Right To Refuse...help!!!

Specialties Correctional

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If anyone can help with this question, PLEASE let me know. I'm a new nurse working in the prison. An inmate was placed on a Level I (suicide) and refused to come out of his cell for me to take his vital signs. Does the inmate have the right to refuse? Let me know your thoughts before I go crazy over the dilemma :bugeyes:

I would imagine so, but I have never worked in a prison.

But I would just say to document, document, document....

I would imagine so, but I have never worked in a prison.

But I would just say to document, document, document....

Thanks for responding...it just seems that if you're allowed to refuse meds u can refuse any treatment. But i'm being told they have to come out of the cell and if they refuse the CO's use force (meaning cuffs and gear up for "battle")...ugghhh!

Specializes in LTC, Hospice, corrections, +.

In my facility they do have the right to refuse. However corrections has the right to seg them. If an inmate refuses a PPD for example he will be ad seg until compliant. I can't force someone to accept a mantoux. But I can keep him out of general population. It would seem to me to be counterproductive to forcibly extract for VS's. A waste of time and a potential safety issue. He fights all the way to the MSO and his BP and pulse are elevated, your not gonna treat for that. And again document, document, document. Good luck.

In my facility they do have the right to refuse. However corrections has the right to seg them. If an inmate refuses a PPD for example he will be ad seg until compliant. I can't force someone to accept a mantoux. But I can keep him out of general population. It would seem to me to be counterproductive to forcibly extract for VS's. A waste of time and a potential safety issue. He fights all the way to the MSO and his BP and pulse are elevated, your not gonna treat for that. And again document, document, document. Good luck.

Thanks, my sentiments exactly. From what i've been reading, it appears that as long as the person is competent they have the right to refuse. However, a court order or legal guardian or doctor's order stating incompetency can over-turn their right to refuse. Thanks for your response...and if all else fails...i'll document, document, document. :D

Specializes in corrections, legal, med/surg, ICU,CCU,.

Inmates have a right to refuse any and all treatment. It is the same as in the community. Refusal needs to be docurmented and the patient needs to be informed of possible consequences. The patient should then be referred to the provider, depending on what is being refused the patient should be referred either immediately or at the next sick call so that the provider can discuss the refusal. In a suicidal inmate Mental Health should also be notified. I usually will ask why the patient is refusing. Often if you start a dialouge with the patient and explain why the treatment is needed they will comply. However, forcing vitals on someone who is refusing is considered assault. For forced care the patient must be declared incompetent and this generally requires a court hearing.

Specializes in Corrections, Emergency.

Crystalwomn - Really well put! I also have found that calmly speaking to the inmate and taking the time to explain the "whats" and "whys" of the situation usually gets them to reconsider, or at the very least they will then explain to me what their rationale is for refusing...sometimes they do have a valid concern, that can then either be addressed or another plan of care can be decided upon that is good for all. Objective documentation of what you did and the inmate's response, and your assessment of the inmate (even with no VS much can be assessed about this inmate - affect, behavior, general appearance, etc) should always be done for every encounter.

Specializes in critical care, med surg, correctional.

In response to inquiry....I have worked in Corrections in the state of NY for over 10 years....an inmate/patient can refuse anything they so choose....an officer cannot force them out of the cell for you to give meds, take vitals, do an assessment etc....They "have the right" to refuse all treatment and care....Just make sure you document that he refused, document the witnesses, and I would initate a refusal form...in NY, if an inmate refuses to sign a refusal form, the nurse, and the witness sign it....this way you are covered......Hope this helps....

What does your supervisor say? What does your written policy manual say? Have you talked with some lawyers about this?

If anyone can help with this question, PLEASE let me know. I'm a new nurse working in the prison. An inmate was placed on a Level I (suicide) and refused to come out of his cell for me to take his vital signs. Does the inmate have the right to refuse? Let me know your thoughts before I go crazy over the dilemma :bugeyes:

Laws and rules vary from state to state, prison to prison and situation to situation....

This I would say he has the right to do even though the inmate is in for psychological observation. If he is up and talking / walking you can document what you see. I agree with the previous postings document, document, documents and name names; Officer so and so was present, Nurse so and so was present.

Now there is such thing as forced care but that is usually due again to psychological problems....

Fun population to work with isn't it...........

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