I have recently spoke to a nurse who works in a detention center. I was surprised to find that if you become arrested you can be denied your medication, even if it is something you cannot just d/c like Paxil. The nurse I spoke to said it's just that way; I have a difficult time accepting that answer.
My very sweet next-door neighbor was arrested for drinking and driving -- he was on injections for schizophrenia -- he committed suicide, due to the fact he was going to jail and would be denied his injections (like he has in the past for same offense). I'm really concerned, even if these people have broken the law.
Has anyone heard of this before?? And can anyone explain why this is???
Targa states that she has "personally litigated a dozen cases against detention facilities on behalf of inmates who were denied medical care. For the most part, the facility's MD discontinued medication that the inmate/detainee's personal physician had prescribed, without consulting with the personal physician. This happens so often and in so many facilities that I could have a law practice specializing in it, if I wanted it."
Have you ever worked in a correctional facility because you seem to have a lack of understanding as to who is medically responsible for the inmate once he is incarcerated. It is the jail doctor who is responsible for assessing the inmate and determining what needs to be prescribed. (The HIV medication incident was unfortunate, but is not the norm) Many times we have information that the personal physician does not have, such as heavy illegal drug and alcohol use. Or the inmate has not seen his personal physician for many years and his symptoms and situation has changed. Or the personal physician is a quack! Every jail doctor that I know will request for old records and consult with outside physicians, if necessary (however he is under no obligation to consult or agree with the outside physician) to determine what the medical history actually is. It is always the jail doctor's legal liability that is at stake here. He has to properly prescribe the correct medication based on his own hands-on exam, experience, and education. Inmates tend to not give accurate medical histories and tend to exaggerate their symptoms. They play a lot of games in order to gain control or get out of jail. It is not an easy environment to work in.
And there are many attorneys specializing in the litigation of Correctional Facilities and every inmate has an attorney at his diposal, which is part of the problem.
I work in a regional treatment center for the Mentally Ill and Dangerous and the Sex Offenders. I could tell you some very disturbing stories about the MI&D patients. They normally come to us after they have been to the court. They have comitted murder, rape and many other horrific acts upon innocent people. These people are very dangerous and are only med complient when they are in the institutionalized setting. One of the other posters noted that they are not med compliant because they do not like the side effects of the drugs and that is a very true statement. Some of the MI&D patients have what is Jarvis. This means if they do not voluntarily take theire meds that we can force them to take them. I understand that these people are mentally ill but I would not want them out on the streets for any reason due to the horrific crimes that they have commited because they did not take their meds. They preferred the alcohol and illegal drugs to treat their symptoms. These are very intelligent people for the most part. They know the difference between right and wrong yet they choose to not take their meds and then decompensate and that is what gets them into trouble. Don't blame corrections for their problems. They have brought their incarceration upon themselves and corrections always seem to get the blame. We are not making any money off of the people either. They are court ordered into the facility and the state is paying for them to be there. The state also pays for their medical, dental, and psychiatric treatment. I would like to know how anyone figures that we are making money off these people. I am only referring to the mentally Ill population. The sex offender programs are just as bad. But don't get me started on that one.
Specializes in Rehab, Corrections, LTC, and Detox Nurse.
Wow... what a bunch of judgmental nursing "professionals".
Personally, I don't care what they've done or have been accused of doing. In the county jail setting, most of them have only been charged and not tried or sentenced. I give them the SAME care and consideration I give now that I work with a different population. I personally made sure ANY inmate who wished to see the doctor or should see the doctor was placed on the sick call list. I am especially pushy about HIV + inmates even if I know they are known drug users and don't comply with thier med regimen. Nonetheless, this a nursing forum and where we are all professionals, we are all human first. Everyone has the right to vent their frustrations from time to time without their professionalism being questioned. Anyway, when you note judgement aren't you in fact passing judgement as well? Corrections is not the easiest place to work for ANY nurse unless you are void of feeling anything at all. Either you hate it or you love it. If you hate it, go and if you love it, stay and and make a difference.
EVERYONE is entitled to adequate medical care NO MATTER WHAT!
I just want to add that there are thousands and thousands of positive patient/nurse contacts everyday in jails and prisons, with thousands of pills being passed and thousands of treatments with good outcomes. I have witnessed many jail nurses and doctors identifying signs and syptoms of disease and saving inmate's lives on a daily basis. One jail doctor recently identified an inmate with cancer, after being misdiagnosed by his personal physician on the outside. But, you never hear about any of this. Only the bad outcomes make headlines. Targa states that she has litigated a dozen cases of bad outcomes at correctional facilities. For some reason that number didn't jump out at me. Compare that to the percentages of bad outcomes in our community hospitals, nursing homes and clinics throughout the country every day.
