reacting lol

If the state is against you administering medications then I do not see the issue here. You cannot be made to administer meds if you were not trained in that capacity, and it's unfair for the chief to even suggest it.

I am confused on one issue though. The county jail standard for Indiana states that any jail officer who administers meds must be trained by the responsible physician and jail administrator. Do you follow the same standards :confused:

Originally posted by Mint Julip

If the state is against you administering medications then I do not see the issue here. You cannot be made to administer meds if you were not trained in that capacity, and it's unfair for the chief to even suggest it.

I am confused on one issue though. The county jail standard for Indiana states that any jail officer who administers meds must be trained by the responsible physician and jail administrator. Do you follow the same standards :confused:

I work in the city jail, so up until this new, goofy rule, we weren't even supposed to administer meds. At the county jail, they have nurses on staff who administer medication, so the jail officers don't even have to mess with it.

Specializes in Med/Surg, ER, L&D, ICU, OR, Educator.

Stand by your principles...your instincts are correct!

You are also on the right track re your union.

There seems to be several issues here. Who gives the initial medical screening? I think someone needs to dig a little deeper into the no meds for 12-24hrs policy too. Memphispanda stated earlier, "Well, I don't know what the answer to the problem is, but I think the current system is a real problem. They are without meds for 12-24 hours?? What if they are diabetic or have a seizure disorder--or any of a couple hundred other things? They just go without? That's crazy and asking for a lawsuit." Memphispanda is absolutely correct. Todd SPN stated "W/o dr orders, I give nothing to nobody. Not even aspirin". The trouble with using that statement is: if the subject has been taking medications at home then there is a Dr's. Order for them to take said medications. Staff can't refuse that medication unless it's overridden by another MD or the MD that dispensed the med in the first place. Tim when you said, they don't give them anything for 12-24 hrs because 90% of the people who get arrested have cocaine, alcohol, or God-knows what else in their system, and giving them medication will make them worse. That's what drug screens are for they only take a few minutes to run. You can't deny the whole because of the one. Even then they would have to agree to the drug screen. Lastly, when it was said "our assistant Chief, in his infinite wisdom, has decided that now, if a prisoner has medication and asks for them, we're now to give it to them". There is a fine line ridden by a few souls when it comes to giving out medications. I don't know what the laws are in your state, but here's how they get away with it in FL. Let's say there is a pt at home being cared for by a home health aid. I think we all would agree that it's illegal for the home health aid to pass medications - right. Here's where it gets tweaked. It's not illegal; however, for the home health aid to assist the pt. with their medications. "Mr. Tim its 4 o'clock isn't it time for your medication do you want me to get the bottle for you. You know how many to take right." Forgive my writing I'm still on my first cup of coffee this am. Listen, I'm not judging anyone here. I'm just looking in from the outside putting in my 2cents. I'm grateful it's someone else's problem not mine. There are a lot of issues with this one. All you can do is cover your own butt. Every time you talk to the suits go home write it all down including the date, time, and who all were there.

Speculating,

Thanks for your input. The whole 12-24 hr thing is the county jail's rule, not ours. We send our prisoners to the county if they need any medical problems. At least thats what we had been doing. County is the ones with the nurses and doctor on staff. She just said the 12-24 thing was a guideline. So if they get sued, I don't care, it's county LOL

As far as us goes, that's what the RN at county told me with assisting in medication. For example, at the minimum security jail in the county, officers there assist with prisoners meds. THe meds are kept at the counter, prisoners walk up when it's time for their meds, the officer hands them the bottle, counts how many they take, and log it in a log book. Every week, the head nurse goes over the log book to make sure prisoners aren't over-medicating themselves. The staff MD also prescribes substitutes for any narcotic prescriptions a prisoner has.

Here at the City jail, we have no nurse at all, and prisoners here are just coming in off the street, and arent' here for the long term like at county. There's no doctor or anything to oversee or check on what we do or what the prisoner has taken. Also, no one is there to prescribe alternate meds. I really don't want to give some slobbering drunk his daily dose of Oxycontin when he comes in and asks for it, and I think this whole policy is a disaster waiting to happen. Hopefully I was able to talk some sense into them, but jail officers arent' "real" officers as far as the department is concerned, so I doubt they'll listen to anything I have to say.

Forgot to mention, you asked about drug screenings...here's how we figure out what to do with someone. When someone is brought it, there is a series of medical questions we ask them. Things like do they take meds, do they use drugs or alcohol, have they attempted suicide...there's about 50 questions. If they take meds or have them with them, we just note it on the screening form and send them to the county jail if we have to. OUr jail is very small. At one time, we have 6 cells, one jail officer working and a computer and that's about it. No way to do a drug screening or anything else. As far as I know, the law in our state only allows for a medical assistant, LPN, or RN to administer medication. I don't think I fall under any of those at the moment lol.

Specializes in Corrections, Psych, Med-Surg.

One more "great" idea by some hot-shot administrator who knows nothing about the realities of the situation AND whose livelihood is not on the line when the law is broken and someone is to blame. If you have a union, make sure it knows about this directive. If you don't have one, you might start thinking about it. Supervisors who are "crossed" by employees who know the law better than they do, and have the courage to stand up for themselves, are not immune to retaliating against them.

"Does anyone have any input or experience with this kind of thing? "

Yes, we all have experienced this kind of thing. It is summed up in my sig line:

Originally posted by sjoe

One more "great" idea by some hot-shot administrator who knows nothing about the realities of the situation AND whose livelihood is not on the line when the law is broken and someone is to blame. If you have a union, make sure it knows about this directive. If you don't have one, you might start thinking about it. Supervisors who are "crossed" by employees who know the law better than they do, and have the courage to stand up for themselves, are not immune to retaliating against them.

"Does anyone have any input or experience with this kind of thing? "

Yes, we all have experienced this kind of thing. It is summed up in my sig line:

Thanks sjoe. We do have a union and my rep told me to find any documentation I can to present to them when I file my grievance. They'll have a hard time arguing if I can show them on paper that not only is this a really bad idea, but not even a legal one.

The beauty of it is, I know all about retaliation. They're already pissed at me and another co-worker because we filed a harassment complaint against some supervisors several months ago. These same administrators tried to cover it up, but we went and got a lawyer and now that's a big ugly mess. But that's another story for another board...

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