Relationship between Officers and Medical

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I'm curious as to how custody relates with medical in prisons and jails around the country. At the prison I work at in CA, we have a love/hate relationship. I wish it was better, but most days, it seems we are at odds with each other. Custody rules the roost (which I agree should be the case in most instances) and medical fits in when custody lets them.

1. How well do custody staff work with and relate to medical in your institution?

2. If you could fix one thing that custody does that gets in the way of you doing your job, what would it be?

3. Has your institution worked to make the relationship between medical and custody better, and if so, what have they done?

Any thoughts on this matter would be greatly appreciated.

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Specializes in correctional, psych, ICU, CCU, ER.

Here, Medical rules, It was tough for the jailers in the beginning, having the 'token female' dictating what to do with some IM's, BUT, overall, they love us, and take very good care of us.

We are the only level 1 jail in the state to have 24/7 RN's (and Only RN's)...otherwise the jailers used to pour and pass medication. Now, if there's an emergency, (for the nurse who's coming in) and there's no nurse, the nurse who works the shift before has to pour the meds and the jailers pass them. Before the nurses came in 24/7, the jail had all of the liquids in gallon bottles. (cough syrup, mylanta, etc) WWWEEELLLLLLLL, there was an order for 10cc of cough syrup, the jailer measured it out, gave it to the IM in a little paper cup, and the IM belched this "big, brown bubble"--turned out the jailer gave him betadine. WWWOOOOOPPPPPPSSS!! IM was 'cleaned out', but otherwise OK.

They're terrified of a repeat.

Thus, in 1999, the medical program was revamped. It was tried, tweaked, some things and ideas were kept, others discarded, we're still growing. (and learning) we are constantly changing and rewriting policy. Thankfully, we have an awesome health department director AND police chief who puts up with us.

The jailers accompany us wherever we go and we get along well. I also acknowledge the good job that they do and that I wouldn't want to do it, looking at stripped IM all day long. Of course, I back them up, if there's an IM they want to get rid of, I can usually find a medical reason to do so. We have a 'it's THEM (the IM'S) against US (the staff)" attitude, and like a family, we get the job done. I tell them, my first priority is my nursing license, my second priority is that 'my' jailers and cops ALL go home safely after watch.

I protect them, advise them, fix their boo-boo's, check their BP's, listen to their tales of the family problems, medicate their headaches and colds, give flu shots, keep records of exposure, and truly love them. In return, they protect me, watch my back, give me the heads up on whatever is going on in the city. They were there 7 months ago to support me and my sons, when my husband, (also a jail nurse here) suddenly died. I am fortunate to have them in my life.

Of course, like any family, this is not to say, there's NEVER a problem. There have been things said, misunderstandings, etc that needed to be addressed and worked through. But, I like to think I'm mature enough, that I can take (and give) constructive criticism. I try to nip things in the bud, BEFORE it goes up the chain of command and to internal affairs. Usually, I can. (But, not always) I try to remember that I have 2 ears and 1 mouth so I listen twice as much as I speak, but THAT doesn't always work out either. :lol2:

For me, what helps, is that they know I'm not trying to hustle anyone, date anyone, break up anyones relationship, tell them how to run the jail, who to arrest, who to release, who to hire, fire, or promote. (unless it relates to a nurse) I'm trying to keep the city liability free, so the lawsuits are kept to a minimum and there's $$ when union contract time comes.

BUT, the most important part---I keep a HEFTY supply of chocolate in my office for coworkers who stop by. :rotfl: and they love me. (they really, really, love me)

I'm sorry that all nurses don't have that experience. What are yours doing to drive you batty?

