Truegem

I guess that must be it. I could swear there was another term. More of a classification of meds, you know, an example would be aphrodisiacs. "You guys put aphrodisiacs in the water." Rather than naming a specific one, such as oysters, or in this case, saltpeter. If I recall, it wasn't a real formal term. It might have been slang. But I cannot find it anywhere so I am beginning to think it doesn't exist. Oh well. Lol. Thanks for your replies.

I'm a little late to the party, but be very careful with anxiety. BP and P elevated, could be anxiety, but still could be MI. Diaphoretic could be anxiety, but still could be MI. Anxiety can be caused by the impending doom feeling with MI. SOB could be anxiety, but still could be MI. I think, in my 22 year career, I have only "diagnosed" 2 chest pains with anxiety.

I'm so sorry for the pain and loss.

Hello, I hope someone can answer this. The subject came up here at work, in the county jail. Does anyone know what they used to give to prisoners and the mentally ill in asylums to reduce their libido? It's considered unethical now. It's like, the opposite of an aphrodisiac. It's not chemical castration. I think that's a more modern term. It's one word and it seems to me it starts with a "P"...? But maybe not. If I'm not mistaken, I think they used to give it to all of them, to keep them from having relations with each other. But I could be wrong. A couple times, in the past, an inmate has said to me "I'm not taking that medicine, you guys put ____ in them." (I assured them we did not!) Or, some have said they put it in the water or the food. It came up in conversation and now it's driving us crazy! Anyway, I appreciate your time. Thanks

The hospital will not admit MH patients with charges pending, but will they see them in the ER? They can really cause damage to themselves! Our policy is to send them out for clearance for mental health housing if they are banging their head. They might even give them some medication, so when they come back, they are calmed down.

Well, they are all patients. We recognize our inmates as patients, and people, and humans. We are courteous and polite. Remember, they each have their story and they may even be unjustly accused. I'm not saying become their friend or give them a hug, just treat them with some sort of decency. But, on the other topic, an old hairy man exposed himself to me a while back. If this had happened outside of the jail, he would have been arrested. But in jail, it's handled like "oh well, that's what dirty old men do.". It's NOT OK!!!

Geode, Librium for Opiate W/D? Why would they need a Benzo? Unless they are withdrawing from ETOH or Benzos. We give Tylenol, a muscle relaxer, Immodium and Tigan if necessary. We don't give Clonidine, although I have heard it helps.

The only meds we give for anxiety would probably be atarax. We use ativan for agitation only. But, yeah, it would probably have the same effect on me. The pain scale annoys me more because it's mandatory that no matter what the patient says, that's their pain. It's only going to take about 5 minutes before it catches on that all they have to do is say the magic number "10". It would not surprise me if this rule soon applies to anxiety as well. Some peole are pushing for the 6th vital sign to be "emotional state".

We are not allowed to fall back on the patient's clinical signs of pain and discomfort because the BRN says that the pain is what they say it is, period. I completely disagree with this, because a. some either do not understand the pain scale even after trying to educate them or b. some think they are going to get some good meds if they say 10. Sorry, but I don't care what number the patient says, a hangnail is not and never will be a 10. I feel that we should be able to assess based on their signs (behavior, grimace, posture, etc) but according to the BRN we are NOT allowed to do this. And if they can speak we are not allowed to use faces. If they say 10, then they must truly feel as if their testicles have just been ripped off, so we have to treat it. It's poor medicine in my opinion and I feel that our nursing assessment skills are being taken away from us. I do understand that perhaps some nurses were thinking "BS" when people were complaining of pain, and these nurses were refusing to medicate them, but I think they could have come up with a more accurate way of assessing pain, than NOT assessing pain at all, which is what we they are telling us to do.

Well, I guess what I mean is...don't you get an awful lot of 10's? Wow, we do. I even try to educate them and they still say 10 as they are sitting there smiling and everything.

Ok, let's talk. Do you feel that the 1 - 10 pain scale works in your institution?

The opening story is funny! Unfortunately most patients will say "yeah, that's how I feel, like someone smashed my balls with two bricks" as they are sitting there smiling, hads placed neatly on their lap, waving to a passerby. Um, Chas....I had a patient who was sitting, smiling, chatting, etc. He was there simply for a vital sign check. I asked if he was having any pain at this time. There seemed to be no need to ask about pain, but I have to ask. He said "I have a slight headache right now." "It's a 10/10." Maybe he misunderstood, 10 is the WORST pain ever! Even attempts at educating about the pain scale did not help. It was still a 10/10. I have to disagree with you Chas, this patient even said "slight headache". Sure, we are not to judge a person's perception of pain, but I feel that it would be poor medicine to medicate with a narcotic based on this. If it's a 10 and we are supposed to believe them, then why would we give Tylenol? This guy needs the full treatment. It's a 10! Call 911, get out the big guns, run to the nearest pixis! Their perception is either a lie, or they do not understand the pain scale. Well, I have already tried to educate this man, so..... As nurses we are taught to assess. You can assess someone sitting and smiling vs. someone in the fetal position. But we are not allowed to do this because their pain is what they say it is, period. Our assessment skills are being thrown out the window. I think this is a complete joke! If nursing was doing a bad job at managing pain, I think we could have found a better solution than this.

What Oz said is exactly what I am saying...I do believe this is ok. I would have to know more about what the DON wrote and why and her role in the whole thing to give an opinion on it.

