We occasionally get patients that are inmates from the jail or prison, and of course a guard is present at all times. I had a patient the last 2 shifts with DKA, and I'd been treating him. This morning, someone mentioned (not sure who- maybe patient) that the patient had a nicotine patch on. Granted, this isn't a common thing for the doctor to order, but the admitting doctor did. I entered the room as the guard was getting very upset, stating that at the jail they don't provide nicotine patches, so the patient should not have one. The guard asked me if the patch was important in the patient's treatment plan. I replied there was a doctor's order for it, and as long as it was safe to give to the patient, then yes, it's part of his treatment plan. (OK, we all know he could live without a nicotine patch, and he'd probably be better off without it in the long run, but I had never had an issue with something like this, with the guard questioning a doctor's order.) The guard had a real problem with this- she called her supervisor, talked to our supervisor- ugh. Our supervisor said we don't have a policy in place for something like this, so we would basically treat the patient with what the doctor ordered. The guard started having an issue with the patient having coffee too, and that was the last I heard of it, as I am NOC and I was leaving all that daytime drama (shift over).
This sounds like a power struggle to me, like the guard is annoyed this patient is getting all of these benefits instead of serving time under her roof. But really, how much power does she have over the patient/prisoner's treatment in the hospital? She kept repeating that the prisoner should only receive what is important in his medical treatment. At the same time, though, shouldn't we treat prisoners like our other patients? If they ask for coffee or other comforts like that, whose policy are we operating under- the jail's or the hospital's? I'm curious about your input- does anyone else have a policy regarding this? We have a policy when an inmate is under surgery, but that's all I could find. This situation might bring about a policy of its own.