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Sounds like you work at a place that is run much better than mine, JailRN. Custody drives me batty by being passive aggressive. I'll request that they take an inmate back to a housing unit or bring me an inmate and they will do it when they feel like getting around to it. I've had to learn how to work around them so I could get my job done on my time, not theirs. If I waited for them to feel like doing something, I'd probably only see 3 inmates a shift. It's a power struggle. I'm respectful of them, say "please" and "thank you" and am willing to help out when I can, but we are not staffed properly and have limited resources so I am always overwhelmed and end up having to say "no" a lot. I have the same motto as you that my license comes first and everything else second, so incident reports have to wait until I've done my patient care. They don't like that, but the lawyers aren't going to be moved if I chose to do an incident report over patient care. Nursing is all about prioritizing and custody is only involved in providing escort for LVN's who medicate the patients, otherwise they really aren't involved in medical whatsoever, except notifying us of a mandown or medical issue. And they even get upset over having to escort the LVN's, especially if it takes the LVN longer to pass meds than they think it should. :rolleyes: I get along well with many, but there are many who feel medical is merely a "necessary evil" and treat us accordingly. I also have been trying to get them to see that by delaying getting an inmate care, they are merely costing the state more money because his condition will more than likely have worsened resulting in complications and the need for hospitalization. Some of them don't seem to get the concept that our tax dollars (the officers and mine) are paying for the inmate's medical care. Prevention will help save the state money. Prevention is not a word uttered very often at my facility except from my mouth it seems. Well, enough of my b*tchin' and moaning. I'm glad it is better at other facilities, though. A couple of nurses who came from other states have told me custody and medical worked together where they came from. It's an ingrained problem within the CDCR system, apparently, which more than likely has contributed to our need to be placed under a federal receivership. Don't get me wrong--I'm not an inmate-lover. I don't want to hear them moaning and groaning about the temperature, the food, or how hard their bunk is...As I always tell them, "If you don't like it, don't come back to prison!" I'm professional towards the inmates and am only there to provide their medical care. I try to stay out of matters of custody as much as I can from a medical standpoint. I only interject in matters of custody when absolutely necessary to prevent loss of life or limb. I just want custody to understand that I'm there to do a job (as they are) and nothing more and that I, too, am concerned with matters of security (my own and theirs). I want them to go home to their families, too, and would hate to hear that something I did contributed to them being harmed. It's an uphill battle, though.

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Specializes in Rehab, Corrections, LTC, and Detox Nurse.

I've always told people that the relationship with security are the drawbacks of corrections

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Our PLATA officers rule. Very, very helpful. Everything is a team effort; you help them, they help you.

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I should clarify that I do help custody out quite a bit. Whenever there is an inmate that they feel needs to be seen by medical, I don't question them and stop what I'm doing to see the inmate. I'm just not so willing to stop what I'm doing to do a 7219 over medicating the inmates I need to medicate. Especially the large number of 7219's they've been wanting us to do. I have too many other things that are a bigger priority than that paperwork.

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To me, it really depends on the individual officer and, also, Sgt. Some are definitely better than others.

For example, it's well known at my facility that the third watch Sgt. on a particular yard is going to be more helpful than the second watch Sgt. So, if I see an inmate at 1:30 p.m. and he needs to be transported, I'll just go ahead and wait for the shift change at 2 p.m. But, if it can't wait then ... I just go straight to the Captain. I usually get what I need that way.

As for the 7219's ... I do try to accomodate custody as much as possible because ... the inmate needs to be assessed for injuries anyway. But if I have an inmate with a more urgent medical problem then, I'll make custody wait for the paperwork.

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Sheri,

We're having to do 7219's mostly not because of an injury or incident, but because ANY inmate who goes in to the Ad/Seg unit, has to have a pre-ad seg 7219 done. We are locking up SNY's in Ad/Seg b/c we don't have room in the SNY yards/housing units. THe other day, they needed twenty 7219! Crazy! Thankfully, the LVN's stepped up to the plate to handle those while I finished doing the inmate's intake screening.

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I see your point, 20 7219's a day would be absurd. Luckily we don't have that policy (at least not yet).

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Specializes in ER, ICU, Nursing Education, LTC, and HHC.
I should clarify that I do help custody out quite a bit. Whenever there is an inmate that they feel needs to be seen by medical, I don't question them and stop what I'm doing to see the inmate. I'm just not so willing to stop what I'm doing to do a 7219 over medicating the inmates I need to medicate. Especially the large number of 7219's they've been wanting us to do. I have too many other things that are a bigger priority than that paperwork.

Thinking of going in to Florida corrections.. what is a 7219?

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