uraqt2

Processing an inmate into a facility is getting a H&P done, getting all labs done (in my state they include HIV & syphilis also if they already have Hep C we include a liver panel), and TB screening. Basically you have to establish a medical record that will follow the inmate throughout their sentence. I must say the facility I work at does not do "processing" but talking with other nurses in the state that do, this is what I've picked up. As far as the quality assurance standards for inmates self medicating I think that is something you should follow up with you state and facility regulations. Hope this helps and welcome to corrections.

As a LPN my major role is to pass medications. However, we also will note orders, re-new medication orders that are expiring and forward to the provider for review, make sure MARs are current and correct (we still have to hand write them but hopefully not for long), do treatments, draw labs, assist with transfers, do intake, respond to "man downs" and other emergencies (with our RN), and assist the RN with sick call (if needed). Basically at my facility we do a little bit of everything. I wish you the best. Keep us posted if you get the position.......good luck.

I don't usually have this problem as the inmates know that when I'm doing med pass I am NOT there to do sick call or other procedures. Med pass is exactly that med pass. However, I do not want to imply that if an inmate has a legit complaint that I won't take the time to look into it. There's nothing wrong with reinforcing the policies to inmates and taking a minute to explain that you are there passing meds not checking B/Ps, if he/she wants his B/P checked then he/she must go through the proper channels. Also, if you know that the inmates has a history of HTN or cardiac and they are asymptomatic you can check the chart to see if they have an order but unless you feel it's necessary to check the B/P I would say that this is inappropriate behavior from the inmate. I would advise the inmate he/she is out of line and leave it at that. If the inmate continues then I would have custody remove the inmate from the area and do a write up.

I can understand wanting to save taxpayers dollars; however, the fact still remains that you should not be reusing MDI's. I suggest that the policy needs to be changed (easier said than done I know) to inmates being allowed to have their meds KOP. At my institution we allow inmates to have their inhalers KOPd and when we issue a new one they MUST return the old one. When the inmates are transported whether in-house, in-state, or even to court the inmates are instructed to put their inhaler in their pocket so that they have access to it. Custody is also notified that the inmate has an order for the inhaler and may need to use it. I have never experienced a problem with this procedure and hope you find a solution to your problem.

At my facility we use to have the officers give OTC meds out and keep a log but somewhere along the lines it was changed to nursing needed to give them out and keep records that went in the chart. Recently, though due to several issues (inmate abuse being the biggest issue ) the policy has been changed to the inmates must submit a kite to be seen either on nursing sick call or by the provider (what a relief this is to med pass nurses). Inmates are not denied medical care for inability to pay so being indigent isn't a reason to not be seen.

A paper trail is the right thing to do. The DON needs to be made aware of such behavior and the "lovebirds" should be split up if they cannot work together. This type of behavior never ceases to sadden my heart. No person ever deserves to be neglected in such a manner. Charting can be done after the residents are taken care of.

Our med pass times are 0400, 1000, 1500 and 1800. Our med passes are adjusted around counts and feeding. If an inmate doesn't want to get up isn't a reason to change the times. We will only change a time if it's related to a work schedule or if the medication itself has to be given at specific times. We educate the inmate, document, and notify the provider of any non-compliance issues. If the med isn't critical we get the med d/c'd. If the med is critical the inmate may be admitted to the infirmary or monitored out on the units. If anything should occur such as the inmate is suppose to be taking a seizure med and they refuse several times then they have a seizure we will charge them for a self inflicted injury. Plus they can be taken off specialty clinic and be billed for every visit until they comply with the policies. The inmates do have a right to refuse treatment; however, documentation is extremely important.

This is a folger adam key. It is used to open doors and food slots. If an inmate gets a hold of one of these it's a recipe for disaster.

I agree that it's very frustrating that inmates usually receive better medical care than the "free world". It's also well known to those who work in corrections that inmates will abuse this privilege just cause they can. Why should they try to become productive individuals when they can get housing, clothing, food, medical, etc.... for little to no cost? Unfortunately for us, it's a way for them to get their needs met. Until the responsibility gets put on the inmates they are not going to change. At my institution we charge the inmates $8.00 for a doc or nurse visit unless it's a self inflicted injury or an altercation then it's $35.00 and up plus we try to keep as much as possible inside the system. All F/U's, specialty clinic (diabetes, HTN, HIV, seizures, etc...), and mental health is free. Although this doesn't always deter inmates from abusing the system it sure does cut down on it. And the reaction they give when they find out if they don't pay the accrued costs while in prison that they get to pay it when they get out is PRICELESS!!!!!!

It's always frustrating when custody attempts to run what medical needs to do. I am very fortunate and have an excellent rapport with the majority of custody staff so this isn't usually a problem for me. However once in a while I'll have custody who wants to run the show and I typically say "You know you called me out here to handle this situation cause you felt it was a medical issue. Now if you want to handle it please don't call me again unless you can trust the fact that I will handle medical issues professionally and to the best of my abilities. Last I checked I'm the one with the licence and have no intentions of losing it or being placed under investigation for any reason. Thanks for the input but I think I'll handle things my way." This usually shuts them down and makes them realize they don't want the responsibilities or legalities of medical.

Very well said Michelle RN.

CEUs most definitely a requirement to renew your licence. In NV. you also need 30 to renew. Many facilities will offer CEs so that you don't have to pay for them.

As much as I don't like to write orders for doctors standing right there I must say sometimes it's easier to just write the verbal and make them sign it before they leave. I once worked with a doc that couldn't even read his own handwriting so if there were any questions about the order you ended up getting a whole new page of orders. We nurses decided to just take his verbal orders and make him sign them. Sure beat the alternative.

Good luck in your new adventure OldMare. Corrections is unlike any field out there but can be very rewarding in it's own way.

I'm so sorry to hear about your situation. First off remember that we've all had med errors in some form or another and it's a horrifying experience. Sounds like you took the right steps by reporting it. My prayers are with you that all will work out and you'll be able to use this as a learning experience.