Question about hs meds...

[MadisonsMomRN, BSN, RN]

Ok, like I said in another post I am new to corrections. We administer meds by pill call where the inmates come to a window and then we have to go out to the segregation units to administer meds to the guys in lock down. Well custody only allows us to make one med pass during the day and one med pass at night. We go out at dinner time because that is what custody wants. Well many of the inmates have hs meds too. So what do you do when an inmate is ordered a med, like Ultram for example, at dinner time and at hs. Many nurses give the dinner pills and the hs at the same time. But I didnt because of the 1 hour rule. I mean I am in my right to do that.

What do you do?

[uraqt2]

I work in max security where we have to go out to ALL inmates and what we do is pm meds and hs meds are considered the same. Our providers are aware of this and order meds accordingly. Maybe you can talk to your provider and ask if the order can be changed to something that fits the schedule of your lock down units.

[MadisonsMomRN, BSN, RN]

Oh ok... we are working on getting some of the orders changed so we can give the meds accordingly! Its the pain meds that really should be changed.

[uraqt2]

One other thing about pain meds, usually we don't give that type of med out on the yard. If an inmate is having that big of a problem it is treated in the infirmary. And we NEVER give narcotic analgesics on the yard. Don't know if you have any policies like this but it may be worth looking into for your lock down yard.

[MadisonsMomRN, BSN, RN]

No we dont give narcotics on the yard either... but do give things like Ultram, phenobarb...

[VegRN]

What do you do about meds that need to be given on an empty stomach for absorption i.e crixivan or meds that interact with many foods or vitamins and need to be given at a time other than close to meals i.e. cipro?

[MadisonsMomRN, BSN, RN]

They don't do ANYTHING... what does your institution do? I guess this is typical but custody has ultimate say in everything that goes on.

I like working there but there is some issues that I am not comfortable with. I know they should be doing certain things that they DON'T do.

[VegRN]

I work in acute care for inmates so they can have meds anytime the md writes for them. We d/c these pts back to their institution with meds like this though. Many of the inmates tell me that they take their meds at their convenience as they keep them in their cell which I have verified by their MAR. I am sure it depends on their security status and I don't get too into that as our institution is operated as max because it is outside the prison.

Insulin and controlled meds they have to go to their HSU for.

I just don't understand having only 2 med passes as their are many meds that have more than BID dosing and interfere with meals and other meds. I agree with you on this issue and would have a problem with this policy too. I can think of so many meds and instances that this BID pill call and PM dosing at supper time would not work.

[nursemomruns]

Ok, like I said in another post I am new to corrections. We administer meds by pill call where the inmates come to a window and then we have to go out to the segregation units to administer meds to the guys in lock down. Well custody only allows us to make one med pass during the day and one med pass at night. We go out at dinner time because that is what custody wants. Well many of the inmates have hs meds too. So what do you do when an inmate is ordered a med, like Ultram for example, at dinner time and at hs. Many nurses give the dinner pills and the hs at the same time. But I didnt because of the 1 hour rule. I mean I am in my right to do that.

What do you do?

At my facility, unless the prisoners are on the infirmary they get meds tid. Some meds are allowed to be kept on their persons, but controlled substances and meds with a high potential for abuse are always from the pill line. Narcotic pain meds are not given in general population. The prisoner has to be on the infirmary for those. This is for supermax, segregation, and general population.

Have you checked with your DOC policy and health care service directives? Custody may WANT it one way, but policy may say they have to do it another way. You may also want to develop a statement for them, with references, about meds that need to be given ac, pc, more than twice a day, etc. If your facility undergoes ACA or NCCHC accreditation, those rules seem to pull a little more.

[MadisonsMomRN, BSN, RN]

Nursemomruns-

I will check into this. Thanks for the info. It seems to me that if a doctor writes an order for meds to be given at certain that there is a reason for it and it should be given that way. Custody isnt not medically trained and I dont understand how they have so much say...

Thanks again.