Should you treat a prisoner different

  1. Hello everyone, here is my question. Should a prisoner be treated different? I am a brand new RN, however, I am not new to the medical field. I work in the prison system as a RN. When I was in school, our instructors ALWAYS stressed to treat the pain. Pain is what the person states it is. Anyway, sometimes I feel very sorry for these men. In my opinonion, just because they are in jail, they shouldn't be treated any different than someone on the street. However, I have to admit, they do get better health care than the working public. They have everything, they get care for chronic illnesses like diabetes, htn, hiv and etc.... They also, get dental services, xray's, wound care, vaccines and medications for everything under the sun that you can think of. We also have a psych Doctor on site 24 hours a day.

    Again I pose the question should the prisoners be treated any different. At my facility, their are some nurses who mistreat these men. For instance if someone come in for a headache, they will tell them to go buy motrin on commissary and put in sick call. I don't no if they have money to buy motrin or not and as RN's we can write some prescriptions under the medical director, so we can write for motrin etc. To make a long story short, the RN's do mistreat them, most of them feel, they are in jail, so they don't deserve good care, however you would give an animal good care. Please let me know what your feelings are regarding this issue.
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    About PEBBLES1

    Joined: Feb '06; Posts: 284; Likes: 89
    RN; from PA , US
    Specialty: heart failure and prison


  3. by   NurseCard
    What kind of prison do you work in?? Sounds like minimum security? I mean, if prisoners are actually able to walk up to where an RN is and ask for motrin, go to a comissary, etc?

    I have taken care of prisoners in the hospital setting, and I never treated them any differently than my other patients and in fact, some of them were much nicer than most of my other patients. I imagine that if I were working as an RN in a prison setting, that I would treat them with the same dignity that I would treat any other patient in any other setting.
  4. by   nicunana
    If your patients were not in prison, their private insurance that they purchased or their medicaid would not pay for motrin for headaches. Why should the taxpayers? I don't see that as treating them differently. I see that as treating them exactly the same as John Q Public ( who BTW is paying the taxes that support your patients and also may not have extra money to buy motrin before payday.) Don't be so hard on your co-workers, who may have seen more abuse of the system than you have, yet.
  5. by   heron
    Hi, Pebbles ... there's a whole forum on correctional nursing on this site. You might find some insights there from experienced correctional nurses that the rest of us don't have.

    I've never worked corrections but I have worked on a locked prison unit in a general hospital as well as with inmates on open wards (with guards). In my limited experience, boundaries are exceedingly important.

    Inmates don't want to be in jail ... many are constantly planning how to "game" the system to make things easier for themselves, get things they wouldn't otherwise be allowed to have, or even get out of jail entirely.

    This is why assessment skills are even more critical in corrections ... it's practically impossible to know when there's another agenda at work and the inmate is trying to manipulate you for one reason or another.

    It's one of the great challenges of correctional nursing: to provide good professional care without being manipulated into an untenable position. I have seen nurses lose their jobs and licenses because they unwittingly got involved in an elaborate scam, thinking they were being "non-judgemental" and "compassionate".

    You didn't specify whether, in the motrin incident, the nurse was following written procedure (no meds without a sick call ... no OTC meds given out if they are available in commissary ... that kind of thing) or she was setting a personal limit with that inmate.

    Before you judge, you might want to ask her - politely - her reasoning for her decision. You also should remember that policies and procedures are written for a reason ... not the least of which is your safety as well as control of the inmate.

    Just some things to think about ... check out the corrections forum here:
  6. by   Chapis
    I think the family should provide anything that their loved incarcerated family member might need & they should pay for it. Not us, that's just my opinion.
  7. by   tencat
    I don't think you should treat them badly, however I don't believe that prisoners should have access to better healthcare than law-abiding John Q. Public. Something is WRONG with that picture.
  8. by   Flare
    Would not treat differently - but never forget that you are dealing with a population where manipulation, deceit and drug abuse are rempant. I am not saying that those apply to everyone - and you will undoubtedly meet those type of people on the streets - but the bottom line is that those inmates are not there because they were being upstanding citizens. Assertiveness and knowing your population goes a long way.
    What are your policies? If they can get OTC meds there and can self medicate then a simple headache may not necessarily be treated in the infirmary.
    Bottom line - remain professional. Give the care you are supposed to give at teh level of care you've been taught. Yes, it stuinks that criminals can get better health care than those on the streets, but it is not up to you or any other staff nurse there to amend treatment protocols to try and balance the world in your own mind.
    Last edit by Flare on Oct 22, '09
  9. by   Orca
    I am a DON in a state correctional facility. To be blunt, it seems to me that you aren't quite acclimated to the situation yet. From reading your opening statement it sounds as if you are identifying with the inmates - which is not a good place to be when you work in a correctional facility. When you hear nurses tell inmates to buy Motrin at the commissary, understand that some inmates who have the means to buy medication try to manipulate medical staff into writing them an order so that they don't have to spend the money. There are also those who just like the attention that coming to medical brings. Some also exaggerate or totally fabricate symptoms in order to get medication - and pain meds are a favorite target, because they can sell or trade them. Don't mistake preventing inmates from engaging in manipulation for cruelty.

