amesly15

I work as an RN in a county jail. We all know the type...inmate comes in, hasn't been to their mental health clinic appointments in months, quit taking their medication, and started using street drugs to self medicate. Is there anyone out there who uses a protocol for 30 days of "clean time" before medications are started? Inmates come in and think, "you gave me Zoloft last time I was here and I need it now." However they have not followed up with any MD or taken medication while out of jail.

What is a gunner?

I work in a County Correctional Facility. My question is...what do other facilities do with inmates booked in who say they are on Klonopin? We had an inmate who had been taking Klonopin through his MD. We varified that was the medication. We have started to taper him off this medication and give him Tegretol to prevent seizures. If someone states they are abusing Klonopin (no prescription in their name) we put them on Tegretol 200mg Bid x one month. We have run urine tests on one inmate who is on Klonopin and he tested negative for benzos twice???? We have read that benzos do not always show up in the urine??? What does your facility do?

"I have a bad case of swamp a**" I didn't even want to ask...

Thanks all. I am developing a policy for opiate withdrawal. We send those with ETOH withdrawal out to Detox at the local hospital.

Hi all, I am interested to hear from you that work in County Jails...do you have an Opiate Withdrawal Policy and if yes but is it? thank you

Well, I am about one year in and it has been a good fit for me. I am working at a County Correctional Facility that is small. I have made some positive changes that make things easier for the nurses ...I hope. I am learning as I go along but definately enjoy the challenges. Mostly, I am learning about chemical dependency and what a HUGE drug problem there is. amesly15

I have been reading protocols from county jails. Some say send to hospital if alcohol level over 0.25. As I am new to the county jail and helping the MD with protocols....I am wondering what other jails do? I have seen protocols that say monitor intoxicated inmates every hour to every 8 hours and put on watch block (15 min. checks). Can anyone share their protocol? Thanks--the Newbie!

I am new to corrections and have read about keep on person medication. This seems like it would be helpful in cutting down on the number of inmates at med call that just come for Ibuprofen or Tylenol. The MD is in favor of using KOP meds. But when I mentioned it to the Jail Administrator...he seemed to not be in favor of it. If anyone could give me advice, articles to read, or policies that would help in my campaign to get the KOP med program going..I would appreciate. I know that the Jail Administrator needs to apply to Commission for a waiver first. thanks amesly:nurse:

Thank you Birdy Oh...I am new to corrections and forget that these inmates are not supposed to be sick

What are your staff to inmate ratios in county jails? Is it usual to have one RN for 120-140 inmates? Seems like at least 2 would be needed. My DON is saying she wants 16 hours covered 7am to 11pm 7 days a week. Currently nurses have been working 12 hrs. with 4 hours on call. They have been able to work this and cover for themselves in regards to holidays, vacations, sick time, etc. I was just wondering what other facilities have for staff? thanks

IM's yes inmates...I think there is a standard that says if inmates refuse treatment they have to fill out a form but that sounds reasonable to document med refused and report if refused 3 times. thanks

For your medication record...do IM's need to sign for meds given and / or refused? Where can I get a MAR with room for several meds on it? I am also looking for a charting system that will work in a county jail.

Going to go for it...I got the position. I am looking forward to the challenges. Patti

Thanks BradyR...tomorrow is my interview. For many reasons ...I do feel this is the job for me. Prior to being a Nursing Supervisor in Homecare I worked in the field for 8 years and was very autnomous. Since writing my first thread I have learned more about the committee at the facility that writes and reviews the policies. I can adapt. I'll just have to see if they choose me...they may not. amesly15

Do any of you work in a County Correctional facility? If yes I am wondering what hours are covered by nurses. At our facility the nurses cover 7am until 7pm then take call from 7pm til 11pm. They are posting a position for a Supervisor of the nurses (cart before the horse) - nurses started covering there from the Public Health Department but with no guidance/supervision other than the Sargents at the Correctional Facility. Any suggestions

Thank you for the advice. The NCCHC website is a great place for me to start reading.

Hi all. Recently I have applied for a job as Supervisor of nurses at our local correctional facility. I ask what the job description is and they said...this is a new position, you will be writing policies and procedures, overseeing day to day operation of the medical unit, scheduling, etc. Well...there have been nurses working there who have been doing the work but have not had a direct Supervior. Should I run toward this or away? I have years of nursing experience - Psych, LTC, and Community Health-Home Care. I am thinking about going for it after reading the Corrections is fanastic thread. What are your most used Policies and Procedures?

In houses where we are aware of urine in chairs...we wear 2 aprons...one backwards to cover our butt! I learned that from a veteran! Patti

Thanks all...looks like we will be having therapy give us the answer to MO826 ASAP. What would homecare be without yet another change? We too are training on MO110. Also focusing on MO230/MO240/ and the new MO426! Makes my head spin

Well, we are getting ready for the new Oasis and I read that some agencies are designing grids for the answer to MO826 the therapy threshold question - where we will now estimate the number of PT/OT/SP visits that will be made. There is a list of the top 26 diagnosis codes. I was thinking of starting there. Has anyone developed a grid for this purpose? We could always hold the lock out until therapy gives us their answer? amesly15 SCHN

and I thought I was the only one experiencing all this. Add staff calling in and trying to cover their patients for the day, rehab staff's clerical asking numerous questions about coding and oasis, other supervisor calling me to ask questions, social worker from the hospital calls to ask how she can get a patient on care, little old lady calls and her ileostomy bag came off an hour ago and she can't get it back on (who can I send), lunch...at the desk (where else), meetings, orientation, chart reviews, stats, more stats (why the hell don't they hire a QA nurse?), emails from the DPS asking why something wasn't done yesterday, on-call nurse calls in (I am on a roll now I might as well take the on call - it will save me looking for someone)....time to go to a therapist and discuss coping mechanisms! My plan is to apply for the next Prevent position that comes up at my agency before I get an ulcer! They look like they have so much fun...funny stories from the STD clinics, visiting those cute little new babies, bat stories and rabies injections--OH YES I AM LEAVING CHHA!

You could check out their outcomes on HomeHealth Compare.

The agency I am working for is looking at using the 485 as the Care Plan. Does anyone else do that? We are on computer and there is so much documentation that can be used. My concern with working off the 485 is the teaching documentation would be lost in notes. For example --teach medication use and side effects could be on the 485...but in the notes a nurse could teach the same med over and over and not teach a different med--without a careplan history of what has been taught and what is left to teach. Any help would be appreciated.

Our Acute Care Hospitalization rate is 41 % ..higher than the state and national average.