We get Opiate W/D, drug W/D, some post-op (not fresh post-op), quadriplegics, etc. We also house C-PAPs there. Not too busy, but it can be, depending on what happens. Reddell, sounds like you are working in two places at once! Yikes! =/

Wow, we only start IV's if we have summoned paramedics. We don't treat dehydration in-house. We only push a couple things in emergency situations.

We had an inmate complaining of something I cannot remember now. One nurse muttered "drug seeking" under her breath. It turned out she was very wrong. Things are not always as they seem. I have also learned that if you walk around talking about faking, a new nurse might interpret your attitude wrong. For example, if (and I do mean IF) I was to walk around talking about faking, I certainly would not mean that one should not see the patient or do a half-assed assessment. No no no! I could say something about faking, but you can bet I am going to try my darndest to prove myself wrong in order to protect my license! But a new nurse might take all that "faking" talk to mean that he or she is supposed to do a quickie half-assed assessment or do nothing. I have seen this actually happen. So, we seasoned correctional nurses have to be very careful when we casually talk about faking. Teach your new nurses that, yes, it happens, but you must always act on is as if it is legitimate.

My first job as an RN was in Oncology. Talk about work! It was crazy busy! Re; #6; while I cared deeply for my Oncology patients, what really got me was the denial the family's could be in. I wanted to scream "no, she's not going to get better, didn't the Dr tell you?" (probably not) It always took me by surprise when they would ask such naive-sounding questions like "when can she come home?" (Um, do you hear that rattle in her chest?) I never felt it was my place to be giving them such shocking news, but I would manage to tell them in my own way. I'm so glad to be a jail nurse now, lol!

My pet peeve is when people ask you a medical question that should be intended for a doctor, then, when you say you don't know, they say "you don't know? But you're a nurse!" Yeah and I went to NURSING school, not med school! I don't diagnose and I can't do a CT scan by scanning you with my eyes!

I'm sure I've read somewhere that it's ok. The nurse doesn't need to have witnessed that she saw you, she is just writing what you tell her. She will indicate this in her charting. Also, you can co-sign it when you get back. I'm sure I read somewhere that it's ok, I'm going to ask the BRN. Thank you for your response.

I found this: "The valproic acid drugs are used as non-opioid pain relievers. They belong to a general class of drugs called anticonvulsants. These drugs may be given along with pain medicines to help control neuropathic pain of cancer (numbness, tingling, burning, shooting, or electric-shock-like pain.) They are also used for preventing seizures, preventing migraine headaches, and other purposes."

I say go for it! Ya gotta be a little tough, though. And you can't be the type who needs to be friends with their patients because inmates are not your friends. You are friends with your coworkers. I have talked to some nurses who say they could never do it because they want to nurture their patients. They are probably not meant for this type of nursing. I find corrections very interesting and every day is something new. If you like adrenalin, then it might be for you. We hire a lot of ER nurses and they love it! We have some tough, hard-core nurses, but we also have some very sweet, delicate 110 pound nurses, ha ha! We have nurses who are a little naive and nurses who aren't. I've said it before and I'll say it again....I feel safer in the jail than I do on the streets. (I don't know if the prison nurses feel the same way, but we feel this way at the jail.) Good luck with your decision! =)

Yes, seizures and chest pain seem to be the most common types of things to "fake". Then there's my LOC story, above. I have never once seen a legitimate seizure from Opiate withdrawal, but many of them say they have seizures due to Heroin withdrawal. I find that a lot of Methamphetamine addicts will say they have asthma....I'm not saying for sure, but it seems so prevalent that I am beginning to wonder if the little surge that Albuterol gives you is better than nothing. Often they don't even know the name of their inhaler. What asthmatic doesn't know "Albuterol"? Ok, I suppose it's possible. But they do see the MD, and they end up getting their inhaler prescribed. It's not for me to say. I once referred a totally obviously fake seizure to the MD. I documented what I saw...the failed hand drop test, the flailing, the lack of a post-ictal state. The MD prescribed Dilantin. What can you do? There will always be people who abuse the system. For a while I wanted to catch them all, but you can't. You just do the best you can. Your license is the most important thing.

I often feel like they are faking but I ALWAYS treat the problem as if they are not faking unless I feel very sure and have something to chart that will back me up. With any head injury, we ask them if they had a loss of consciousness. They almost always say yes. The arresting officer will say they witnessed the entire incident and that the inmate was conscious the entire time. First of all, is that officer going to stand up for me in court? Heck no! So we have to go by what the inmate says. He may not even have a bump on his head or a scratch, but it's best to play it safe. We have had incidents, but I don't want to mention them specifically. In one incident the nurse said "he's just drug-seeking" and he turned out to be very sick.

Let's say you forgot to chart something. Can't you call the charge nurse and have her write "dressing changed at 0300." per N. Jones, RN and then she signs her name too? (My example isn't the greatest, but you know what I mean.) I have heard that this is acceptable, but my peers are saying no. What if you forgot to chart something very important and you can't get back to the hospital because you are going on vacation? It seems to me this should be ok. In fact, I'm sure I read somewhere that this is acceptable, but I don't recall where I read it. Thanks, Patti

In response to the first reply to this thread.....gag. They deserve nothing spiritual or lovely or whatever after poisoning their babies with drugs or ony thinking of themselves while they were out committing their crime.