Patients Who Are Prisoners

saskrn · Feb 13, 2005

I've taken care of prisoners before, but I have never had so many guards around. Wow!

I don't treat them any differently than any other patient, whether it be from an empathy perspective or for anything else. I try not to judge, although I know sometimes it's hard.

Fiona59 · Feb 13, 2005

I've only ever worked with one prisoner and he only had the one guard. But he was polite, considerate, kind (I was a student), very patient, offered to do his accucheck. The guard was polite and professional.

He's a patient, who gets the same treatment as anybody else. It's usually the visitors to others in the unit who are scared/offended when they see the guard sitting in the hall.

ARNPsomeday · Feb 13, 2005

I'm not a criminal justice professional, but do I think we have some of the wording just a little bit mistaken. I think these patients are to be referred to as being "in state custody" or "in federal custody". If they are in the custoy of a marshall, that means they're in federal custody. I also think that the armed folks in uniform who watch the inmates are not guards, as guards protect a building or structure. It would seem they are either federal marshalls or correctional officers, depending upon which authority has custody.

If someone else knows more about this, please jump in and correct me. Just a little bit of trivia that will help us use the proper professional terminology of those who are in the know.

Nesher, BSN, RN · Feb 13, 2005

Had a prisoner patient who had a stem cell transplant - guard of course, shackles when walking about. We were a tad loose with him at first and like any patient allowed him visitors - that came to a grinding halt when he was found in his bathroom doing the wild thing with his wife - she was supposed to be helping with his shower. We are all still amzed he had the energy for the act considering what a transplant does to you.

He was very afriad to go back to prison for fear of infection - we did send him and he did get readmited for an infection...

Guards on the roof? Where is this at and what was the person accused of??

CritterLover, BSN, RN · Feb 13, 2005

i worked in a trauma unit for several years, and it was always amusing to see the patient with a sheriff's deputy or two sitting at bedside (on overtime), hand-cuffed to the bed frame, while on a norcuron drip (not going anywhere anytime soon........) but when they hurt a police officer, they are going to get a maximum amount of surveillance.

as for the officers on the roof, i never saw that, but there were times that we had gang members where we would have to blacken out the windows to keep anyone from seeing inside. (we were on the ground floor).

for the patients in coustody who could talk, they were generally quite polite and cooperative if they were coming from the jail/prison. now, the ones who were being newly arrested were often rude and obnoxious (fairly rare, usually if they were in position to post bail they did, and they sheriff's department was not eager to have anyone in the hospital in coustdy if they could avoid it, as they would then have to pay the bill. they would prefer to arrest them once they are discharged and avoid the hospital bill).

anyway, i never really treated them any differently. just needed to remind the deputy that they had to leave the key to the hand cuffs when they went out to smoke, just on the chance the patient might go into v-tach while the officer was gone and we might have to shock them.

stidget99 · Feb 13, 2005

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.

I have cared for two prisoners in my nursing career. The first was a nurse convicted of killing elderly w/ K+ injections. It was very very difficult to take care of this man. He was supposed to be one of us---striving to provide loving and caring treatment. As far as I was/am concerned, this particular patient did not deserve the same quality of care as other patients.

The second was a quadraplegic patient. Now obviously this patient was not going anywhere soon. But the guards insisted that this man stay cuffed to the bed. What made it worse was his skin began breaking down under the ankle cuffs. We tried placing padding under the cuffs but the skin was still looking terrible. The prison officials stated that it was policy to cuff ALL patients regardless of the circumstances. Needless to say, we got this same patient later on for ulcers to BLEs.

As far as the guards go....most were rude, inconsiderate and the way they treated the prisoners was just awful. And, with me working the noc shift, I had opportunity to walk in on a lot of them.........sleeping. Must be nice to be getting paid OT to sleep.

Cameelrn · Feb 13, 2005

The prisoners (or whatever you choose to call those who are normally incarcerated in a prison) who need so many guards (or whatever...), including those outside, are federal prisoners and, now it's only a guess here, but I think it's a logical one, they have committed some heinous crime(s) to require so much guarding. The prisons in our area (we have a whole valley full of them) have housed such criminals as the Oklahoma City bomber and other terrorists. All my patients get the same care. I just don't use endearments with my prisoner-patients, for instance. I do not know what they did, so it is easy not to be angry with them. I try to think of them as men and (a few) women who made mistakes when they were young and have been paying the price, but I keep in mind that many are sociopaths, who can be quite charming They know that if they complain of chest pain they will be brought to the hospital for testing and have a couple of days out of prison, but we do get some who do have serious health issues as well.

By the way, guards who fall asleep on the job should be reported. We have a responsibility to the other patients and if that prisoner were dangerous and got loose because the guard was asleep and you didn't report it....

We usually try to keep a wash cloth between the patient's skin and the shackle. I know what you mean about how silly it is sometimes that they are shackled...I had one who was dying and still had to be shackled. We tried unsuccessfully to get the Warden to allow him to be unshackled.

saskrn · Feb 13, 2005

I remember plenty of times where the guards were sleeping or would go for a smoke, leaving the prisoner alone. Of course he was handcuffed, but it used to make me uncomfortable, for safety reasons.

meownsmile, BSN, RN · Feb 13, 2005

We care for inmates, it seems more frequently anymore, but a guard is present at all times. NO smoke breaks, no sleeping, no visitors for either guard or guest. We promptly report guards who have been caught sleeping, disrespectful of our staff and occasionally the one who is on the phone the ENTIRE shift.

We normally dont ever have problems with them as patients, usually because the same rules apply while at the hospital as do while they are in population. They get write ups, time added to their sentances etc if they have problems while at the hospital just like if something occurs while they are at their facility.

And we require that our staff remove their name badges before entering the room. There is no reason the patient needs to know what your name is. It can just lead to problems after they return, remember they have writing priviledges, telephone priviledges and we have had it become a problem one time only.

saskrn · Feb 13, 2005

I think the most problem I've had with prisoners is in the ER, when I'm drawing BAT's. Of course, they're not sober either.

Cameelrn · Feb 13, 2005

We care for inmates, it seems more frequently anymore, but a guard is present at all times. NO smoke breaks, no sleeping, no visitors for either guard or guest. We promptly report guards who have been caught sleeping, disrespectful of our staff and occasionally the one who is on the phone the ENTIRE shift.
We normally dont ever have problems with them as patients, usually because the same rules apply while at the hospital as do while they are in population. They get write ups, time added to their sentances etc if they have problems while at the hospital just like if something occurs while they are at their facility.
And we require that our staff remove their name badges before entering the room. There is no reason the patient needs to know what your name is. It can just lead to problems after they return, remember they have writing priviledges, telephone priviledges and we have had it become a problem one time only.

That's exactly why I don't have my last name on my name tag.