What's the best way to deter inmates from abusing the safety cell?

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Specializes in Telemetry, correctional.

I work at a detention facility where detainees and inmates will claim that they are suicidal either because they want to be alone, attempt to get extra food or they want someone to talk to (the officer that will be posted outside the door). 90% of these detainees/inmates who claim suicidality are not actually suicidal but they know that as soon as they make that clam, policy says, we must place them in the safety cell. Is there any way around this? How can this be deterred?

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Specializes in Oncology.

Have a psychiatrist come see them and charge a small copay for that. I'm sure that is against their rights, though.

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Specializes in Telemetry, correctional.

These detainees and inmates have all the rights in the World. They are receiving FREE healthcare. They have the option to see a psychologist, psychiatrist, MD, MLP, Social Worker daily if they choose for free. That's definitely not the issue.

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Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.

I'm guessing that it's going to have to come from Administration, not from Nursing or Corrections. But my first thought is to make it so that the safety cell isn't a particularly enjoyable place to be.

Maybe play audiobooks that are "inspirational" or "motivational" in nature.

Maybe cook nasty-smelling foods in the area.

Maybe make it uncomfortably hot in summer and cold in winter.

Maybe get all the staff to fart in the vicinity.

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Specializes in Critical Care; Cardiac; Professional Development.

Ask the officer just outside not to engage the prisoner in conversation.

Remove creature comforts.

Remove the reward of extra food.

Basically get rid of the currency that makes this a better situation than their own cell. The desire to be alone isn't something you can do anything about. Being as crowded as these souls are would make me suicidal for sure or at least willing to pretend to be just to get away from them.

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Specializes in retired LTC.

From reading your post, it would seem that the "extra" priveleges would not be normally permitted under standard conditions. So why is the time in the 'safety cell' any different?

Since when does 'suicidal precautions' include extra sandwiches or a guard providing conversation? Seems to me that that's the problem being allowed to happen. Like if they know they can get away with the 'extras' then they'll try like the dickens to do so.

PPs brillohead & not.done.yet are thinking like me.

You have no real choice but to 'safety cell' them when they cry wolf, but you don't have to provide all the creature comforts.

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Once this situation is resolved we'll also know the answer to the endless cycle of admitting patients who should not be admitted but have presented to the ED on enough occasions with the same (baseless) complaints so that we must admit them for expensive tests that will take days, and thousands and thousands of dollars in resources. Only to discharge them when their faked nausea or abdominal pains have been sufficiently resolved with free food and drugs. And then the cycle will repeat when they once more feel the urge for cable TV, sandwiches, ginger ale, and Dilaudid.

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Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
Once this situation is resolved we'll also know the answer to the endless cycle of admitting patients who should not be admitted but have presented to the ED on enough occasions with the same (baseless) complaints so that we must admit them for expensive tests that will take days, and thousands and thousands of dollars in resources. Only to discharge them when their faked nausea or abdominal pains have been sufficiently resolved with free food and drugs. And then the cycle will repeat when they once more feel the urge for cable TV, sandwiches, ginger ale, and Dilaudid.

Exactly why I suggested what I did. Contracts for narcotics and strict adherence to fluid restrictions and dietary limitations is one way we're coping with some of these patients.

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Specializes in Medical and general practice now LTC.

Moved to the Correctional Nursing forum

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I would hope the safety cell is truly a safety cell. The ones at the prison where I worked had a metal cot, no sheets, blankets or pillows, and the usual metal toilet/sink. The inmates went in there completely nude. They usually wound up wrapped from head to toe in toilet paper, mummy style, shivering on the metal cot. They got the same food, and nobody stood out there to talk to them. I never saw any inmate be suicidal longer than 24 hours.

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Specializes in Psych, Peds, Education, Infection Control.

I agree with the above posters who recommend making it a not-fun place to be. No extra perks. We had a similar problem on my inpatient psych unit with certain patients ALWAYS wanting to use the quiet room for time-out when they felt like not participating in treatment. (Since this is specifically inpatient, of course some escape from the milieu was allowed, but I mean when they were using it as an excuse to not do anything treatment related at all.) When we stopped them from bringing activities or snacks in there and didn't let them dress the bed up and take a nap (you can do that in your room) and didn't have staff outside of their Q15 min checks stopping in to chat with them beyond safety checks...they eventually found it a less attractive place to be.

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I have now been In corrections for the last 6 years and recently started working in the mental health department as a nurse..i have learned that as annoying as it is, we can't change the fact that inmates can be manipulative..we do what we can to ensure safety for staff and the innate and let it up the lsw or psychologist to decide wether or not they're "faking". Oh well if u end up having 10 people on constant watch in one night..u did ur part by doing your best to make sure no one died..

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