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Texas County Jail Nurse Speaks Out!

Jul 4th, 2013 | Category: Conditions in County Jails

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Update, November 2013 Jail Nurse has started her own website!: http://www.texasjailnurse.com/

Her post continues below:

I have a staff of 10 and we try to provide the best care available. Not the best care you can get in jail, but the best care available.

Please understand all facilities are different. Each jail will have a procedure on what medications they allow, how they process sick calls and how they deal with detox issues and emergencies.

We have a doctor and a prescription formulary [list of medications] that we use. I will request medical records from your physician and will use those records as a guideline for your treatment while you are in my care. In MOST cases I am going to leave you on the medications your physician has prescribed even if it is not part of my formulary. If you have been seeing your physician and are on a medication regimen that is working, I have no desire to start from scratch and try to figure out what medications you need.

In my facility we do not allow narcotic pain medication or other controlled substances.  If you are currently taking those medications we have a detox protocol. Our treatment is based on type of medications, drug and/or alcohol use. My minimum detox is 10 days and can go to 30-45 days as needed. I do not want you to suffer while you are here and I want to make sure you are safe.

There are always exceptions. Example; You have surgery while you are in my care and the doctor sends a prescription for hydrocodone for 5 days. You are going to get the hydrocodone for 5 days. If after 5 days you are still in severe pain, you will be evaluated and your medication will be extended if needed.

Generally we do your complete medical intake within the first 4-6 hours of your incarceration. This is separate from the booking intake medical portion done immediately upon your arrival that includes recent drug/alcohol use and questions for suicide evaluation. During the booking portion if you state you are suicidal or have just used meth, you are seen by Medical immediately. DO NOT LIE TO ME. Do not tell me you do not do drugs or drink, if you do. I am asking so I can provide medical care. I cannot help you and give you proper treatment if you do not tell me. You will not “catch” a charge because you tell me you just shot up heroin. But now I will know what to give you if you start to overdose. Your honest answers to my questions may save your life.

DO NOT say you are having chest pain, unless you are. Chest pain is taken seriously and is treated as an emergency. If I’m doing your EKG and you tell me you are not really having chest pain you just wanted to come out of the dorm or make a phone call, don’t be surprised when you get a write up. DO NOT call your family and tell them you are having a serious medical problem and are being ignored, unless you are.  If I get a phone call from your Mom and she is hysterical and yelling at me because you told her you are dying and being ignored, then I go to the dorm to check and you are on the rec yard shooting hoops. Guess what, I am calling your Mom back and letting her know. I am going to make sure your mom has my direct phone line, I may even get you on speaker phone with your mom and ask you to sign a medical release so I can speak with your mom if she has to call me back. Do not put your family through hell worrying about you when you are fine. Do not use the scare of your health as a means to try and pressure your family to bond you.

If you say you are going to harm yourself I will take you seriously. I have a safety smock, a safety cell and even a restraint chair for extreme situations. You will be placed on continuous camera monitoring, 5 minute direct observation checks, a 15 minute Officer check, every 6 hour vital sign check, 12 hour evaluation by a nurse and a 24 review by a Mental Health Professional. If you are not able to keep yourself safe, I will do what I have to do to keep you safe.

I want to make sure you go home. I will do my best to make sure you go home in better condition than when you arrived at my facility.

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8 years ago

I am the “Jail Nurse” from the above post. I have read and re-read the article and I want to apologize if it comes across as “stern”. I wrote the above letter after reading the recent articles posted here about the death of Tommy Taylor and April Troyn. I am very passionate about my career and making sure we are doing the right thing for all. It pains me when there is a loss of life that could have been prevented or when a family is suffering due to the unknown, such as the case with April Troyn.
I often use The Texas Jail Project articles as training tools for my staff. Showing them the things we do not want to do and pointing out areas where we can improve. I support the work you do here and I hope Diane Claitor and the TJP will take it as a compliment that I never want to see myself or my county listed on this site.

5 years ago

I did not read stern into your article, I read it as concern for your patients. It is good to know that at least your facility has someone who cares.

8 years ago

I have to turn myself in harris county on July 10 for 30 days. I am currently prescribed 2. 8 mg suboxone every day and I also take vicodin and soma everyday. I am worried about the withdrawl process and what to expect

7 years ago

i wish you were in denton county taking care of my husband!

8 years ago

I wish there were more nurses like you in the county jail system. God bless you as you seek to take care of your inmates. I appreciate it when anyone in the system treats inmates, not only as human, but also as family.

