Denying Meds

Sunshine22 · Jan 26, 2005

I can't speak for all facilities, only mine, but we do not deny any medications when an inmate comes in. We do have to verify them 1st, so we are not just giving something that Bubba says that he takes. We do this thru the M.D.'s office and/or pharmacy. This protects us both. Should we have a chronic care inmate come in, we do the above asap and then we monitor closely and consult with our M.D.(who is on call 24/7) on what needs to be done. Now, we do have a full nursing staff 24/7, which is a lot different than some jails who only have part time medical staffs. Fiestynurse is shooting straight with what she is saying. I just wanted to back her up as much as I could. This is not the norm, and I wonder who the medical staff is at the places that were discussed. I work for PHS and we have definite policies and proceedures that cover what we need to do concerning all areas. Should we come across something that we are uncertain of, then we have access to the whole PHS staff via the internet that we can find answers from. Our HSAs are very good at helping a fellow HSA when needed. You just put the question in the email to all and you have several answers within minutes.

BSNinTX · Mar 2, 2005

Unfortunately, not all correctional health care systems are the same. I can assure you this would not have happened in our joint.

My brother, who has had IDDM for years, was recently incarcerated. He was not given his insulin for 4 days. He was taken to the E.R. from the jail, in a coma. He had a blood sugar of over 750. He was stable prior to that because he watched his diet, checked his sugar, and took his insulin like he was suppose to.
Now, he has Renal Failure because of it. And his IDDM is very brittle now.
The kicker is, his wife even offered to bring in his insulin and needles and accucheck monitor so that he could be stable, and the jailors denied it.
Yes, there is a pending lawsuit over it!

HEDNURSE · Mar 6, 2005

Unfortunately, not all correctional health care systems are the same. I can assure you this would not have happened in our joint.

NOR IN THE JOINT I WORK IN EITHER. AS THE INTAKES ARE METICULOUS. EVEN ACTIVELY LISTENING TO THE BS. OF EXTRA PILLOWS EXTRA MATTERESSES. LOL! THIS OCCURANCE WAS PROBABLY AT COUNTY LEVEL OR CITY LEVEL AND AS THE POPULATION OF SKIDS POUR IN OFF THE STREET THERE DOES SEEM TO BE A SOMEWHAT INDIFFERANCE TO THE HEALTH DELIVERY SYSTEM AND THIS IS MERELY AN OBSERVATION MADE AS MY POST IS AT A "RECEPTION CENTER" ......... PRETTY TRICK NAME FOR ENTERING THE SYSTEM TO DO YOUR BID OR BIDS!! SORRY FOR YOUR BRO'S PROBLEMS AND HOPE ALL WORKS OUT WELL AND YA WIN A TON OF MONEY TO PAY FOR HIS INCARCERATION AS HIS ACCUITY LEVEL HAS GONE FROM A PROBABLE 2 TO A 4 ............. AND THAT ALSO CHANGES HIS PLACEMENT RELATED TO THE CUSTODIAL LEVEL AS WELL. ..... OH YEAH IN MY STATE IF A SKID SUES AND WINS THE STATE THEN PUTS A FREEZE ON IT TO PAY FOR THAT SKIDS INCARCERATION!! NICE TO SEE A SKID PAY FOR HIS OWN WRONG DOING!

BSNinTX · Mar 6, 2005

Gee, and I thought only my federal prisoners all wanted a lower bunk, extra mattess, extra pillow, no ladder use, no heavy lifting, no prolonged standing, no prolonged sitting, no prolonged walking, "but don't write anything that would mean I can't play basketball, go to the weight pile, run 5 miles a day, or work in the factory - I need the money to buy all my junk food and then come in to medical and claim I'm indigent and need free OTC meds."

