You know, the topic in this thread was suicide prevention and with so many mental health patients in jails our job of preventing suicide becomes that much more difficult. Both nursing and corrections officers have to be on top of their game to see the signs if and when they present, that an inmate is at risk.

I’ve been a nurse for more than 30 years and I totally enjoy correctional nursing. You stated a lot of very true points. Most inmates embellish or outright lie about health issues. However, medical staff is caught between a rock and a hard place in making treatment decisions. The pressure from families, administrators and other staff is incredible. I have to remind my nurses constantly that every issue does not require a pill as part of the intervention. Sometimes education takes care of the problem. But most of the inmates behaviors are the same behaviors they displayed on the outside. When I worked in the ER, there were many people who neglected their health until they became so seriously ill that they ended up hospitalized for days or weeks. In the jail, they know that they have access to medical (including psychiatric help). Most of these people take pills or use drugs for any and everything because they don’t want to deal with life, pain or both.This behavior does not stop at the jail house door. If they are drug seekers on the outside, they will be drug seekers on the inside. Lastly, mental health issues are becoming the norm. We have adolescents who were on meds for behavior who become adults with issues. They have been taught all their lives that there is a pill to fix everything. The drug companies love it!!!!

The nurses we have adapted to the jail environment. That means they got “tougher” in their attitude with inmates. Inmates are bullshitters quite frankly, you cannot believe what they tell you. I have seen inmates go to medical for a pimple, for hangnails, for the nurse to cut their toenails. Our PA said that out of the 50 inmates or more he sees twice a week about three of them really have medical issues. They also think that the facility will pay for elective surgery which is not going to happen. Unfortunately it’s a scam most of the time. The other issue is mental health medications. When we have to give zidis at $40 a pill to an inmate we really need to evaluate the use of generic psychotropic meds. Good luck to you Mta 7035..

It’s a really hard job for nurses in correction unless they work at a facility where they are required to go to the academy and be officers. Most of us have very little idea how the system works and the inmates can often use that lack of knowledge against us. Much too often we butt heads with officers rather than work with officers to get to the bottom of whatever is going on with an inmate. Better communication between the medical units and the housing units and administration can make a world of difference in outcomes.

I always though with the exception of a few the nursing staff had a tough job.Me,I never complaint about all the questions that where ask,that is how we knew we had a first timer,depressed over being lockout,the world they knew gone.. Or just got a dear John,,,girl on the Streep found another man… Getting a good history on the inmate usually help to get a good feel for what I was dealing with;wanting attention or a possible suicide…

Prevention of suicide is a hard task for all correctional personnel. As a nurse manager, I see inmates who have a history of behaviors which place them at risk for suicidal behavior but have limited resources to really evaluate or treat theses individuals. My staff often put people on suicide watch because of comments made without doing a full evaluation. I have had officers get upset with me and my staff because we ask “too many questions” trying to figure out if an inmate is attention seeking or actually has a psychological issue that requires deeper investiagation and treatment. Lastly, there are so few community resources available. I am fortunate to have a mental health social worker three times a week, who goes above and beyond the call of duty to try to coordinate care for these patients while inside and upon release. As a small jail, we are really lucky to have that kind of help. Bad news for all of us is that as the budget allotted for mental health continues to dry up, the jail and prison population will increase with more and more inmates being clients in need of mental health treatment.

Of the past 5 successful suicides at my last prison, 1 was on 3rd shift. 2 on 2nd shift and 1 on 1st shift. None of the Inmates indicated they were going to kill themselves.

Good post Jamestown.It is a constant job,not just 3rd shift or the holidays,Christmas in particular.
I have one during change of shift.doing my inspections,when I got to his cell he told me he was going to kill himself.i told him as soon as I was done with the inspection,I was calling the sgt.I’m serious co,so am I ,he preceded to swallow a disposable razor blade and 3 small batteries.The shrink took him off suciede watch the day before the incident…..constant all year round job.

There was a pretty good article about suicide prevention on this forum today. Here are my comments to his article:
Suicide prevention is a constant job in all correction facilities. Many officers think that inmates kill themselves at night while everyone is sleeping but that’s not the norm. If an inmate is depressed because of being incarcerated or if they are facing years in prison due to their sentence they are very likely to kill themselves. COs need to be watchful for suicides during the daytime. I have seen at least five of them during the day, two of those died. One of the most popular times for them to commit suicide is during shift change because they know the officers are busy exchanging radios, information, checking paperwork, etc. An inmate does not always hang themselves high on the bars. We have seen them hang low from the bed and one tied his sheet to the bars, his neck and then just ran backwards as fast as he could. Another way is overdosing on hoarded meds (usually psychotropic) mixing them with cough syrup or drink mixes. Others have cut themselves with razors although all of the ones we have seen survived because they didn’t sever arteries. It is also true if you have a successful suicide other inmates will attempt it within a few weeks, they tend to follow another. Good article.