Anyone have advice on offenders that abuse sick call

Atheos · Jan 11, 2009

Error. Sorry :)

Mr Ian · Jan 11, 2009

Is this a problem with the offenders or the custodial staff referring everything to health?

Thing is - if there's no genuine condition then it's a behaviour, and not a health issue. And conduct issues belong to the custodial staff.

What benefits do they get out of sick call? Can't you send them back to work after if nothing shows up? Or are they all undiagnosable complaints?

If you start being selective about who is genuine - you run the risk of making an error and being called on it.

I'd just continue to complete the checks but record the number of times someone presents with (apparently) nothing. At the end of a week/month tally up the frequent offender ..err... offenders and talk with the custodial staff.

It's part of the system and most inmates know how to work it to their advantage.

so alive LPN · Jan 11, 2009

Could you request an MD, DO, or ER slip stating they were there? Although, when I worked at a particular LTC facility (won't mention the name), the way out of that was to say no insurance, and couldn't afford to go.

deyo321 · Jan 11, 2009

Do you charge for visits? Corrections will call me first and say so and so wants to see the nurse. I'll ask what for...if I am busy ...no. They should get their tylenol on med pass etc. I always remind the inmates that there may not be an officer available to oversee them between med passes so they need to remember to get what they need when I am on the floor. If I need to see an IM or corrections wants them seen there is no charge. Requests are in writing and $5 PA call, $4 nurse visit. All indigents are seen obviously but still have to fill out a request. We have abusers of course but the charge seems to slow it some.

JDCitizen · Jan 11, 2009

In Georgia for instance the system is broken.

- There is no automatic co-pay it is assessed by the nurse seeing the patient (no pressure there).

- The nurse triaging the sick calls is usually the same one seeing the patients.

- There is often times that a referral occurs to the NP, PA, MD that has no rhyme of reason

- Things like three colds in one year seem to make it a chronic issue.

- The rule is they place a sick call and have to be seen within so many working days.

- We care for inmates and a vast majority will/do skirt the rules and laws to their advantage.

- Plus most if not all of them know the rules better than you or me. I we mess up they are there to watch the fall.

Unlike for us in the free world some judge has decided that they have a constitutional right for the most part to free medical care. So we have soft shoes, inserts, no prolonged standing, bottom bunk, etc...

We have the ability to control bad behavior but the inmates with hypertension, diabetes, obesity, etc., still get store call to buy cigarettes, little Debbie's, cokes, etc..

CCHP-RN · Jan 14, 2009

In my experience the best thing you can do is make sure all of the people seeing inmates are consistent.

Also, DO NOT give the inmate ANYTHING if no symptoms are present! Follow your protocol exactly as it is written. So many healthcare providers and nurses give them pills just to get them to go away, but that is the worst thing you can do.

If one nurse gives them pills even when symptoms don't support the need, then it doesn't work.

The inmates eventually understand that only if they are truly sick will they get medications or treatment. (Just remember they still have to be evaluated). The word gets out with the inmates and even the new ones that come in hear that they won't get meds unless they are SICK.

Hope this helps.

The other good thing is the copay. That cut our sick calls from 30 a day to 6 a day. (that tells you something right there)

morris-lpn · Jan 22, 2009

After you assess them and there is no significant findings, i write them up for malingering. it always helps that security is on your side.

Vito Andolini · Jan 30, 2009

Ah, yes, good old recreational sick call.

Vito Andolini · Jan 30, 2009

In my experience the best thing you can do is make sure all of the people seeing inmates are consistent.
Also, DO NOT give the inmate ANYTHING if no symptoms are present! Follow your protocol exactly as it is written. So many healthcare providers and nurses give them pills just to get them to go away, but that is the worst thing you can do.
If one nurse gives them pills even when symptoms don't support the need, then it doesn't work.
The inmates eventually understand that only if they are truly sick will they get medications or treatment. (Just remember they still have to be evaluated). The word gets out with the inmates and even the new ones that come in hear that they won't get meds unless they are SICK.
Hope this helps.
The other good thing is the copay. That cut our sick calls from 30 a day to 6 a day. (that tells you something right there)

It might mean only that they are sick but not willing/able to pay the copay.

PattyB RN · Jan 30, 2009

I know you posted this a while ago but I just read it and have to say I'm chuckling to myself. I'm an elementary school nurse and it just crossed my mind...I wonder how many of your "frequent flyers" were the same in school. I'd love to take a poll! It is apparent that in every aspect of health care there are the "regulars". My daughter works in an ED; she sees them. I worked in a pediatrics office; they were there too. I think there's just a certain number of people who think they are sick all of the time. I just do my assessment of each person and if I find nothing objective they go back to class. I'm consistent and no-nonsense and the kids know it. I'm hoping it teaches them a life lesson. If/when I get a student who abuses the health room, I refer them to our school psychologist or social worker because there's usually always an undercurrent of some sort of stressor. I would imagine it's got to be the same in prison only worse...Thanks for doing a job that is not ever covered in nursing school!

FireStarterRN, BSN, RN · Jan 30, 2009

Our facility makes them get a Dr note after 2 days.