Are prisoners denied necessities? CNN article

Orca, ADN, ASN, RN · Feb 22, 2018

I worked at the women's facility in my state for eight years. The women were provided pads. The inmates didn't always get what they wanted, but they got what they needed.

In reading the article about Arizona, it seems that pads are being provided, just not an unlimited amount of them. We had inmates who insisted on far more pads than were routinely provided. In those cases, we had a provider examine them to see if there was an underlying problem.

I suppose that it comes down to one's definition of "sufficient". Providing unlimited anything to inmates leads nowhere good. In our facility, some inmates were using pads to make ink for tattoos.

nursesunny, ASN, BSN, MSN, LPN, RN · Mar 23, 2018

In our facility, some inmates were using pads to make ink for tattoos.

Interesting...We had inmates in CA make a ladder from disposed of gloves and catheters...seriously if they just put that ingenuity to good use! But the public at large doesn't realize that even band-aids are regulated....why you ask? Because they make handles for their shanks.

It is another world and I hate the judgment when we work every day with child molesters and rapists and give better care than I see in the community (less than 24 hour wait for routine care, immediate access 24 hours per day for urgent issues with 8 minute response time, have you been to an urgent care??? 2 hour waits are standard in the community but not in prison!)

I am proud of giving care where others are too afraid or don't want to but then to have people who have never seen what I see second guess the care is ridiculous. Example....last week 1 inmate took 4 ambulance rides to the ER for "chest pain." We had to send him out for a second opinion as we don't have a MD on staff 24 hours, but he waits until 15 minutes after the doctors' shift ends to make his complaint of pain. He knows every loop hole and exploits it.

We are in a small community with limited resources therefore someone's granny might have to wait while he gets chauffeured to the hospital via ambulance, or your child might have to wait in the waiting room longer in the ER with a broken wrist because he is sucking up valuable resources because he is bored of the scenery in prison. UHHHH...but don't get me wrong, 99% of the time I love my job, I just HATE arm chair quarterbacks and this topic in particular.

JailNightingale · Mar 25, 2018

At my facility, a county jail we provide female patients with pads or tampons as requested at no charge.

Orca, ADN, ASN, RN · Mar 26, 2018

Nursesunny makes an excellent point. It is easy for those who don't work in our environment to throw rocks at us over the supplies provided or the care given. We have to consider things that would never be an issue with a hospital, the games that inmates play, and the things that they do with supplies and common items that they get. For instance, we stopped giving psyllium in bulk because inmates figured out how to make shanks out of it. I was just in a meeting where it was discussed possibly doing away with fruit with meals, because we have a rampant problem with pruno (prison alcohol, for the uninitiated). Nursesunny's example of the California inmates building a ladder from old gloves and catheters shows the kind of things that we have to consider when we give things to inmates. They aren't always used for the intended purpose. Inmates can always make plausible arguments for getting more of this or that, but their motives may be more nefarious than the general public realizes.

Neats, BSN · Mar 30, 2018

It depends on what your definition is for medical necessity.

I had the pleasure of developing a sort of "Coed" prison. Think a quad area and a postage stamp corner and surrounded by 2 layers of fencing. The females were housed in that postage stamp area. It made for some creative facility movements at time.

Some/Many Supplies are medical necessary these women taught me how to make a tampon out of a Kotex, these Kotex we ordered for the females were like the kind you get after birth except they stick to the undergarment, no frills that is for sure. The females complained a lot, they wanted tampons, no we did not order those. Other items we did not order were chap stick, I told them to use butter. Now if they had a medical condition this would be different but they would get not chapstick but some other medication for their lip ills. I refused to order chapstick because it is not medically necessary, my state does not have monies to throw away. The inmates can earn money and buy their own chapstick from the commissary. Same with tampons and other items that we take for granted and are not necessary for life.

It is not just a matter of the inmates making things out of what appear to be nothing but what is medically necessary. I have seen a single shot gun made out of a retractable pen.

The inmates malingering is rampant and if you have to send out for chest pain so be it, I would also ensure Behavioral Health is part of this persons treatment plan. I would have your back each and every time you send this offender out.

I would ensure at the hospital he sees no one except medical necessary healthcare staff, and upon return to the prison make it difficult, hence a brown paper bag for his meal, has to come to medical every 6 hours just to be checked out (if this interferes with visitation, programming, TV schedule, sleep schedule, has to come to medical for all his medication, then so be it. I have had them stay in medical over meals, called in for sack lunch and all of a sudden no more pain it is gone. It happens a lot during sporting broadcasts. I do not like they abuse medical this way, it is like this on the outside as well, but I can make their visit a little more unpleasant without harm so they may think twice about their malingering ways.

