Wonder how often this happens

Specialties Correctional

Published

I have a friend that is a physician at a hospital that is near a maximum security state prison.

She was telling me about the protocol that has to be followed when they bring in inmate in for care....which is always three guards...two in the room and one outside the door, patient has to be handcuffed to the bed at all times, etc.

What she told me next really, really shocked me.

She said that whenever a patient was discharged, even for a serious injury or surgery that may be health and not violence related, when the attending physician feels that a heavier med is needed and gives the guard a prescription, the guards hand it back and always say, "Save your paper, the only thing this guy is getting is Tylenol".

Knowing that medications are under lock and key at a prison and obviously not given to inmates to take back to their cells, my friend has always had concern over the management of pain, knowing that Tylenol isn't a cure-all for everything, especially when they have abdominal or back surgery, have broken bones, etc.

To me, I am very surprised that guards are allowed to make, what boils down to a medical decision regarding the patient.

Specializes in behavioral health.

The officers here are very professional. I am sure your daughter is miserable, she's in jail. But I would like you to consider that we are professionals and do deal with alot of drug abusers. What an inmate cries to mommy may not be the exact truth by a long shot. Drug abusers often have a victims attitude and want sympathy for what "we" are doing to "them". Not many of them take responsibility for their outcomes. Not saying that this is your daughter, just what a great deal of my experience involves. And yes I consider addiction a disease, I so often see the ravages of it. Not intended to offend, just offering the other side.

No offense taken. My daughter has played the victim many of times, not owning up to any of her part in the situation. And, you are right, I was not there, so I don't know the whole story. I will never know all versions of what happened. But, I am still angry about her not getting her meds that were prescribed by her psychiatrist.(non-narcotic) And, yes, the bottom line is that its her fault for being in jail.

I am glad that the officers are professional where you work. Many jails have some very "unprofessional" officers.

That sucks.....its definitely a conflict. I mean....as a nurse or doctor it is your duty and it should be your want to heal and help eveyone.....but then again you can understand that they have probably had situations where problems arised.....hard situation to deal with.

This used to be the case in California, not any longer. First of all, upon discharge, all hospital discharge documentation is place in an envelope, sealed and handed to an officer that delivers it to medical staff where the inmate is assessed as soon as he returns to institutional grounds. Pain management will be based on those recommendations, and what is available in the formulary (Tylenol #3, Ultram, Methadone, etc.)

Here in Georgia even with the patient having a signed release we don't always get that envelope of hospital discharge information and/or workup... Phone calls: Very hard to get information due to no one wanting to give out non-dictated information.

As for management we look at the ER/Hospitals diagnosis and treatment regiment directions (when available): We use them, change them or send the patient out again because or original reason for sending the patient out was ignored...

Overall the occasional officer may try to plug in his/her two cents worth at the hospital I won't deny that does not happen. I will say some patients went to the hospital because of officer did his/her job and chimed in.. The officers are good at plugging in information the patient may not remember or know.

Specializes in corrections, psychiatric.

I don't believe "Always", although I don't say that officers may not say that.... My question is why is the physician giving officers instructions???? There is absolutely no reason why he should do this. Staff should be folding the paperwork, sealing with tape, with instructions to give to the medical department.

The final decision regarding pain medication lies with the prison physician and he will prescribe what he believes appropriate in the circumstances... in some cases, this may indeed be tylenol.

I don't believe "Always", although I don't say that officers may not say that.... My question is why is the physician giving officers instructions???? There is absolutely no reason why he should do this. Staff should be folding the paperwork, sealing with tape, with instructions to give to the medical department.

The final decision regarding pain medication lies with the prison physician and he will prescribe what he believes appropriate in the circumstances... in some cases, this may indeed be tylenol.

Some prisons don't have 24x7 medical on hand. Those very officers in some circumstances will be calling a doctor on call.

The question should be why the medical folks in the hospitals make no attempt to give report to other medical persons who for the most part initiated the trip and/or will be taking care of the patient on his/her return.

Specializes in corrections, psychiatric.

I know that some jails and juvenile facilities do not have 24 hour nursing staff, but I am not aware of any adult prisons without nursing staff. I think this inmate, from the post, came from a maximum security facility.

I think it would be rather dangerous not to have a 24 hour nursing staff.

Here in Georgia not all prisons have 24x7 coverage on site.

Specializes in Addictions, Corrections, QA/Education.

Antipyschotics require eval by our mental health dept. They are IMO over-prescribed in the general population by pcp's.

Our mental health dept (psychiatrist) prescribes mental health meds. Our doctor does not prescribe any mental health meds. We are strict on what we give out due to all the drug seeking out there!

Specializes in corrections, psychiatric.

Really? How many inmates at those facilities, and are they medically screened to go to those prisons?

Our mental health dept (psychiatrist) prescribes mental health meds. Our doctor does not prescribe any mental health meds. We are strict on what we give out due to all the drug seeking out there!

Georgia: Our medical doctors continue mental health medications on intakes for a short time until they can see a mental health doctor otherwise we just consult with mental health; we don't prescribe.

Specializes in Hospice, corrections, psychiatry, rehab, LTC.

We don't accept scripts, or medications from outside sources. The recommendations of hospital doctors are advisory only in a prison environment. We give pain medications up to and including Oxycodone, but an inmate must be housed in the infirmary in order to get them.

Antipyschotics require eval by our mental health dept. They are IMO over-prescribed in the general population by pcp's.

Very true. Seroquel in particular is a problem. It is so popular with drug users that it has acquired street names. Abuse and sales on the yard were such big problems that Nevada DOC took it off the formulary entirely. The first warning sign is that we started getting written requests for treatment (when I worked outpatient mental health) that said merely "I need Seroquel" without stating what the problem was.

We don't accept scripts, or medications from outside sources. The recommendations of hospital doctors are advisory only in a prison environment. We give pain medications up to and including Oxycodone, but an inmate must be housed in the infirmary in order to get them.

Very true. Seroquel in particular is a problem. It is so popular with drug users that it has acquired street names. Abuse and sales on the yard were such big problems that Nevada DOC took it off the formulary entirely. The first warning sign is that we started getting written requests for treatment (when I worked outpatient mental health) that said merely "I need Seroquel" without stating what the problem was.

:bugeyes: :lol2: :icon_roll

Sort of like the inmate that told me that his pain was helped by an Ultram a friend had given him on the dorm.

Problem with that statement: Ultram is a DOT medication and given only on pill call.

Instant change in policy: All Ultram is now crushed and floated.

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