mp1965

Hi, I have been working in corrections for 15 years and this practice is quite common. In my area medical is just a commodity. We are not included or considered part of the correctional setting. the security staff especially those with rank can view our actions or decisions as not following orders and yes we get reprimanded as such. So much for nursing judgement.

I work in a correctional setting where the patient's become too familiar to me as they continue to return. A report was given to me regarding a young male who was lying in bed complaining his heart hurt. This patient arrived the night prior and was fully assessed and intake by an RN during 3:00 p.m. to 11:00 p.m shift. He had no acute or chronic issues. Noted from prior incarceration was a heart murmur for which he had a full work up and was negative. The patient was not on any meds and he reported his only illegal substance was smoking cannabis. Given his age, and history I used nursing judgement and did not feel he needed immediate evaluation at that time and would be evaluated by the nurse who visits the housing units daily for patient complaints. I exercised my judgement and advised out secretary he would be evaluated in his housing area and if he became worse or things changed the officer would be calling medical again. I was reprimanded for my judgement because the patient was evaluated later by the triage RN in the unit who reported patient was diaphoretic although when he was brought up to medical and questioned and evaluated by the provider this was denied by the patient and was not observed by the provider. The patient's dx was anxiety related which is what my impression of the situation was at the time. Chest pain is a common complaint which patient's state to be able to get out of their housing areas and when they report to medical the story changes. I though I used proper nursing judgement based on the information I received and yet I was reprimanded.