The inmates always know we are there in an emergency, if you malinger and get caught there are consequences to pay. I do not want to ever think they feel like they cannot come to medical.

Lastly when they are inmates they are under our care custody and control. All their needs are taken care of they have clothes (that serve all seasons), food that adheres to the FDA Dietary recommendation and even modified to the inmates diet i.e. vegan, Kosher, and other religious dietary needs, shelter, personal supplies to include soap/shampoo/hygiene supplies/towels/wash cloths. They have access to education, to a commissary (like a grocery store) that supplies name brand...everything snacks, soup, teas, coffee, soda pop, personal items, you can even buy small TV's, books, Radios, Sunglasses, warm clothing, tennis shoes, chapstick, tampons, shampoo...It is usually a list of 3-5 pages of what you can buy and the limit of what you can buy. I use this list of what they have purchased for diabetic education in chronic care when they come to their appointment and their A1C is high. Yeah I am that nurse. I hold them accountable.

I guess my point is they come to prison with nothing and no ability to pay for anything their Maslows Hierachy of needs are meet at the first 2 levels regardless of your feeling about safety. The Maslows 3rd level of love you have to work at that and many of these inmates have burned bridges. Just saying its hard to love a difficult person.

You have the opportunity to get a job in prison and despite what you hear there are jobs that pay from 25 cents an hour (think an inmate pulling dandelion weeds from the grass areas, usually the older inmates have this job as it gives them a purpose) to making up to I have seen $25.00 an hour (usually the last year in prison on work release-jobs like electrical installer, plumber certified...) some of their monies are taken by the state for restitution, some they get to keep, hence ability to pay for that TV they wanted)

I do not feel sorry for anyone of them this is their responsibility to serve their time because they broke the law.

Kooky Korky, BSN, RN · May 24, 2019

On 3/30/2018 at 2:01 PM, Neats said:
It depends on what your definition is for medical necessity.
I had the pleasure of developing a sort of "Coed" prison. Think a quad area and a postage stamp corner and surrounded by 2 layers of fencing. The females were housed in that postage stamp area. It made for some creative facility movements at time.
Some/Many Supplies are medical necessary these women taught me how to make a tampon out of a Kotex, these Kotex we ordered for the females were like the kind you get after birth except they stick to the undergarment, no frills that is for sure. The females complained a lot, they wanted tampons, no we did not order those. Other items we did not order were chap stick, I told them to use butter. Now if they had a medical condition this would be different but they would get not chapstick but some other medication for their lip ills. I refused to order chapstick because it is not medically necessary, my state does not have monies to throw away. The inmates can earn money and buy their own chapstick from the commissary. Same with tampons and other items that we take for granted and are not necessary for life.
It is not just a matter of the inmates making things out of what appear to be nothing but what is medically necessary. I have seen a single shot gun made out of a retractable pen.
The inmates malingering is rampant and if you have to send out for chest pain so be it, I would also ensure Behavioral Health is part of this persons treatment plan. I would have your back each and every time you send this offender out.
I would ensure at the hospital he sees no one except medical necessary healthcare staff, and upon return to the prison make it difficult, hence a brown paper bag for his meal, has to come to medical every 6 hours just to be checked out (if this interferes with visitation, programming, TV schedule, sleep schedule, has to come to medical for all his medication, then so be it. I have had them stay in medical over meals, called in for sack lunch and all of a sudden no more pain it is gone. It happens a lot during sporting broadcasts. I do not like they abuse medical this way, it is like this on the outside as well, but I can make their visit a little more unpleasant without harm so they may think twice about their malingering ways.
The inmates always know we are there in an emergency, if you malinger and get caught there are consequences to pay. I do not want to ever think they feel like they cannot come to medical.
Lastly when they are inmates they are under our care custody and control. All their needs are taken care of they have clothes (that serve all seasons), food that adheres to the FDA Dietary recommendation and even modified to the inmates diet i.e. vegan, Kosher, and other religious dietary needs, shelter, personal supplies to include soap/shampoo/hygiene supplies/towels/wash cloths. They have access to education, to a commissary (like a grocery store) that supplies name brand...everything snacks, soup, teas, coffee, soda pop, personal items, you can even buy small TV's, books, Radios, Sunglasses, warm clothing, tennis shoes, chapstick, tampons, shampoo...It is usually a list of 3-5 pages of what you can buy and the limit of what you can buy. I use this list of what they have purchased for diabetic education in chronic care when they come to their appointment and their A1C is high. Yeah I am that nurse. I hold them accountable.
I guess my point is they come to prison with nothing and no ability to pay for anything their Maslows Hierachy of needs are meet at the first 2 levels regardless of your feeling about safety. The Maslows 3rd level of love you have to work at that and many of these inmates have burned bridges. Just saying its hard to love a difficult person.
You have the opportunity to get a job in prison and despite what you hear there are jobs that pay from 25 cents an hour (think an inmate pulling dandelion weeds from the grass areas, usually the older inmates have this job as it gives them a purpose) to making up to I have seen $25.00 an hour (usually the last year in prison on work release-jobs like electrical installer, plumber certified...) some of their monies are taken by the state for restitution, some they get to keep, hence ability to pay for that TV they wanted)
I do not feel sorry for anyone of them this is their responsibility to serve their time because they broke the law.

