The Paper Trail

[DawnJ]

I have an inmate who was "beaten by the cops" on arrest. He did have a black eye and complains of back and extremity pain. He shows no indication of disability and despite imaging studies, multiple doctor and nurse evaluations telling him he is OK and just needs to heal---he puts in a sick call slip every single day for a month.

Every single day he tells me the same complaints, that "nothing has been done" and then verbally abuses me. Every day, I tell him what medical attention he received on each date and review the plan of care. Then I end up warning him twice and then ending the visit because of abuse and charging him the nominal fee for a nurse visit. Then he hands me his sick call slip for the next day.

Part of me recognized that if you do the same thing repeatedly you are going to get the same results. I think this guy is building a paper trail through medical because he wants to sue the police dept. and possibly medical if he can show negligence. Any advice from those with more time in corrections than I have?

[mikethemurse, BSN, RN]

Sounds about right, and you will deal with this time and time again in this specialty. The best advice that I have is just to document, document, document. Also, if the inmate is becoming verbally abusive, where are the COs, and why is he not being charged by them/you (not just for sick call but for conduct which disrupts, at least). Also, talk to your DON, maybe a good "come to jesus" talk from admin would help. Anyway good luck! I do feel your pain...about to deal with my own guy who is a lot like yours. And there will be a note in the chart documenting what I do for this guy.

[DawnJ]

My next plan is to involve the CO. I've been trying to handle it myself up until now, since he isn't threatening me personally, he is loud and profane. When I give him the stern "mom" lecture he apologizes and is OK for about 5 minutes before we start again with the swearing. I'm not a prude, a few colorful, descriptive terms don't bother me, but when they are loud and angry I put my foot down

[ocean.baby]

Everywhere I have worked in corrections the sick call ends immediately upon the inmate starting to swear or becoming disruptive, even if I do not feel threatened. If it is a facility where a CO is not always present at medical visits, I notify both the inmate and COs that he will no longer be seen in medical due to his behavior unless a CO is present (document behaviors in this notice). Always stop the interview/visit once negative behavior starts as it can easily escalate out of control.

Make sure you document how he ambulated, sits/stands, moves extremities, etc. each and every visit.