prsion nurses

antares · Jun 18, 2011

I had clinical in the county jail last semester. The information I have was just from talking to the nurses and observing, because I was with an NP. I don't know how closely it mirrors prison nursing, but I'll tell you what I know.

The med unit is an clinic within the jail itself and under the DOH. Employees are county DOH employees. It does not have an inpatient unit. Inmates were seen for their complaint or injury and sent out if they needed hospitalization. There is a dentist who does fillins and extractions, an optitian, a mid-wife who does paps and see all pregnant inmates and patient who recently delivered, social workers who perform initial mental health assessments if the assessment was indicated, and psych np's and an MD who did med management and minimal counseling, and MDs/NPs who treat other complaints.

When the LPNs came in, they were assigned to the clinic or medications. In the clinic, there is at least one RN who is in charge, but there is usually a second RN, several LPN, and a couple of medical assistants. This facility also has a nurse dedicated to fingersticks and insulin coverages only during that shift.

LPNs who are assigned to meds only pass meds that day. Med nurses go up to the tiers and call out the names of the inmates, one at a time, that they had meds for. The inmates were locked in their cells at this time. The inmates would get the meds and take them in front of the nurse. If an inmate was meeting with his lawyer or going to court or otherwise absent during med pass, he/she could go to the med counter before or after the med pass to take his/her meds.

When the nurse is up on the tier passing meds, if an inmate appeared to need the attention of the medical staff, the nurse would send him down for a "sick call." An inmate could also put in a request for a sick call or a CO could send him/her down to the clinic for a sick call. The med unit operated only between the hours of 7a-11p. After hours, if there is a request for medical attention, the inmate would be brought to the ER by the sherrifs department or, if necessary, an ambulance. Upon the inmates return, he would be seen by a MD/NP who would review the ER record, and order meds if necessary. Upon return, the inmate would be seen by the MD/NP at the clinic and treatment would be continued if necessary. For all sick calls and hospital returns, the inmate would be weighed and vitaled, and then wait for a provider to become availible. If the provider ordered meds as stat, then a clinic nurse would get the med from the PYXIS or the pharmacy would prepare it fast, and the inmate would get the med before returning to the tier. If the med was routine, then the med would be given at the next med pass for which it was availible.

In the evening, new inmates would arrive from the courts in groups. Females would give a urine sample for a pregnancy test and were then triaged, vitaled, and weighed. If an inmate reported any condition for which they were on medication, or had abnormal vital signes, they would join a queue to see the provider. If the VS were still abnormal by the time they see the provider, they may be ordered on daily monitoring if it didn't need urgent management, otherwise they would be ordered a stat med.

Inmates came down througout the day for dressing changes, finger sticks, respiratory treatments, etc.

Hope this helps.