copy-cat" acts of self-harm

[eleldub]

I am a correctional nurse. Two days ago I had two patients commit "copy-cat" acts of self-harm. Beforehand, they were bantering back and forth; one giving the other instructions from the neighboring cell--in how to hurt himself to get a trip to the hospital, so they could get better-tasting coffee, "goodies," and "prettier nurses." First one hurt himself, drawing blood. Then the other did the same thing. Two separate arrangements for a trip to the ER. Not even to mention, all the running back and forth to apply pressure dressings; back-to-back calls to doctors and mental health teams; and finally the assembly of correctional officers it took to manage these crises as quickly as they possibly could. I took a mental health day (off) to recover from the horror of it all.

In my perfect world, there would be specialized institutions for the criminally insane. At least, if a nurse chooses that type of work, he or she could see something like coming and be psychologically prepared for such a ghastly occurrence. I'm sure the two of them are having a good laugh now; at my expense.

Nursing. The skills that pay the bills. Have I really loved the profession I have spent over 25 years in? Frankly, not really.

[mikethemurse, BSN, RN]

First, Iam sorry you had a tough shift. How long have you been in corrections? The reason I ask is because, maybe this is a regional thing, but that type of thing was pretty much par for the coorifice in most of the several county jails I have been in. Some nights (I worked nights) were MH nights with crazy or (crazy because it will maybe help my case) inmates doing all kinds of things to themselves and others. Some nights it was I'm going to try to die fromETOH/Opiate/whatever I can get my hands on withdrawal. Nature of the beast. Also human nature to want to vent, especially to anonymous strangers on the internet. I get, and have done it myself, and this reply is not a dig on you. Iwas just confused at your surprise at a pretty common thing. Inmates sometimes do stupid things in order to get what they want. At the end of the day, you did your job, and everyone lived! Good day all around.

[OrganizedChaos, LVN]

I have to echo what the PP said. This is very common in corrections. You either love corrections or you hate it.

Inmates are a very smart bunch & know how to work the system. You always have to be 2 steps ahead because if you are even with the inmate you are behind. If you need any suggestions don't hesitate to come on here & ask. There are a lot of seasoned correctional nurses on here.

[elkpark]

There's really no line anymore distinguishing the psychiatric community from everyone else. Anyone who works in a correctional setting is going to see lots of psychiatric issues and behaviors, since the inadequate mental health services in so many communities have basically made the US correctional system the de facto public mental health system in the country. There are "specialized institutions for the criminally insane" -- but the guys you're describing don't meet the definition of "criminally insane"; they're just manipulating the system to try to get what they want (as we all do, I'd point out -- the difference is that most of the rest of us do it more effectively and don't run afoul of "the system").

[SheriffLauren]

Agreed. Many patients/people self harm in order to gain something (attention, the good drugs, a tip in the ambulance). It's strategic manipulation, not categorically a mental health issue.