It's just after 4:00 AM. An incarcerated person was admitted to the infirmary yesterday evening for medical observation after a day of persistent vomiting, dizziness, and generalized weakness. Following a nursing evaluation and consultation with the provider, the decision was made to continue ... Read More about Clinical Decision-Making: He’s Sleeping…Should I Wake Him?

Withdrawal is one of the most common conditions encountered in correctional healthcare. For many nurses entering the specialty, learning to recognize and manage withdrawal becomes a major focus of orientation and training. While those skills are important, one of the most valuable lessons I learned ... Read More about Things I Wish Someone Had Told Me About Withdrawal

This week I am at the National Commission on Correctional Health Care's Fall conference, and if you have ever attended, you know the feeling. Within a few hours, the hallways fill with conversations that would make little sense almost anywhere else. Someone describes a medication pass that ran two ... Read More about Finding Your People

It's 2:30 in the morning. You saw a patient at evening sick call for a cough and fever, and you have reassessed him twice since then. His respiratory rate is a little faster than it was earlier, and his oxygen saturation is a few points lower. He tells you he feels about the same. Nothing is ... Read More about When It’s Time to Call the Provider

When I review a medical record, I rarely look at a single note by itself. I read the record from beginning to end, and over time the individual entries begin to tell a story. Sometimes the story is reassuring. Sometimes it shows something that no one recognized while it was happening. Consider a ... Read More about The Story Your Documentation Tells