Passing KOP's

[jschut, BSN, RN]

We have a new system for passing KOP's. Now, a nurse, a QMA and 1 guard are to wheel a cart full of KOP's dorm to dorm and have this complete in 1.5 hrs each night.

The offenders are out and doing req time, and here we are, 3 sitting ducks, with a cart full of meds, walking dorm to dorm.

This is done because the offenders aren't coming up to get the meds, so now, we have to carry it to them.

#1- I (among others) feel this practice is dangerous.

#2- The offenders will figure out that we are doing this at the same time every night, and may come up with a plan.... steal, harm? who knows.

#3- This cuts down on the nurses time to get their work done, and I didn't know we were running a hotel with room service..... if they don't come up to get their meds... cancel them!

How do you other correctional nurses feel about this practice?

[katkonk, BSN, RN]

Well, I can only say what the attitude in Texas would be. They are KOP's, not DOT's. It is the inmate's responsibility to pick up his meds. They will come running when they are sick because they AREN'T taking them! It shifts the responsibility to them. If they don't take their KOP meds, then they need to make them DOT meds if the person's health is suffering because of poor compliance (especially if staff are having to go out and pick them up off the floor with stretchers because they are non-compliant with anti-seizure meds or diabetic oral meds, etc). I think it is a waste of staff time to go out like that. Specifically, if they are out at recreation time, education, law library, etc. , then how will you get the meds to them if they aren't around? The delivery service idea sounds bad to me. However, if there is an issue with the C/O's not letting them out to come and get their KOP's, then that would be a different problem completely.

Re: the safety issues...I don't know what your particular environment is like, so I cannot form an opinion.

Good luck with the new procedure. Repost to this thread in the future, and update on how it is going. Which state are you in?

[Orca, ADN, ASN, RN]

This procedure sounds very ill-advised to me. Inmates not on restricted units could pick up their KOPs. We have specific days and times at which we dispense KOPs (usually Saturday and Sunday, early afternoon, because there is generally less going on in the clinic). We only hand-deliver KOPs to our lockdown units.

Dragging meds across the yard on a cart sounds like a recipe for disaster, especially if the yard is open while you're doing this. Suppose the cart turns over or something falls off, and you are in a crowd of inmates. I don't know how you could possibly account for the medications.

[Opera26]

That sounds nuts to me. When I read your post, I thought, "what"? Let the IMs come for their meds. I don't get whatever it is they (whoever's idea this was) are thinking. Change the time the pharm tech gives out the KOPs, if that would help. That is just whack! (BTW, what's a QMA?)

Op

[jschut, BSN, RN]

Well, the update so far is this:

one nurse has been suspended for refusing to go out in a horrid wind and freezing rain storm, and 2 others refused just the other night (I don't know what happened to them yet.).

The "acting" administrator gave us all the spiel about "teamwork" and how other facilities do it this way... all the double talk about how "this is where we are right now..." and when it was suggested that offenders come and get thier meds or cancel them, he says that it's our responsibility to get the meds TO the inmates, no matter what.

There's already been 3 nurse attacks in a few short months, and yet we're expected to go out in all sorts of weather, inmates on rec time and put ourselves in danger of getting sick or being attacked ourselves?

Needless to say, I am leaving as soon as I find another job, and I won't look back.

And in addition, my pay that was promised to me has now been made $2 less and of course, Mr Admin says that that can't be helped either.....

Whatever.

Makes me wish I had stayed where I was till graduation and THEN looked. But I guess hindsight is always 20/20, eh?

PS: A QMA is a qualified medical technician, and is able to pass meds under a nurses direction.

[Orca, ADN, ASN, RN]

This supervisor has a warped sense of responsibility. The inmates are not invalids, and they are not incapable of picking up their meds. The fact that there have been assaults points out a serious security issue with the current procedure. I can't imagine any responsible manager holding the nurses responsible for a procedure like this. I would not order my staff to do anything like this in the first place. The supervisor has a responsibility to see to the safety of the staff, and at some point the inmates have to be held accountable for their medications.

