This is a Classic post that is just as pertinent today as it was when first written!
Danielle Carbon, LPN, works in a county jail with an average daily census of 1300. Here is her correctional nursing tale.
The Background
I’ve been working as a correctional nurse in a county jail for 8 years. One phrase that seems to come out of my mouth time and time again is “It’s not always detox.” I have learned that even though the signs and symptoms of any condition could be right there slapping you in the face, there could always be something hiding in the shadows.
The Tale
A few years ago I had the privilege of working as infirmary dayshift charge nurse. During report the off-going charge nurse told me of a patient with a history of drug abuse. Due to the amount he used he was automatically housed in the infirmary and treated for detox. He was approximately three days into the withdrawal protocol but not showing much improvement.
When I assessed him he was lying in bed – a slender white male in his mid-40’s. As he sat up I could see he was weak with fine motor tremors. He denied any specific symptoms, but said he felt sick. A little over a week ago he was diagnosed with tonsillitis and never fully felt better. He reported feeling worse the last two days. His blood pressure mildly elevated and his pulse was in the 140’s. I made a call to the doctor immediately. His diagnosis after we drew stat labs was acute Hashimoto’s thyroiditis. With treatment, he was like a new man. He left the jail being diagnosed and treated for an illness he had no idea he had; and he was fully detoxed from a drug that took over 20 years of his life.
The Lesson
One thing I have learned working corrections is sometimes there will be a zebra in your herd of horses. You always need to keep your eyes open in case one comes your way. Also don’t always assume” it’s just detox” when a patient with a drug history is looking and feeling ill because sometimes IT’S NOT!
Do you have a tale to share with others? Share it in our comments section, below. Let’s help each other become better correctional nurses!
Gayle Burrow says
What a powerful story from the nurse who cared for the patient. Also the physician who listened to her assessment and followed through. Yes the zebra in a herd of horses is a great analogy–thanks Danielle for taking the time to share with others.
Germeline Nabua, PHRN, CNN, USRN says
This is my first time to hear about correctional nursing. I’m from the Philippines and we don’t get to encounter such field but it’s totally amazing to get to know it through your blog. Love your posts.
Debra Wagner says
I thought the article was great I have worked as a Jail nurse for 14 years. I love it. Just when you think you have seen it all something else comes along and takes you by surprise. You really have to watch and listen to your Inmates and some time dig information out of them.
Lori Roscoe says
Thanks Debra! It is so true that we often have to ask questions based on your observations as well as what the patient told you. It is also important to objectively look at what is going on and ask yourself if it makes sense…in this case, the nurse identified that it was not usual that her patient was not improving with his “detox” symptoms when she expected that he would.
Lori
jailaid says
I agree with you. If you are a correctional nurse, you must check the history of the patient. Because they might have an existing medical condition, but they just don’t know it. Salute to you!