Wonder how often this happens - page 2

I have a friend that is a physician at a hospital that is near a maximum security state prison. She was telling me about the protocol that has to be followed when they bring in inmate in for... Read More

  1. by   SoulChic
    That sucks.....its definitely a conflict. I mean....as a nurse or doctor it is your duty and it should be your want to heal and help eveyone.....but then again you can understand that they have probably had situations where problems arised.....hard situation to deal with.
  2. by   JDCitizen
    Quote from Troublant RN
    This used to be the case in California, not any longer. First of all, upon discharge, all hospital discharge documentation is place in an envelope, sealed and handed to an officer that delivers it to medical staff where the inmate is assessed as soon as he returns to institutional grounds. Pain management will be based on those recommendations, and what is available in the formulary (Tylenol #3, Ultram, Methadone, etc.)
    Here in Georgia even with the patient having a signed release we don't always get that envelope of hospital discharge information and/or workup... Phone calls: Very hard to get information due to no one wanting to give out non-dictated information.

    As for management we look at the ER/Hospitals diagnosis and treatment regiment directions (when available): We use them, change them or send the patient out again because or original reason for sending the patient out was ignored...

    Overall the occasional officer may try to plug in his/her two cents worth at the hospital I won't deny that does not happen. I will say some patients went to the hospital because of officer did his/her job and chimed in.. The officers are good at plugging in information the patient may not remember or know.
  3. by   prison_nurse
    I don't believe "Always", although I don't say that officers may not say that.... My question is why is the physician giving officers instructions???? There is absolutely no reason why he should do this. Staff should be folding the paperwork, sealing with tape, with instructions to give to the medical department.

    The final decision regarding pain medication lies with the prison physician and he will prescribe what he believes appropriate in the circumstances... in some cases, this may indeed be tylenol.
  4. by   JDCitizen
    Quote from prison_nurse
    I don't believe "Always", although I don't say that officers may not say that.... My question is why is the physician giving officers instructions???? There is absolutely no reason why he should do this. Staff should be folding the paperwork, sealing with tape, with instructions to give to the medical department.

    The final decision regarding pain medication lies with the prison physician and he will prescribe what he believes appropriate in the circumstances... in some cases, this may indeed be tylenol.
    Some prisons don't have 24x7 medical on hand. Those very officers in some circumstances will be calling a doctor on call.

    The question should be why the medical folks in the hospitals make no attempt to give report to other medical persons who for the most part initiated the trip and/or will be taking care of the patient on his/her return.
  5. by   prison_nurse
    I know that some jails and juvenile facilities do not have 24 hour nursing staff, but I am not aware of any adult prisons without nursing staff. I think this inmate, from the post, came from a maximum security facility.

    I think it would be rather dangerous not to have a 24 hour nursing staff.
  6. by   JDCitizen
    Here in Georgia not all prisons have 24x7 coverage on site.
  7. by   MadisonsMomRN
    Quote from deyo321

    Antipyschotics require eval by our mental health dept. They are IMO over-prescribed in the general population by pcp's.
    Our mental health dept (psychiatrist) prescribes mental health meds. Our doctor does not prescribe any mental health meds. We are strict on what we give out due to all the drug seeking out there!
  8. by   prison_nurse
    Really? How many inmates at those facilities, and are they medically screened to go to those prisons?
  9. by   JDCitizen
    Quote from MadisonsMomRN
    Our mental health dept (psychiatrist) prescribes mental health meds. Our doctor does not prescribe any mental health meds. We are strict on what we give out due to all the drug seeking out there!
    Georgia: Our medical doctors continue mental health medications on intakes for a short time until they can see a mental health doctor otherwise we just consult with mental health; we don't prescribe.
  10. by   Orca
    We don't accept scripts, or medications from outside sources. The recommendations of hospital doctors are advisory only in a prison environment. We give pain medications up to and including Oxycodone, but an inmate must be housed in the infirmary in order to get them.

    Antipyschotics require eval by our mental health dept. They are IMO over-prescribed in the general population by pcp's.
    Very true. Seroquel in particular is a problem. It is so popular with drug users that it has acquired street names. Abuse and sales on the yard were such big problems that Nevada DOC took it off the formulary entirely. The first warning sign is that we started getting written requests for treatment (when I worked outpatient mental health) that said merely "I need Seroquel" without stating what the problem was.
  11. by   JDCitizen
    Quote from Orca
    We don't accept scripts, or medications from outside sources. The recommendations of hospital doctors are advisory only in a prison environment. We give pain medications up to and including Oxycodone, but an inmate must be housed in the infirmary in order to get them.


    Very true. Seroquel in particular is a problem. It is so popular with drug users that it has acquired street names. Abuse and sales on the yard were such big problems that Nevada DOC took it off the formulary entirely. The first warning sign is that we started getting written requests for treatment (when I worked outpatient mental health) that said merely "I need Seroquel" without stating what the problem was.
    :icon_roll

    Sort of like the inmate that told me that his pain was helped by an Ultram a friend had given him on the dorm.
    Problem with that statement: Ultram is a DOT medication and given only on pill call.
    Instant change in policy: All Ultram is now crushed and floated.
  12. by   Truegem
    In regards to the first question asked in thie thread....I don't think the deputy/officer was trying to make a decision. I think he was trying to tell the MD that that is all the jails will order. And he probably didn't literally mean Tylenol. He was probably using the word Tylenol to mean basic non-narcotic pain meds. Not necessarily true, as I'm seeing that some facilities give Tylenol with Codeine or Darvocet, etc. The only narcotic we give is Tylenol with Codeine. It's fine. I have never had anyone complain that their pain wasn't being covered adequately.
  13. by   annahummer
    As an ER nurse we know not to send pain medication scripts to any of our inmate patients. Oral antibiotics are all our prison's will accept

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