EVEN ACTIVELY LISTENING TO THE BS. OF EXTRA PILLOWS EXTRA MATTERESSES.

crjnursewarrior · Apr 10, 2005

I have to get on my soapbox here! Fiestynurse and the others that are defending the healthcare in the jail/prison systems....you are so RIGHT! I think that these people who are complaining about the people who do not get the appropriate meds in jail/prison need to take into consideration the fact that most of these people, when they were not incarcerated, NEVER went to the doctor! They NEVER would have gone to the store and bought Tylenol...but now that they are incarcerated they have become such health conscious individuals! UNREAL! I am not saying that anyone's brother should have been neglected their insulin and it is certainly sad if someone commits suicide when they are faced with imprisonment, but that person had more problems that obviously contributed to suicide than just the prospect of not being given his "injections". The problem with most situations where someone is not given the adequiate medical attention or medication they need is when the facility they are incarcerated in does not have a medical staff available 24/7. Many of the city/county facilities only have officers available that are not trained adequately to deal with these medical problems. Again, as Fiestynurse mentioned, HIPPA laws prohibit us from telling these people's families how they complain and complain and after after being seen on nurse sick call and prescribed medication they refuse to get up in the morning and take the medication. Yes they ALL want extra mattresses and pain meds for their backs, but have no trouble in the rec yard...ANOTHER factor I think these whining naysayers and family members need to consider is cost...most of these inmates get this care for FREE!!!! Law-abiding citizens must PAY for their healthcare. Considering the price they pay for it, I feel the care they receive is MORE than adequate. I have NEVER seen an inmate be denied medication that he truly needs. :angryfire

sonoma_gal · May 30, 2005

Can't believe I am reading this thread on Memorial Day but here goes...

I have worked for many years in a correctional facility with excellent medical, mental, and dental health care. We get inmates on essential medications within hours of intake. Psych meds wait up to 24 hours except in someone who will be on detox meds. Our facility waits, in most cases, to start psych meds until detox is complete. We have 24/7 RN coverage. We also have a somewhat small (compared to other correctional facilities) average census.

We had spent about $15,000 a month on psych meds such as Zyprexa and

also do give the q 2weeks injections for antipsychotics if inmates have been on these before. We also have a program to keep dually diagnosed people from reoffending. Funds for this are being cut. The public doesn't want to

be taxed more and hence cuts.

We have now been determined to be too expensive. We have been compared with other jails where a contract medical service is used. In order to "save our jobs" we must now endeavor to work "more like a contractor."

I hate to think of how much less we will be able to do with inmates medical needs. I anticipate all kinds of problems. Soon we will cut staffing levels.

I will keep you all posted.

BackOff · Jun 7, 2005

I don't know about other correction facilities but I am the only nurse for the county jail and I cannot work 24/7 However, medications are packaged by me for the detention officers to give. If an inmate comes in over the weekend, I am called if they have medication with them for me to approve dispensing. If they just say they are taking a particular medication, it must be verified before just handing it out. Almost everyone arrested is taking the following: Percocet, oxycontin, valium, xanax, lortab, soma. All at the same time and swear they must have it immediately. Unfortunate things happen in all facilities.

ARNPsomeday · Jun 7, 2005

many communities have developed programs for the mentally ill to keep them out of the jails. they have special "mental health courts," with judges who are educated and sympathetic to the problems of the mentally ill. the local police departments have developed supportive programs and trained officers to assist the mentally ill when they act out. efforts are being made to get them into outpatient treatment, rather than throw them into the jails. it's just such a huge problem.
the suicide info was very helpful donmurray - thanks.

i hear you, fiestynurse. one thing about mental health courts. as far as i know, only those accused of non-violent misdemeanors qualify. if a police officer feels the defendant resisted with violence then that's it. the are taken to regular court where empathy and proper knowledge about mental illness are usually lacking, starting with the judge all the way to the public defender. there are rare gems who are exceptions.

some police officers are trained in a program called crisis intervention team, or cit. this effort has had good results in miami, fl where " we have the highest percentage of people with mental illness of any urban community in the united states" . you can read a brief article by the judge who started this effort in this city at: http://www.miami.com/mld/miamiherald/news/opinion/9437508.htm

if you can't read it send me a msg . i'll be happy to copy and paste it here (with the proper credits, of course ;d )

NiceNurse · Jun 19, 2005

I am so glad I read this thread, I wish everyone who has a relative in prison/jail could read it and the jailers too.

I was wondering if anyone has a good answer I can give when a lawsuit is threatened by an inmate? If I had a dollar for every inmate who said "I know my rights if I don't get my meds, a second mattress, etc. I'll sue you". Usually before I've even got their name on the screening sheet.

Seems like suddenly the women all have a hx of CA, need PAP smears, and the men have "blisters" on their memberes. Oh and Oxycontin or Methadone will cure them.

