Prisioners as Patients

gingerzoe · Sep 9, 2003

I work in a secure juvenile facility. We have adolescent boys age 14-20. When they are transferred to the hospital or doctors office they have to wear handcuffs and shackles, unless it is deemed medically necessary not to have one or the other. Rarely if never do they have neither on. The reason-more excape while on a med run. Luckily, we have never had anyone escape, and I have been here for five years.

Marie_LPN, RN, LPN, RN · Sep 9, 2003

We don't get prisoners that often, but it depends on where they came from on how things are handled.

City/County Jail: One, maybe two guards, both stay inside the room, patient is handcuffed to the bed frame.

Federals: Two guards in the room, one posted in front of the door, pt. handcuffed to the bed.

For both, the handcuffs are removed for any procedure. If they have surgery, a guard (usually the supervisor from the incarcerating facility must be present, scrubs, sterile and all. If the pt. is to be ambulated, they are ambulated in a hall that visitors or other pts. don't have access to, both guards accompany.

And also the typical isolation sign that says "You must see nurse before entering this room" is posted on the door.

RN-PA, RN · Sep 9, 2003

We have prisoners from the county prison at our hospital and they usually have one leg shackled to the bed. There is always a guard at the bedside, 24 hours/day, but the patient is allowed to go to the bathroom unaccompanied which I tend to think isn't necessarily safe.

debbytentwo · Sep 9, 2003

I have worked in the prison system...most inmates were not cuffed or chained. However, in "the hole" they had leg irons and belly chains and cuffs. I had a hard time getting a blood pressure around all that jewelry, but I bought a wrist BP cuff that worked really well. It is very demeaning for the inmate, but just part of the rules you have to live by to try to get care to this population. The hardest thing to do was to have a little privacy in the "hole" situation because the Officers felt they had to be within about 6 feet of me working with the patient. I usually tried to have them stand far enough away not to be able to hear anything told to me in confidentiality, preferably outside the door which was glass. These guys wont say anything hardly at all of significance if the conversation is overheard for fear of a writeup. Something might have happened to cause an injury or infection which they don't want to have any repercussions from. I personally don't care how the "injury" occurred, but just want the inmate to live through it and not be injured for life. Also try to keep them comfortable if injured. We could only use Tylenol or IBU unless we had a doctor's order, and the guys understood this. If they were hurting, they did appreciate ibuprofen. It can be a rewarding job.

sierranurse · Sep 9, 2003

I have had many inmates as patient's in the past. I also worked for a while in correctional medicine for a county jail facility.

While there are many potentially hazordous situations, for the most part, the custody staff is very accomodating in providing for your safety. If that is your question.

I have been in some compromising situations but rarely. Even with inmates from San Quentin, Folsom, & Pelican Bay.

doobiedo, RN · Sep 9, 2003

I worked at a hospital that treated the prisoners. There was always a guard present in the room. If the nurse or other health care worker entered the room and pulled the curtains the guard was behind those curtains at all times with the nurse or health care worker. One leg of the prisoner was shackeled to the bed (or litter if the pt was moved) at all times.

The guards did not carry guns....only the rover guard had a gun and relieved for lunch and break or was called if emergency....logic was that the prisoner could possibly get the guard's gun if the bedside guard carried one.

If the pt was moved to the general floor (I worked ICU) then there was a certain florr they were sent too and all were roomed within the same area and the only roomate they had was another prisoner. They were not roomed with the general population.

Most prisoners did not give us a hard time and were nice and polite....I believe to an extent they enjoyed being out in public for awhile...if they refused treatment no one argued with them...they were sent back to the prison after thorough explanation of the possible consequences of refusing treatment.

We were never told what the prisoner was in for nor did we really want to know....although some times the prisoner might tell us without us asking

live4today, RN · Sep 9, 2003

I worked at a university hospital in years past that had an entire floor designated for the care of prisoners. I had to float there on occasion, and each prisoner had a guard, handcuffs that handcuffed one hand to the bed, and the feet were tied down as well. The nurse could not be in the room with the patient without the guard present. Their eating utensils had to be plastic. I felt safe enough, but would not work in a prison itself as a nurse. A riot could break out, or worse. :eek:

renerian, BSN, RN · Sep 9, 2003

At the hospital I used to work at we had prisoners at times. Sometimes a guard but always one leg restrained.

renerian

Marie_LPN, RN, LPN, RN · Sep 10, 2003

Originally posted by cheerfuldoer
I worked at a university hospital in years past that had an entire floor designated for the care of prisoners. I had to float there on occasion, and each prisoner had a guard, handcuffs that handcuffed one hand to the bed, and the feet were tied down as well. The nurse could not be in the room with the patient without the guard present. Their eating utensils had to be plastic. I felt safe enough, but would not work in a prison itself as a nurse. A riot could break out, or worse.

I'm surprised they even had the plastic utensils. Those can be broken and sharpened to a point.

Our "restrained" pts get spoons, that's it.

live4today, RN · Sep 10, 2003

A guard always watched them do everything from eating to elimination. They only had one hand loosened to eat, then away with the trays. :)

debbytentwo · Sep 11, 2003

That hospital floor sounds like you got in some hard=core inmates! I do hope everyone realizes that *anything* can be made into a weapon. Actually, things are a little easier in prison. The inmates are more removed from escaping, so they don't wear all the heavy metal unless they are in "the hole". When in the hospital, it would be easier to find a way to get loose, overpower the officer and staff, and take off. One hospital I worked at had a cancer patient who noted where a certain nurse put her purse. Then he watched to see where she parked her car and what kind of car it was. One day, he was able to take off from Columbia, Missouri, and wasn't caught until he was into Illinois. But really, as for prison outbreaks, although there is certainly a risk there and it is important to be aware of it, medical staff are not the choice for hurting. Medical staff (most of them anyway) have helped inmates, and are usually treated pretty well. But there are corrections officers which have a definite sadistical side, and you better believe they will be wishing they were out of there! I really don't know why, but that occupation seems to attract some pretty strange people, who usually think it is their personal objective in life to provide punishment to those who have fallen into the hands of the prison system. Take care, and do watch your back!