Patients Who Are Prisoners

Nurses General Nursing

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How do you manage patients who need to be guarded? In our hospital they are in the general population and have the number of guards appropriate to their status. We refer to them by a number or initials so that families, friends, and perhaps enemies, don't show up. Sometimes that means one guard, and sometimes that means four guards in the room with one on the roof and more in vehicles parked around the buildings. We actually do not take any special measures in treating them other than to not empathize with them as deeply. They are usually the most appropriate and polite patients we have. In fact, we have more trouble with the guards being inappropriate. We don't lose track of the fact that they are prisoners (or dangerous mental patients), though.

In 1989 when I got my kidney transplant, there was a prisoner two rooms down the hall from me. He had been there for four days already and I hadn't even known he was in there-- until day 5, when he took advantage of his guard being in the bathroom and pushed his IV pole down to the Patient Lounge... apparently going 4 days with no TV was getting to him.

Suddenly there was a loud alarm going off, the doors to all patient rooms and stairways shut, and all of the elevators on our floor shut down. An announcement came over the PA, telling everyone to stay in their rooms. A few minutes later the doors opened again and I could hear yelling in the hallway. A nurse told me that they'd caught the prisoner in the lounge and that he was probably sorry he'd done it.

I found out why a few weeks later-- there was the prisoner and his guard in our transplant clinic. The prisoner was now sporting a huge sling on his left arm and seemed afraid to move at all. I wonder if his arm ever healed properly or if he kept his transplant, but we never saw him again.

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I worked in a maximum security prison that held the worst of the worst. These inmates were the ones that could not comply with the rules in the other prisons so they came to us. We were also only the second prison in my state to house the inpatient mental health. We had over 175 ICONS-intensive control -segregation inmates and another 200 MCONS-maximum control- segregation inmates. I had no problems with the inmates they were always respectful and nice to me. I left because of my supervisor. She liked to think that her way was the only way. She in fact made more mistakes than us newbies on paperwork etc. I was there to provide nursing care to the inmates not to punish them, their punishment had already been handed down by the judge and jury. Hey who hasn't made a mistake. Maybe ours was not murder or robbery but a sin is a sin. By the way it was the easiest nursing I have ever had the privilage to perform.:rolleyes:

I work at a State Mental Hospital. My unit consists of men who's charges range from murder, child molestation, rape, stalking, terrorism.....

I know what the charges are on all of my patients. I find it easier in my situation to keep in mind they are charges, not convictions. My patients have been found not competent to stand trial due to mental illness. Many admit to their crimes, but I don't discuss them unless the patient brings it up. For the most part, they are polite. We try to run the unit like a hospital, not a prison unless the guys start acting like crimminals. It is a lock down building so in many ways it is like a prison or jail but the patients are treated much better here so they are pretty motivated to be good.

If you have trouble treating patients with a crimminal history, I feel you should trade the patient. Most supervisors would understand if you just can't treat this patient the same as any other.

Lori

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I agree that we should try to remember to call "guards" corrections officers. That is the proper title in our facility. I work in a probation detention center so most of our prisoners are not considered very violent. We have probation violators for things like DUI, child molestation or child abuse, burglary, robbery, etc. I have never felt in danger and depend on the officers to keep me safe. They work long hours for very little money and most of them are very professional and fair. You will always find someone who doesn't follow his job description, but they are very few. When our detainees go to the hospital, they are required to be cuffed. Our officers will allow the cuffs to come off if medical care is compromised but the detainee is never left alone. Safety is the number one priority of these officers. I appreciate them very much.

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Specializes in LDRP.

I am a RN student, haven't had a patient who was in police custody yet. Though where I go for my GYN care is where the local female inmates are taken for pre-natal care, so i've seen a few of those. they come with a female sherriff's deputy, usually.

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Specializes in LTC, assisted living, med-surg, psych.
That's exactly why I don't want to know what my prisoner-patients did. We are pretty strict about that. Sometimes a guard will try to tell me and I'll tell them to stop that I'm afraid knowing will affect the care I give. I think it is human to be affected by knowing that a patient is a child molestor, so it just makes sense to take that knowledge out of the equation.

We rarely have patients in police custody, but when we do I go out of my way to NOT find out why. The few prisoners I have dealt with have been very quiet and polite, and I've never had a problem with them.......although I couldn't quite suppress a shudder when I learned later that they were child molesters or killers! :eek: :chair: It just makes it easier for me to treat these patients with care and compassion if I don't know what their crimes are. :stone

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