New to site, have a question

VegRN · Mar 3, 2007

I think this is scary, scary, scary that the sheriff is trying to do this. If an inmate is complaining of a medical complaint, a nurse needs to assess it. How can a lay person even know the right questions to ask? There are so many different medical conditions, complaints and the like and so much to know about assessing each complaint. How can a lay person be substituted for the many years of education and experience that a nurse has. You just can't.

I would start by trying to explain to this Sheriff how complex the assessments can be and that there is no way you can possibly write down a list of questions that an officer is to ask the inmate. SOB, CP etc can have many possible causes, severities and without looking at the inmate sometimes you cannot tell what is going on. Are there any examples you could give where an officer has had an opinion about the inmates medical complaint and the nurse assessed the pt and the officers opinion was wrong? Maybe there is some good examples in the lawsuits.

Are you comfortable with saying that you don't feel comfortable with a non medical person relaying an assessment to you? That it's your license and without looking at the inmate you are not comfortable giving recommendations as to what to do. And that if the officer gave wrong information or not the right information that the inmate could suffer and the department could get sued. How do the officers feel about this? Do they agree/disagree? If they disagree are they comfortable saying this?

Gosh, I feel for you. I hope you are able to make the sheriff see that this is a terrible idea.

rgcirn · Mar 4, 2007

Hello,

I work in a correctional facility and we have to take call on our weekends. If the officers call us because someone has a medical complaint, we insist on talking with the inmate. At least we can to a telephone triage and "see" what is going on through the inmates eyes.

It doesn't eliminate coming in to assess the inmate, what it does is eliminate the sometimes wrong assessment of the correctional officer. I've found that they tend to embellish (sp) what the inmate is saying.

This way if the inmate is c/o cp you can ask the inmate the appropriate questions.

I would never rely on the correctional officer to ask the appropriate questions. Simply because each case is different.

Maybe this could be an option the sheriff might go for. It could reduce the number of times you must come in while on call, however he needs to know that coming in to see an ill inmate will never be eliminated.

Hope this helps, good luck.

rgcirn

inmatern726 · Mar 4, 2007

Thank you for answering my questions. I appreciate the input, and will let you know how everything goes at the meeting Wednesday.

VegRN · Mar 4, 2007

I agree with rgcirn, telephone triaging the inmate yourself is a much better idea. That way, you can decide for yourself if you need to come in.

nurseT · Mar 5, 2007

Hi, hope I am doing this correctly. I have been an RN for 20 yrs, the last 3 in correctional nursing, the previous years in a level 1 trauma center ER. I am now the "manager" of medical in a county jail, with inmate population of 350. I work days, another RN works evenings, and our doctor is there 5 mornings a week. That is it for employees. One of us is on call at night and weekends. We are employeed by the sheriff's dep't., and are members of their union. Here is my question:
We have a new sheriff, just elected in November. He is trying to make me come up with a list of questions that the officers can ask the inmates to help us determine if their medical needs are valid. He is doing this to try to save money on having us come in when we are on call, or having to send an inmate to the ER for further evaluation. He also seems to think that we have very limited liability toward the inmates' health care.
Outside of just calling him an ignorant fool (don't think that would go over very well!!), any direction you can give me would be most welcome. I am looking particulary for malpractice cases that inmates have won, and documentation of what happens when medical professionals rely on lay persons assessments. sorry so long, but thanks in advance for any help.
If it matters, I am in Illinois.

Don't bother argueing with the sheriff. Have the Doctor address the sheriff's problem. I do have a paper in place called " Jail staff Medical Documentation". On it are places for the officer to write the inmates name and age, cheif complaint, when it started, a set of vital signs. When the nurse was notified and her instructions. If they call me at home, these are all the questions I will be asking, so I tell them, Use this worksheet ahead of time to save you and myself alot of time. I have a VS machine that a child can use. And I triage from there. After I get the medical information, I may ask whats going on with the inmate re: get sentenced today, bad news from family? What. Sometimes I discover they are simply having a panic attack because it just sunk in that they will lose their kids due to being incarcerated. Panic attacks are real for the inmate and very common. I developed a panic attack instruction sheet to give to the inmates to read. It lists all the symptoms that you can experience with a panic atack and how to cope with it. They are allowed to keep a small paper sack for this purpose. My sheriff and jail commander try to tell me how to run the medical too. The new sheriff needs to be advised that you are his professional consultant. With great respect for their responsibilities, I just tell them, they can follow my advice or be responsible for makeing their own medical decisions because I have medical laws to follow and will not break them for any reason.

AHCANJS · Mar 10, 2007

I work with over 2200 inmates and have had the pleasure of meeting former Medical Directors from Illinois Corrections. There are multiple resources for standards related to Jail Standards based on the type of jail. I work in prison, so it's a bit different. One avenue might be to encourage the Sheriff to become ACA Certified.

I agree with the above mention of having the MD/DO manage the situation with the Sheriff. I don't know about Illinois; however, most departments REQUIRE deputies to be trained and/or certified in Community First Aid and CPR. Having someone other than qualified medical staff determining access to healthcare is very dangerous water to tread. However, for the officers/deputies- they must have basic training in recognition of psychiatric disorders and major health care issues (such as asthma, diabetic emergency, cardio, seizures) Some jails have deputies who are paramedics or are close enough to the fire dept. to have paramedic/medic respond to assist in assessments. Review your job description and State Practice Acts (etc), to make sure you are not put in the position of breaking the law or being the one named in a lawsuit. Best of luck.

WYDiceDancer · Mar 25, 2007

Why do you have so little staff? Do you not have a greater incidence of drug/alcohol problems that have to be handled on nights and weekends? I would ask that sheriff if he thought a lawsuit was more in keeping with his budget than additional medical staff.

VegRN · Apr 1, 2007

Why do you have so little staff? Do you not have a greater incidence of drug/alcohol problems that have to be handled on nights and weekends? I would ask that sheriff if he thought a lawsuit was more in keeping with his budget than additional medical staff.

hahhahahahahaaaa. Too funny!