I'm a correctional officer and have been for the last 5 years. I'm currently in clinicals to be an RN. As a correctional officer I transport inmates to and from hospital while accompaning them during their hospital stay. So, I can give you incite on the scope of both roles correctional officer and nurse. I think the confusion comes in at just how much authority does a correctional officer have. Well, I'll tell you what many nurses in my state don't know. While an inmate is in my custody I am awarded the powers of a State Trooper. Even when I'm going to and from my post (hospital).
With that said it is the correctional officers who have the final say on how the inmate will be restrained during ambulation. Of course, advisement from medical staff is considered before a final decision is by the officers on duty. Inmates are state property no matter how you look at it. Your not going to see specific rules in your policy manual because every inmates security level is different and so are there charges. So this is why it is at the discretion of the correctional officers on duty. You as a nurse should still remain an advocate for your patient by advising correctional staff of treatments/therapy.
Correctional staff on duty at hospitals must ensure that contraband does not enter the room. That no family members of the inmate contact or attempt to visit unless the inmate is terminally ill. Family members are not even allowed to know the location of the inmate in fact. Every individual who enters the inmates room is to be identified. We are also supposed to make sure the inmate is not being discriminated upon because of his status.
You as a nurse don't know what the inmate is capable of. Nor do you know if your patient/inmate visit to the hospital is an elaborate plot to escape. We as correctional officers are not only watching the inmate but we are also watching YOU and other staff. We don't know if you as a nurse may possibly be in fact assisting the inmate in escaping. These are things we try to observe/detect as correctional officers. As correctional officers we have info on hand that describes the inmates charges, behavior, alias, last known address, social security # etc. This info enables us to make informed decisions when it comes to restraints needed. It is at the complete discretion of the officers on duty. So, if an officer insists on the inmate wearing cuffs after advisement from medical staff about ambulation. Just let the officer restrain him/her as the officers see fit. ITS FOR MY SAFETY, YOUR SAFETY AND THE PUBLICS SAFETY. Most officers have common sense and can differentiate whats good for security and in the best interest of the patient/inmates recovery. So an officer is not going to let an inmate develop a pressure ulcer on purpose. In fact many correctional officers work with staff nurses as teammates rather than against them.
This just happened three weeks ago. We had an incident involving an inmates family member who manipulated the nurse into believing she was the power of attorney. The nurse said that the family member then asked where he was located. The nurse unaware of the policy and procedures told her the inmates room number. This situation could have gotten ugly, but I informed the nurse that the inmate is a ward of the state (state property) and that power of attorney is irrelevant at this point. And this inmate was not terminally ill. We then remained on high alert on the possibility of an attempt to escape for the rest of the night. Luckily, there was no incident after that.
The moral to the story is to work with correctional officers and communicate while respecting HIPPA.