I pretty much like what you have said.

I just wonder if you realize that there are some innocent people locked up.

TAKOO01, BSN · May 24, 2019

On 3/23/2018 at 6:10 AM, nursesunny said:
Interesting...We had inmates in CA make a ladder from disposed of gloves and catheters...seriously if they just put that ingenuity to good use! But the public at large doesn't realize that even band-aids are regulated....why you ask? Because they make handles for their shanks.
It is another world and I hate the judgment when we work every day with child molesters and rapists and give better care than I see in the community (less than 24 hour wait for routine care, immediate access 24 hours per day for urgent issues with 8 minute response time, have you been to an urgent care??? 2 hour waits are standard in the community but not in prison!)
I am proud of giving care where others are too afraid or don't want to but then to have people who have never seen what I see second guess the care is ridiculous. Example....last week 1 inmate took 4 ambulance rides to the ER for "chest pain." We had to send him out for a second opinion as we don't have a MD on staff 24 hours, but he waits until 15 minutes after the doctors' shift ends to make his complaint of pain. He knows every loop hole and exploits it.
We are in a small community with limited resources therefore someone's granny might have to wait while he gets chauffeured to the hospital via ambulance, or your child might have to wait in the waiting room longer in the ER with a broken wrist because he is sucking up valuable resources because he is bored of the scenery in prison. UHHHH...but don't get me wrong, 99% of the time I love my job, I just HATE arm chair quarterbacks and this topic in particular.

You said everything I wanted to say....

People actully picketed outside my institution because they felt inmates were deprived. Local politicians even showed up. They have no idea what they're protesting about, and I doubt they would last a day in the job.

nursesunny, ASN, BSN, MSN, LPN, RN · May 30, 2019

On 5/23/2019 at 10:36 PM, Kooky Korky said:
I pretty much like what you have said.
I just wonder if you realize that there are some innocent people locked up.

I don't care one bit. Innocent or guilty doesn't impact my ability or will to participate in healing. I am not invested in the punishment aspect of prison because that isn't my job it is the job of the court. I know the care exceeds what is available to the community 100%.....because I moonlight there so am well aware of the disparity of care

Orca, ADN, ASN, RN · May 31, 2019

We have grievances (and lawsuits) filed by inmates who haven't been seen in a tenth of the time that it would take me to get in to see my own doctor. They neglect their own care for their entire lives, and we are supposed to fix everything in one (non-chargeable) visit.

As far as there being innocent people here, they have gone through the court system and been found guilty of a crime. This isn't North Korea, where people are randomly hauled off the streets and thrown into prison for little or no reason, never to be heard from again. Yes, mistakes are sometimes made, but my job is to deal with what happens after inmates get here. If they are indeed innocent, that is the court's job to sort out.

Orca, ADN, ASN, RN · Jun 1, 2019

Here's a hint, BTW...they are all innocent. Just ask them.

Trauma Columnist · Jun 3, 2019

As an APRN who volunteers with a prison activist group in my state, I visit all the state prisons. Some are better at addressing offenders needs then others. In the women's prisons I did not hear of anyone being denied feminine hygiene items. What I did find was that if they soiled their underwear they often had to continue to wear it for a day or two due to the lack of washing machines.

In the male prisons, I found many issues with stopping and starting meds abruptly due to the state's formulary and the budget.

IMHO both of these issues are untenable.