Nurse's Sick Call

We usually begin our clinic sick call @ about 0730 and it runs until about 0945 or so. Usually have 90 - 100 names on the list, but subtract about 30 for the diabetic care which is usually started about 0545-0630. So...scheduled interactions account for aproximately 60-70 per day, including a smaller list on both Sat and Sun. Our LPN's do see pt.'s as we work under protocols that are signed by our doctors. All our interactions are signed off by the MD's. So we are basically working with standing orders, anything that falls outside the parameters must be referred to MD or called to doc on call. We do require a $7 copay for sick call unless the pt is indigent in which case all care is free. The $7 covers all care related to the original c/o so that includes all meds, referrrals to specialists, etc. The rest are drop ins basketball injuries, fights, work injuries and so forth. We try to staff at least four nurses for this, but would like to add another for the incidentals, such as triaging, phone, med confirmations, etc...

Our population runs between 1800-2000, depending on what is going on in the community. Recent prostitution stings have upped our female population, for example.

I work in a very large (population hovers around 3,000 almost all the time) county jail. We do not have 'open sick call' like some prisons do. The patients submit an '82' form, which is a request for medical attention, and the various medication nurses respond to as many as they can during their 8 hour tour of duty. How many they respond to varies, depending of course on what's going on that day--like how many emergencies, real or pt-imagined, that they have to deal with. The exception to this procedure is in the maximum security section. Max has a nurse assigned to the clinic and his/her job is to do all the treatments, 82's, emergencies, and diabetics on the maximum side. Again, how many 82's they respond to depends on what's going on that day. We have about 30-something diabetics and about 10-20 treatments on dayshift alone. We charge a co-pay of $8 to see the nurse if an 82 has been submitted and we have a book of physician-approved protocols to deal with the common ailments. If the patient is seen by the nurse and then referred on to the mid-level, they are not charged the $8 again when they are seen.

How many sick call slips do you respond to in an 8 hour shift? How many would you consider to be reasonable? How long does your daily sick call usually last? How many inmates are you responsible for? How is the nurse's sick call divided-up? Do you allow LVNs to do sick call?

Our prison divided the sick call process up by dorms where the inmates live. We only have RNs do sick call. We schedule sick calls every 15 min. from about 0800 to 1300 with a 45 min. break somewhere between 1045-1130 so the RN can come up for air. There are currently 3 dorm areas and 1 segreagation area where sick call is done.There are small nurses stations in each area. One of the dorms was so backlogged for the past year with overflowing sick calls, that we began to do that dorm on weekends as well, and now are caught up. This is to keep in mind that our facility is a state prison with 1300 women. We also have Med Clinic visits,and specialty clinics running some days of the month. If we are short of an RN for a particular sick call assignment, we are forced to hold sick call up in the Outpatient area, which ties up an RN who is working Outpatient that day. But we manage. We generally do not ever have sick call on weekends or holidays, except for the weekend catch-up attempt I told you about with the one busy dorm. I also hope we will not continue that on weekends, as it could start a trend among the inmates to "flood" the sick call box so that we have to do this with other dorms!