[katkonk, BSN, RN]

very interesting update! are you in california? just want to know which state is doing this ill-advised

policy. i'm interested in the attacks on nurses that you mentioned. how and where (what part of the

facility) did they happen? how badly were the nurses injured? perhaps we can all learn from the mistakes

of other facilities. i am with orca - the administrator has an obligation to protect the staff first. i am wondering

if you are in california, as i am curious as to whether it is the federal overseer which is telling them that medical

needs to get the meds to the inmates by whatever means possible-hence the delivery service. and i do not

blame you for looking for another job. please repost with more updates and any answers to these questions if and when you can. best wishes with your future, whether in corrections or not. personally, i am waiting to hear more fallout from our big event here in texas where an inmate that was being transported obtained a gun, held two guards at gunpoint, tied them up in back, drove the van around a while and then escaped. he stayed free for over a week before he was caught. now he is telling anyone who will listen that "a nurse and a senior correctional officer" were the ones that smuggled the gun in to him. he states that he paid the nurse the money, by earning money from a drug smuggling "ring" inside prison. i don't know that i believe him, but obviously he obtained the gun in some way. scary, scary, scary. if a nurse did sell him a gun, it is so far beyond my comprehension of what you would do to your fellow human beings-putting them in jeopardy, that i cannot imagine. it think he got it elsewhere and just wants to get revenge on a couple of people he doesn't like in the system.

[Quiskeya]

In our facility some inmates have KOP meds, such as albuterol and nitro, these are the most common. During med pass when an inmate does not want to come up to the cart for their meds, we simply mark "refused" on our eMAR. If the medication is a medication that cannot be refused, we have "force meds" orders from the MD if necessary. I usually try to find out the reason why they don't want their meds and I usually persuade them to take it. If they still refuse, they have to sign a "refusal" form.

[BeachBum66]

''I'm interested in the attacks on nurses that you mentioned. How and where (what part of the

facility) did they happen? How badly were the nurses injured? Perhaps we can all learn from the mistakes

of other facilities.''

..This. Please let us know what happened.

[jschut, BSN, RN]

1. A lady walked into a restroom and an inmate was hiding in there and beat her pretty good. Another nurse walking by heard her screams and when she stumbled out of the restroom, helped shield her against the wall away from the inmate and alerted officers with her radio.

2. Was an officer (sorry about the confusion- my mistake). She was attacked by an offender, but was able to take control. However, she was hurt and still holds visible scars.

3. A nurse was pushed into a room right outside of the Infirmary by an inmate "worker" who attempted sexual assault. The nurse was able to break free and reported the situation.

[it's hot in phoenix]

What state are you working in? Ours use to do KOP's the same way. but it was only 1 LPN and an the officer would be at the yard when she got there, but she was alone on the trip to each yard. They changed to everyone (except I 5's) to come to medical and it was so much more time effecient. I work in a right to work state, but in the DOC we have 2 unions and they are extremely helpful for issues such as yours. Good luck to you and please be safe:bow::bow:

[katkonk, BSN, RN]

. A lady walked into a restroom and an inmate was hiding in there and beat her pretty good. Another nurse walking by heard her screams and when she stumbled out of the restroom, helped shield her against the wall away from the inmate and alerted officers with her radio.

2. Was an officer (sorry about the confusion- my mistake). She was attacked by an offender, but was able to take control. However, she was hurt and still holds visible scars.

3. A nurse was pushed into a room right outside of the Infirmary by an inmate "worker" who attempted sexual assault. The nurse was able to break free and reported the situation.

Scary...very scary....

However good to know. I have often felt uneasy when going to the restroom when no one else is around, and inmates that are supposed to be "trusted" work and wander around at will. I guess all environments within the prison have the potential for being a place of attack. Usually I feel safe, but a bit of consciousness-raising is always good to remind us of what can go wrong. Thank you for the update and sharing. Good luck with your local issues. I hope that you find an appropriate avenue for appealing their decision to stop this ill-advised practice. What state body oversees issues in the prison system? Perhaps if you cannot solve it locally, you can write to the governing authority on a state-oversight level and voice your concern about the possibility of injury to staff??