Correctional Nurse . Net

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1. Love your post about Bridging Meds. In a jail setting it can be a particularly thorny problem. Detainees bring in med bottles filled 6 months prior that had no refills remaining,… pain meds that they have been getting from pain management that they have been crushing and shooting up,…hypnotics and benzos for sleep that they want to continue to take in jail,..and polypharmacy is also commonly seen. Had an inmate come in on 2 loop diuretics, no K+ replacement, and stated he had no lab done at the time he was in the community. Our facility is lucky, in that our dept head reviews all intakes for meds/potential problems, and all the nursing staff know that they can either call me at home or email me when they have an intake that is on meds.I can imagine that large facilities have a hard time with staying on top of this problem.

   Comment by Glenda Bivona | October 13, 2009 | Reply

   • Thanks for your feedback, Glenda. Your experience is common. Our patient population is not well-adapted to follow-through, is it? We have to sort out a lot of info to get them the care they need.

     Comment by Lorry Schoenly | October 13, 2009 | Reply

2. I have a question about corrections training for nursing staff. I work in a university hospital, on a corrections (only) unit. I am attempting to find any resources about correctional training guidelines for nurses caring for hospitalized inmates, but have been unsuccessful in locating nursing specific information. Any assistance you can provide will be most helpful.

   Comment by Dana "Buzz" Daniel BS, BSN, ACRN | November 1, 2010 | Reply

   • Thanks for your question, Buzz: There isn’t much out there, I’m afraid, for those in your special situation (you should write something!!!) General correctional healthcare information is applicable, though. Try to get your hands on a copy of “Clinical Practice in Correctional Medicine” Edited by Michael Puisis (out of print). Has 4 excellent chapters specific to nursing practice and the general medical chapters about the inmate population, dealing with security, and ethical/legal issues would apply in your situation, as well.

     Comment by Lorry Schoenly | November 4, 2010 | Reply

3. OK, I need to know… Does ammonia capsules ( if someone is having a seizure a true seizure) make the seizure worse. I have been a correctional nurse for 2 yrs, and I currently hold down a full time hospital position. Total yrs of nursing experience 3.5 yrs. I did all the things you are suppose to do when someone is having a seizure real or not. Assess pt. O2 sats, pulse rate, hand over head or even male parts, sternum rub ( which was effective) until another nurse came on the scene and popped another ammonia capsule and then she said ” Oh no, it made it his seizure worse” The man was moaning during the sternum rub ” it hurts, it hurts.” This man was not having a true seizure. He was talking and you could not open his eyelids to assess his eyes. When nurse # 2 came on, she literally pushed me out of the way had her personal little o2 machine and it clearing showed 96- 97 % RA pulse 106, and decided he was not faking. I/m body was not rigid, nor was his lips blue. (From the time of the call this seizure lasted 10 plus minutes and still had continued while EMS was there). Threw on a non re breather mask at 8L and told the correction officers to call EMS, after I had already aroused the guy and he was moaning to me and another officer..Did I mention she was the supervisor!
   Please tell me every trick in the book to determine at beside or in this case in a dorm b/t bunks the quick tall tails to confirm your judgement of an inmate faking a seizure. This obviously frustrated me.

   Comment by Brown RN | November 5, 2011 | Reply

   • Yes, I can see from your description of the situation that you would be frustrated, however, I don’t really have anything further to offer. The most important nursing function is delivering adequate care to the patient including assessment of vital signs and establishing safety during the seizure activity. It is important to clearly and factually document your observations without critique of motivation. I am guessing that part of the frustration is the public countermanding of your evaluation and care by the supervising nurse who arrived at the scene later. There is something there in the relationship that may need to be explored. It is important for custody and the inmate population to see you as united around a common purpose. The inmates, especially, can use any staff friction to ‘divide and conquer’. Don’t let them manipulate clinical staff. A private heart-to-heart with your supervisor to discuss how you might better work together would be important.

     Thanks for sharing this nurse story. We need more dialog and support in the correctional nursing community. If you haven’t already, you may want to check out the correctional nurse discussions over at allnurses.com.

     Comment by Lorry Schoenly | November 6, 2011 | Reply

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