I recently had a conversation with a graduate student, who has been researching doctor empathy and compassion in Corrections and comparing it to empathy and compassion on the outside. He has interviewed hundreds of doctors, who work in jails and prisons. He has sent out a number of surveys to both correctional doctors and outside community doctors. He's been working on this for three years and has a lot of quantitative data. Interestingly, he is finding little difference in the two groups. He is hoping to publish his work soon. I am looking forward to reading his completed thesis. Correctional Healthcare is somewhat of an untouched area of study in Academia. Attention all you nursing graduate students out there!
I am not sure where you are getting making money off inmates with mental illness. I do back flips everytime these individuals get released or sent to the pen. My budget has skyrocketed because opf drugs like Zyprexa, seroquel and Cymbalta. County government loses all the way around in this and there isn't anything that can be done. Also counties aren't the ones placing the charges, it is individuals, family members thinking jail can help their family and business trying to keep patrons safe.
I understand every thing you are saying, I am just mad because there would be a lot less criminals if they were locked up getting the right treatment instead of having a crisis all the time and the county pressing charges for things they tear up or break. They just want to make money off of them!! Is this really legal if it happens in your own home, can the county press charges for a mental person breaking a window out of his own home?
Targa states that she has "personally litigated a dozen cases against detention facilities on behalf of inmates who were denied medical care. For the most part, the facility's MD discontinued medication that the inmate/detainee's personal physician had prescribed, without consulting with the personal physician. This happens so often and in so many facilities that I could have a law practice specializing in it, if I wanted it."
Have you ever worked in a correctional facility because you seem to have a "
Is Targa a lawyer? Is he/she here doing research for lawsuits? That is a scary thought.
Specializes in Geriatrics/Oncology/Psych/College Health.
Folks, enough of the bickering and accusations. Attacks on others' motives and professionalism, regardless of who they are from or toward, do violate the TOS.
No one is saying that inmates don't deserve care while under the guardianship of the state/feds - just that the manipulation that is more common in that setting necessitates an even higher degree and acuity of assessment skills to perform our jobs.
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
You are so right crjnursewarrior, these guys come in through intake and are put through a complete physical which includes meds being ordered. Many have not seen a Dr. in years and right at intake/processing that pain in his ankle for 3 yrs, broken tooth for 2 yrs, etc, has now become an immediate life threatening event as far as the offender is concerned. Not all are like this though. As far as offenders not getting their meds, we run pill windows for these guys to go to and pick up their meds. Some decide not to get out of bed or they find other things to do besides getting to the pill window. The insulin dependant diabetics also don't show up many times for their finger sticks or their insulin. They receive lay-ins (appts) for their fingersticks and insulin. We don't have the staff to chase down 1000's of guys to find out why they didn't show up at the pill window or the clinic and then give them the meds or treatment that they didn't want to go get. Most of the time it is the offenders decision if he is going to be compliant or not, but most of the families are not aware of this.
Targa states that she has "personally litigated a dozen cases against detention facilities on behalf of inmates who were denied medical care. For the most part, the facility's MD discontinued medication that the inmate/detainee's personal physician had prescribed, without consulting with the personal physician. This happens so often and in so many facilities that I could have a law practice specializing in it, if I wanted it."
Have you ever worked in a correctional facility because you seem to have a lack of understanding as to who is medically responsible for the inmate once he is incarcerated. It is the jail doctor who is responsible for assessing the inmate and determining what needs to be prescribed. (The HIV medication incident was unfortunate, but is not the norm) Many times we have information that the personal physician does not have, such as heavy illegal drug and alcohol use. Or the inmate has not seen his personal physician for many years and his symptoms and situation has changed. Or the personal physician is a quack! Every jail doctor that I know will request for old records and consult with outside physicians, if necessary (however he is under no obligation to consult or agree with the outside physician) to determine what the medical history actually is. It is always the jail doctor's legal liability that is at stake here. He has to properly prescribe the correct medication based on his own hands-on exam, experience, and education. Inmates tend to not give accurate medical histories and tend to exaggerate their symptoms. They play a lot of games in order to gain control or get out of jail. It is not an easy environment to work in.
And there are many attorneys specializing in the litigation of Correctional Facilities and every inmate has an attorney at his diposal, which is part of the problem.
All of what FiestyNurse is saying here is SO TRUE...what these people who do not work in a correctional facility fail to understand is that inmates are NOT denied medical care that they NEED...they are sometimes denied medical care they WANT!! They ALL want Hydrocodone or Oxycontin for their back pain...none of them NEED it and it is not given. Why would you perpetuate someone's chemical dependency problem? We detox the inmate off this stuff per our protocol and then they stay off of it while they are incarcerated. Once they get out, they go back to these legalized drug dealers they call doctors and they get them started on it all over again. These are the people that should be the subject of lawsuits...the doctor who is ignorant and negligent enough to prescribe oxycontin for back pain...it is a drug for people with terminal illnessess...back pain is NOT terminal.
