Diabetics and prison

Shell3 · Apr 4, 2006

when the inmates go through processing, they do a complete h/p, lab work, etc..Special diets are offered to the inmates, but most don't take it. (Not enough food, food too bland?? who knows..) The inmates do their own fingersticks and administer their own insulin at the medical clinic. It is a very highly controlled process. Needles are kept on high watch. The inmate is not allowed to leave the med admin area until the nurse assures that the needle has been placed in the sharps. What the officers know about diabetic emergencies is based on the experience and knowledge of the officers. They are not specifically trained in that area. If there is a problem the medical dept is immediately called. We have a two minute response time to any emergencies. I hope that answered your question.

betsy1963 · Apr 5, 2006

The diabetics can use the glucometer and inject their own insulin under our supervision. The insulin is drawn up for them in the medication room. The lancets and syringes are safety ones to prevent needlesticks after they use them.

crjnursewarrior · Apr 16, 2006

At the facility where I worked, all inmates go through medical intake screening where medical history is taken. Medication dosages are verified with a pharmacy or physician's office and the inmate is then ordered meds by our physician. Fingersticks are done as ordered, usually BID at 0600 and 1630. The inmate is brought to medical and the inmate usually sticks their own finger, with the supervision of the nurse and the correctional officer. The insulin is given by the nurse. The inmate is not allowed to give their own injection. They are put on ADA diets but usually end up signing a refusal of treatment form for that. They are not allowed to buy any food items off commissary if they are on an ADA diet, but when they sign the refusal they are then allowed to get the food items. Most of them end up being better controlled there, even with the refusal of the ADA diet and the commissary food, than they were on the streets. :specs:

grannynurse FNP student · Apr 16, 2006

At the facility where I worked, all inmates go through medical intake screening where medical history is taken. Medication dosages are verified with a pharmacy or physician's office and the inmate is then ordered meds by our physician. Fingersticks are done as ordered, usually BID at 0600 and 1630. The inmate is brought to medical and the inmate usually sticks their own finger, with the supervision of the nurse and the correctional officer. The insulin is given by the nurse. The inmate is not allowed to give their own injection. They are put on ADA diets but usually end up signing a refusal of treatment form for that. They are not allowed to buy any food items off commissary if they are on an ADA diet, but when they sign the refusal they are then allowed to get the food items. Most of them end up being better controlled there, even with the refusal of the ADA diet and the commissary food, than they were on the streets.

Thanks. One thing, there is no such thibg as an ADA diet. The ADA has suggestions but no formal diet.

Grannynurse:balloons:

crjnursewarrior · Apr 17, 2006

Thanks. One thing, there is no such thibg as an ADA diet. The ADA has suggestions but no formal diet.
Grannynurse:balloons:

Right...I understand that, but the ADA puts out guidelines that the dietary dept. follows and it is listed as ADA diet on the special diet requisition form that we had to fill out, so I always just refer to it as that.

grannynurse FNP student · Apr 17, 2006

Right...I understand that, but the ADA puts out guidelines that the dietary dept. follows and it is listed as ADA diet on the special diet requisition form that we had to fill out, so I always just refer to it as that.

Then the dietary department needs to make a change before they find themselves in legal difficulty. Perhaps they should refer to it as a low carb or low whatever diet. I'm surprised your chief dietician has picked up on this mistake. I wonder if many of your diabetic prisoners have ever received adequate education regarding their disease management.

Grannynurse:balloons:

suzanne4, RN · Apr 17, 2006

Sorry to inform you but hospitals are still using the ADA guidelines, and you will see 1800 cal ADA, 1600 cal ADA, etc. Any modifications can also be added to that, such as 1800 cal ADA, low salt, low cholestral, etc.

ADA guidelines are still being used. They are guidelines, they are not a diet, and never were. But that is how the dietitians calculate the amounts of foods, based on that.

crjnursewarrior · Apr 18, 2006

Then the dietary department needs to make a change before they find themselves in legal difficulty. Perhaps they should refer to it as a low carb or low whatever diet. I'm surprised your chief dietician has picked up on this mistake. I wonder if many of your diabetic prisoners have ever received adequate education regarding their disease management.
Grannynurse:balloons:

There is no chief dietician in the facility and most of the kitchen staff are contract employees. I don't think they have any formal dietary training. The diet requisition form is printed by the contracted medical company...so really they are the ones in the wrong, you are right...they are setting themselves up for legal trouble. But, what can you expect? This is the same company who has a detox protocol order for Mag Sulfate 1 mg in "each buttock"...now, I don't know about you, but the at the nursing school I went to, "buttock" was not one of the IM injection sites we were taught! That place is a lawsauit waiting to happen!! That is one reason I am so happy I no longer work there!!! I would try to tell them about things of this nature and they would just get all offended and act like it was no big deal.

Anyway, as for adequate diabetic education...we try to educate as much as possible. You have to understand the setting. Most of the inmates have limited education and understanding, so it must be simplified for them to understand which is possible to do, but the other problem is their apathy toward their disease. Most of them do not want to hear about controlling their disease and then there are those who simply don't care about or worry about anything else except getting out of jail and getting their next drug/alcohol fix. So, it's a real drag when trying to educate them...but alas, as nurses, we still try.:chuckle