Prisioners as Patients

flashpoint · Sep 13, 2003

Most of the time, our inmates are released from jail so th ecounty doesn't have to pay the hospital bill! When we have more serious offenders who cannot be released, we have a jailer in the room with them. Most of the time, the inmates are not restrained unless they are considered a flight risk. Their telephones are removed from the room and they have to follow the same rules as the jail as far as TV, books, visitors, snacks, etc. They get regular silverware, etc, unless the jailer feels they may use it as a weapon, etc. Sometimes we keep them in a secluded area, sometimes not...we had a grandmother that murdered her grandson that was put in an empty ICU bed to keep her out of the public eye, but most of the time they are in a regular patient bed. Nurses are informed of the nature of their crimes (we know what they did most of the time anyway) so that we can be aware of things like not going in alone (even when the jailer is there) or not having pretty young CNAs go into the sex offenders rooms, etc. If a nurse has a problem caring for an inmate for whatever reason, they are usually reassigned if it doesn't cause too many problems with staffing. I had a patient threaten to kill me once and when he wen to jail for killing his wife, I didn't have to take care of him when he came to the hospital...one of our nurse's daughter was raped and she was put on paid leave when the rapist was in the hospital. Our management tries to be as accomodating as possible in similar situations.

JedsMom, ASN, RN · Sep 16, 2003

When we send inmates to the hospital they are accompanied by a deputy and are in leg irons and handcuffs. If they are admitted, we hire a guard service to watch them. They remain cuffed to the bed with a leg iron and have no phone or visitors. If they are a Federal prisoner they have two guards assigned to them.

RN-PA, RN · Sep 16, 2003

As I've read through the various responses, it makes me realize how lax the rules are about hospitalized prisoners our local County Prison seems to have compared to some of the prisoner patients elsewhere.

The few patients I've cared for over the past 5 years generally appeared to enjoy their hospitalizations. I can't say for sure what the phone call situation was-- the phone was still in their room-- but I saw visitors with the inmates, one even lying in bed with him with a guard sitting next to the bed in a chair watching TV which seemed to be on 24/7. One time, after asking the patient and his visitors to quiet down one Saturday afternoon for the second time, without success, I finally shut the door to the room. One patient was constantly asking for juice, water ice, soda (clear liquid diet, admitted with abdominal pain). When numerous tests failed to come up with any problems, the patient started to report that he was seeing blood in his urine (but kept forgetting to leave us a specimen in urinal), and last I remember he was complaining of a severe tooth ache. :rolleyes: Yes, I documented everything. Also, we're never told what their crime was.

June55Baby · Sep 16, 2003

Many thanks to all of you who have shared with me your procedures for prisioners.

Our Hospital Administrative Staff, Risk Manager, and I met with the representatives from the state department of corrections last week and after finding out what their policies and procedures were, we came up with a very good policy for the security of inmates.

- we will not know what for what crime the prisioner is incarcerated.

- no visitors, no telephone

- all prisioners will be held to the same procedures no matter if the crime was murder or bad checks.

- all prisioner will have a 1 on 1 guard 24/7 at the bedside.

- all prisioners will have forensic restraints at all times (unless medically contraindicated), handcuffs with waist chains and leg irons.

- all prisioners will be admitted through the ER (a secured/lock down area) and will be transported by wheelchair or stretcher with forensic restraint covered by a sheet.

- the inmate may be out of bed except when a member of the hospital staff is in the room, at which time the patient must be confined to the bed with the guard actually at the bedside.

There are several other important points, but our biggest concern was the safety of staff, patients, and visitors and now we feel better about that.

!

Thanks again for your input and ideas!

June

KaroSnowQueen, RN · Sep 16, 2003

Our prisoners are shackled to the bed by one leg. Guard at beside 24/7. Prisoners families are not told they are in hospital, pt's name listed as A. Orange, B. Orange (Orange being a code word referring to their prison garb) in pt census. No info given out. Pt wrapped in blankets to hide shackles on leg to wc when transferred for tests, etc, accompanied by guard at all times. Two more guards accompany pt on transfer back to facility.