8 years ago

Jail Nurse, I see your post as a sincere attempt to communicate to your patients what they can expect from you and what you expect from them. That is not stern; that is professional. Being honest and open about expectations, and doing so in a compassionate way, leads to better communication and better care. I applaud your dedication to your patients and your profession. Thank you so much for writing this letter and sharing it with us.

8 years ago

Dear ‘Jail Nurse’, Your letter filled me with hope. Something we (at the Texas Jail Project) have not felt for some time now. Thank you so much for writing us. I do hope we will hear more from you in the future. Your comments, suggestions, insights and whatever else you may have to offer us in making our work more effective will be greatly appreciated. THANK YOU!

8 years ago

Jail Nurse,

Thank you for this article! I think the more information that is available regarding medical care in TX county jails the better. Thank you for taking the time to share this with the TXJP and for encouraging staff to read the stories posted here!

8 years ago

Dear jail nurse…tommy has never lied about being addicted to drugs on any medical forms… I have his medical records! I understand the harse and stern opinion… And I appreciate your care and concern for inmates. What I do not like us the politics and lies that comes with your job. How the people in charge of the facility can lie and use the medical staff as scapegoats! In my brothers case he never saw a medical person until they called the code! They knew he was slurring his words and put him in a kennel like a dog to die for hours before they noticed!

8 years ago

Dear Anon. June 16, 2013 at 4:53

First I am so sorry for the loss of your brother. I have read the full article and believe I see the chain of events. When Tommy arrived at Bexar County he should have been evaluated, questioned and monitored. At the first sign of distress he should have been given Narcan and transported to the infirmary or ER, I believe this was an accidental overdose. Tommy had been incarcerated for a number of weeks and detoxed during that time frame. When he took the dose of methadone prior to turning himself in the amount was too much since he had been clean for 3-4 weeks. I have seen this happen before with my own sister. My sister survived her methadone overdose but did have a heart attack during the process.

In the facility where I work if you are found falsifying documentation and inmate checks, you are suspended or fired. I have had 2 people falsify medical records (both were a vital sign check). Both people were fired as soon as it was confirmed by video they had not done the check and documentd they had.

Jail staff must be held accountable for their actions, inaction and subsequent results.
Again, I am so sorry for your loss.

8 years ago

Dear Jail Nurse,

I also run a county jail, and as the only medical person on staff I want to tell you I could not have said it any better.
Thank you for your letter.

Another jail nurse

8 years ago

I have question and a question. I love the passion you show. I have a family member that is going to be spending about 8 months in the Gregg County jail. They is currently is a behavioral health hospital and has been diagnosed with bipolar,depression and personality disorder. I am concerned for there mental health they will need his psych meds. I am very concerned about his safety. Due to transgendered which they want to be the opposite sex. Is there a Trans gender cell or will they be put in isolation? Please help.

8 years ago

I know a lady who was also a jail nurse; very good one also. It doesn’t matter how good medical staff is if inmates are not allowed to get to them. Two days before my son supposedly hung himself in Montgomery County TX, he called & said he was throwing up blood (previous stomach problem & in all honestly meth also).

When they took him back to jail after supposed hanging (less than 24 hrs after coming out of a coma); with diagnosed anoxic brain injury, seizures from the injury and pneumonia: he was put into a cell not hospital, like officer Hensley first told me on the phone. Rickey could not walk, could not talk, could not feed himself, or go to bathroom.
That was a Wednesday afternoon, other than right after he was brought from hospital that day he was not seen by medical until the following Monday. Took them two days for mental health evaluation. Then on Monday Jail Medical Supervisor Edsel West (a paramedic not a nurse of MD) e-mailed Rocky Quertemous the Jail Administrator requesting to have him mover to another medical facility because his level of care exceed the level of care available in the Montgomery County Jail. Instead they called me & ask if I would come get him if they released him on PR Bond. I had already hired an Attorney that had been to the DA’s office and was waiting on Judge to sign off on PR bond. When I got him out that afternoon he was almost dead. I am not making this up. I have medical records to prove it. Partially collapsed lung, multiple cracked & fractured ribs, cuts, bruises, & scrapes on his entire body. Urine burns where they tied (he had rolled gauze wrapped around his ankles) him in restraint chair. He was so starved & dehydrated his muscles had already started to wither & the connective tissue was in his urine. Sodium level was lethal is what I was told & they had to change the IV fluid because of it. He was in the hospital for three weeks after that & was diagnosed with a TBI also, from the blow on his head that was not there in the first hospital.