You are so right crjnursewarrior, these guys come in through intake and are put through a complete physical which includes meds being ordered. Many have not seen a Dr. in years and right at intake/processing that pain in his ankle for 3 yrs, broken tooth for 2 yrs, etc, has now become an immediate life threatening event as far as the offender is concerned. Not all are like this though. As far as offenders not getting their meds, we run pill windows for these guys to go to and pick up their meds. Some decide not to get out of bed or they find other things to do besides getting to the pill window. The insulin dependant diabetics also don't show up many times for their finger sticks or their insulin. They receive lay-ins (appts) for their fingersticks and insulin. We don't have the staff to chase down 1000's of guys to find out why they didn't show up at the pill window or the clinic and then give them the meds or treatment that they didn't want to go get. Most of the time it is the offenders decision if he is going to be compliant or not, but most of the families are not aware of this.
EXACTLY!! We have only 300 inmates at our facility, but it would be IMPOSSIBLE to chase that many people around and beg them to take their meds. These people are ADULTS! They need to take RESPONSIBILITY for their healthcare...here enlies the problem...they don't ever want to take responsibility for anything including their healthcare...that is why they are criminals!!! There is one fact that these naysayers who do not work in a correctional environment fail to understand. These people are not housed in our facility FOR healthcare...they are not there BECAUSE they are sick...if they have chronic or acute medical problems while they are incarcerated, it is our job and our responsibility to care for them...which is done 99.99% of the time far better than they EVER would have gotten on the streets. But it is NOT our job to give them anything and everything their little drug-seeking hearts desire. A lot of these people are career criminals and they manipulate the system to get whatever they can from it...and you and I, as taxpayers, are footing the bill!!!! STOP THE INSANITY!!
I am a NP and tried correctional medicine last year. I HATED it. Yes, the meds will be changed and/or denied in alot of instances. Even in long term care and for inmates in the system for life. If the med is on the formulary, it will be used, and if not, nope. And the substitutions are a joke. Very narrow list of drugs used to treat a wide variety of illnesses and/or disorders, physical and/or mental, I might add. And, if they have a probable disease process requiring long term care and due for parole soon (soon could mean within the next year or so), they will be denied referral. Or, if referral is done and a chronic problem is found requiring surgery, this will be postponed until it progresses to the point of almost emergent care.
I hate to give the state that this is going on. It is the truth, although. Hard to believe, but true.
This is not true in ALL states/correctional facilities. Yes, we only give formulary meds, but our formulary is not a very narrow list of drugs, infact it is about 25 pages long and the meds on it are comparable to anything the inmates are Rx'd on the streets. I think you fail to see the point that MOST of this litigation against correctional facilities has to do with inmates not getting what they WANT...they are given the treatment they NEED, it is just not what they WANT. My boss, the Medical Administrator, works for HOURS on end sending out inmates to any specialty appointments they NEED. Why should taxpayers money be wasted on frivilous unfounded medical complaints and then again on lawsuits over it? You don't think these inmates are paying for these lawyers do you?
fiestynurse
921 Posts
Targa states that she has "personally litigated a dozen cases against detention facilities on behalf of inmates who were denied medical care. For the most part, the facility's MD discontinued medication that the inmate/detainee's personal physician had prescribed, without consulting with the personal physician. This happens so often and in so many facilities that I could have a law practice specializing in it, if I wanted it."
Have you ever worked in a correctional facility because you seem to have a lack of understanding as to who is medically responsible for the inmate once he is incarcerated. It is the jail doctor who is responsible for assessing the inmate and determining what needs to be prescribed. (The HIV medication incident was unfortunate, but is not the norm) Many times we have information that the personal physician does not have, such as heavy illegal drug and alcohol use. Or the inmate has not seen his personal physician for many years and his symptoms and situation has changed. Or the personal physician is a quack! Every jail doctor that I know will request for old records and consult with outside physicians, if necessary (however he is under no obligation to consult or agree with the outside physician) to determine what the medical history actually is. It is always the jail doctor's legal liability that is at stake here. He has to properly prescribe the correct medication based on his own hands-on exam, experience, and education. Inmates tend to not give accurate medical histories and tend to exaggerate their symptoms. They play a lot of games in order to gain control or get out of jail. It is not an easy environment to work in.
And there are many attorneys specializing in the litigation of Correctional Facilities and every inmate has an attorney at his diposal, which is part of the problem.