I have to get on my soapbox here! Fiestynurse and the others that are defending the healthcare in the jail/prison systems....you are so RIGHT! I think that these people who are complaining about the people who do not get the appropriate meds in jail/prison need to take into consideration the fact that most of these people, when they were not incarcerated, NEVER went to the doctor! They NEVER would have gone to

stevierae · Jun 22, 2005

Schizophrenic people present a far greater risk to themselves than they do to the public, and the suicide rate is higher for those with the diagnosis. Unsure if the stats were similar for UK & US, I googled and found schizophrenia.com
" Suicide is unfortunately the number one cause of death for people with schizophrenia - but it is highly preventable! Upwards of 40% of people that have schizophrenia will attempt suicide at least once.

But, I wonder if they are more prone to commit suicide during times when they are non compliant with their meds---and, here, many of the street people you see talking to the voices in their heads (yes, they are schizophrenic) are ON the street because they refuse to remain compliant with their meds--they don't like the side effects.

I don't know about them being a danger to themselves, but the ones I see all the time in San Francisco and Oakland--usually panhandling in between talkign to or yelling at the voices in their heads---tend to get violent when they don't get what they want. I am not easily intimidated, but I have been hit and spat upon, and had feces thrown at me. It comes with the territory, I think, when you take BART (the rapid transit system) outside of which many camp out with their shopping carts hoding all their belongings, and panhandle.

stevierae · Jun 22, 2005

My brother, who has had IDDM for years, was recently incarcerated. He was not given his insulin for 4 days. He was taken to the E.R. from the jail, in a coma. He had a blood sugar of over 750. He was stable prior to that because he watched his diet, checked his sugar, and took his insulin like he was suppose to.
Now, he has Renal Failure because of it. And his IDDM is very brittle now.
The kicker is, his wife even offered to bring in his insulin and needles and accucheck monitor so that he could be stable, and the jailors denied it.
Yes, there is a pending lawsuit over it!

This is a sad situation and, if accurate, tragic.

Now, my OWN brother- in- law had the opposite problem.

He had brittle diabetes and was in and out of the prison infirmary (is that the proper name for the prison hospital?)

He was expected to die and got permission to go home to do so. He was still a prisoner, mind you; however, he was in such bad shape he was absolutely bedridden. He wasn't exactly healthy enough to go out and rob banks or sell crack, LOL!

So he was home a week or two, but his wife couldn't get him to remain compliant with his p.o. meds, and he refused his blood sugar testign and his insulin injections.

One fine day, honest to goodness BOUNTY HUNTERS showed up on his doorstep--wouldn't have believed it had I not been there myself, visiting in rural Georgia--

Back to the "grey bar hotel" for him. :rotfl:

(I think his wife tipped them off, but she ain't sayin'.) :uhoh21:

jamangel · Jul 5, 2005

My brother, who has had IDDM for years, was recently incarcerated. He was not given his insulin for 4 days. He was taken to the E.R. from the jail, in a coma. He had a blood sugar of over 750. He was stable prior to that because he watched his diet, checked his sugar, and took his insulin like he was suppose to.
Now, he has Renal Failure because of it. And his IDDM is very brittle now.
The kicker is, his wife even offered to bring in his insulin and needles and accucheck monitor so that he could be stable, and the jailors denied it.
Yes, there is a pending lawsuit over it!

I think your situation is very unfortunate. I don't know if I'd say that is the norm. At the jail where I work, if an inmate is on a medication, including psychotropics after the physician is gone for the day, then the family member can bring in the ORIGINAL current prescription bottle with meds and that inmates name imprinted. The info is copied and an order is obtained for it. If it is a psychotropic then a short order is obtained until the next day when the psychiatrist can see them. Diabetes is kind of ridiculous not to treat. If an inmate states he has DM, then a BS is obtained and if he/she can tell us his regimen (oral or SQ) we can get an order for it and routine accuchecks from the doctor by calling him. I work in Augusta Georgia but every facility has it's own policy. Unfortunately, there can be negative care given to inmates because of where they are. Also, you have 2 agendas going on in corrections. Medical has their own and Security has their own. Majority of the times, security wins. The atomosphere between the two is not of the best. Sometimes, medical wants to help but security shuts you down :angryfire . I didn't even know there were facilities that did not have 24 hr nursing. An inmate can be admitted at anytime of the day or night. Maybe the 2 can come together one day, hopefully :rolleyes: .