    This does not mean that you totally ignore all requests for pain medication, but you have to be very thorough in assessing the situation. Heaven help you if you are identified on the yard as the nurse who always gives inmates pain medication. Inmates will request you by name, they will staff split and "let the games begin".
    Last edit by Orca on Oct 22, '09
  10. by   systoly
    I have no experience in corrections, but from reading this post it appears to me that prisoners ARE treated differently, because I don't know anyone who gets to consult a RN for a (assumed minor) headache. Do the prisoners have to wait several days before an appointment is available? What is their copay? Do they have to give up recreation time while they sit and wait to be seen?
  11. by   pagandeva2000
    I have not worked in corrections, so, I don't come with an experienced answer. However, I think you should follow the suggestions listed here thus far, beginning with thoroughly reading the policy and procedure manuals, and then, as mentioned, ask the nurses what makes them make the decisions that they do. While I have not worked in a prison, I have worked in psych, and have interacted with some really hard core street people even in that enviornment and the first thing I learned some time ago is to set limits with them. I didn't speak down to them, I tried to follow up on things reported to the best of my ability, but, I had to learn the difference between being overly compassionate and keeping a professional persona.
  12. by   Jaila
    Assessment, assessment! You have to treat these folks with respect that you would any patient, without coddling them. That said, they are inmates and there is often a game of manipulation going on. I know one of the things that amazed me at first was how well they know the system. Ofcourse they would though...they live in it. We do have the capability to give OTC meds and supplies when needed. But you have to assess for the need. As far as them getting better care than John Q public ... Well I don't think that is the case. They get the basics... They have that right. There is charges for medical services. Dont have the misunderstanding that they get all the free medical they want. I think you have to be fair and firm. Good assessment skills to help you weed through the b.s.
  13. by   PEBBLES1
    I work in a min security prison. As RN's we can write some prescriptions under the medical director. I will give you a couple of examples that I have witness, 1st. I was doing a wound care and I notice 1 of the inmates had a toothache and he did put in a dental sick call slip. He didn't ask for a motrin but because I saw he was in pain, I asked him what was wrong and he told me, so I gave him something for the pain and I was told by another RN, that I shouldn't have given him a motrin. Another example, I had an inmate who returned from the hospital, he had surgery and he had an order for percocet, however we don't have percocets their, all the RN had to do was call the MD, to get an order for something else and she refused. I asked her in private why she didn't, she told me because he is an inmate and don't need it. I am a brand new nurse and I was taught to always treat the pain 1st.

    Their is no doubt that some of them are BS, but you can't measure what they feel and in my opinion, they should not be treated any different. I just feel they are human 1st and nursing teaches us not to discriminate. Also, we should remember that just because they are in jail, we shouldn't judge anyone. I try to always be mindful, that I could be in their shoes or it could be one of my family members, so I feel we should always be careful how we treat people. Not to mention that 1 day they will get out and they do remember nasty people. I have ran into a few inmates, that I didn't recognize and they spoke to me and told me how nice I treated them or how I said an encouraging word to them. Thank you for your comments
  14. by   diane227
    I worked some time in a woman's prison as the psychiatric nurse for that facility. I do feel that all people need to be treated as human beings and with respect. But with that being said, you have to understand the mental games that are being played every second of every minute in prison. Prisoners have nothing to do all day except figure out ways to game the system. And they know how to pick a target. They know who they can manipulate and if they feel that they can work you, they will and that rumor will get around the prison in no time. I think you have to be professional and firm with them. And I think you have to be very careful about dispensing pain medications. Once you start, I guarantee you that everyone will be in there wanting pain medication. I would not expect them to buy their own motrin or tylenol because many of them do not have the funds to do this and I do think that some of the nurses who work within the prison system are not very nice. I met people working at the prison who were more nuts than the prisoners. And mean as hell. And I don't think you need to be that way. I don't think you need to lose your humanity. I often spoke with women who had never had anyone show them any kindness throughout their entire life and were very suspect when I did show them that kindness. Don't let your fellow nurses try to change you. But do have a high level of suspicion and be careful. If you have to go out on a tier to see someone make sure you have a couple of guards out there with you. And don't be alone in a room with any prisoner for any reason. Never trust anyone to that extent. These guys did not get in prison for doing something nice for someone. Good luck and let me know how it goes. I miss the prison and all of my patients there. I think of them often.