Since he had no insurance the hospital MADE me take him home.

My point is caring medical staff is WORTHLESS if they never make it there.

7 years ago

Hello Laura, My husband was in medical nearly his whole stay at Montgomery County Jail, and was in there during this time period. We had similar problems with medical, and administration, with several violations including numerous assaults by officers, denied mental health care, denied proper medical specialists, improper medications being given and or substituted, denied basics like hot water, showers, rec, clean-up, and being fed, along with the infamous restraint chair for over 12 hrs not properly checked on as state mandates, priviledges taken away for complaining/grievances. We have a lot of proof with documentation and would love to get with you and compare notes. The only way this could ever possibly end is for all who have had issues to band together with their proof for there is power in numbers. Email me @ 1stCorinthians3:17@gmail.com. Please use an alias email address with
nothing connected to your name/address etc, as u can never be too careful when dealing with Montgomery County. We’ll be expecting your reply

4 years ago

In response to Laura’s post… I agree 100 percent. It don’t matter how good of a nurse anyone is, or how well you do your job, etc. If the inmates can’t reach anyone for help, then what good can you do? There is an article about my brothers death in Dallas County Jail in Aug. 2009 on this website. His name is Craig Morris.
The medical staff rushed to him once they heard he was on the floor dead.

6 years ago

Anyone know if detox services for alcohol is provided for at Harris County jail? A friend of mine was in jail for 80 days for her 2nd DWI. She barely remembers being there.

6 years ago

-Dear Concerned Nurse-
I have made the choice recently to take 10 months State Jail and have until this coming Tuesday morning to turn myself in. I have been seeing a Pysch Doc & Family Physician Doctor for the past 5 months on a treatment program to try and get rid of my 10 year drug addiction to pain killers. I have been taking Suboxone, Anti-Depresent/Anxiety (Well-Butrion/Prozac), and Adderall since I have been diagnosed with sever ADHD. I have winged myself off the suboxone knowing I cant take it on the inside, but both my doctors believe if I am not allowed to continue taking the other meds while being locked up that it could have a very serious counter reaction on my body/mind, bringing back thoughts of suicide and sever depression. Can my doctor write a letter to Harris County/TDC recomending I stay on my current prescriptions. And can I bring those medications with me with the original bottle to give to athoritys when I turn myself in, so they can be dispensed to me as doctor has precribed them. Would be gratful for your advice.
-Concered future inmate-

6 years ago

Your post was a blessing to read, thank you for caring. I have a question. My boyfriend is about to be incarcerated at Lynchner State jail after processed in Harris county. I want to be sure that he will be distributed his psychiatric medications, which are stat meds. One is for his severe ADD, generic Adderall. Being not just a controlled substance, but a triplicate, I want to know exactly who to speak to to find out all the specifics about this. He has letters from his doctors & valid scripts. Unfortunately, not all government employees are as kind and caring as you, especially when it comes to inmates. Who or what are the correct channels of getting the right info of what he might also need to know or bring before turning himself in. I realize he won’t get his meds right away during processing at Harris county, its the long term (10 months) effects I’m concerned over if he won’t get them at the Ataskacita jail. I just want to make sure we covered all the bases of what is required for him to continue with his psych treatment & med regiment. Anything from anyone that can tell me what’s what, or throw any relevant tips my way is welcomed too. Thanks, God bless!

Joyceline Burns
4 years ago

My son is MHMR n he just tried to hang him self n the Dallas county jail y can’t anyone help

4 years ago

I too am an agency nurse and work at a jail close to Austin Texas, as well I’m a Disabled Vet working at the VA. I do still thank those that have served, no matter what brought them to the jail, for their service. I don’t want them to think that they are forgotten for their service to this country. I try to make sure that all inmate are still in my eyes a “patient” and so I treat them with dignity, provide the best care that I can with compassion. I truly try to take the time to answer their questions, to complete med line requests, provide patient education on how to complete refill requests. I take the time to ask each patient in each cell, especially in lock down units how they are even if I’m not passing meds to them. That moment of concern and caring sometimes and hopefully makes the difference. I cut up with the inmates, but also let them know if they are crossing a line of impropriety in their communicating with me. When we respond to an inmate in the units, we stay with them until and EMS unit arrives to take over care or we take them to the clinic. I try not to get in the mentality that everyone has an agenda and is a liar. I also agree with the nurse above who posted this originally, please don’t lie to us either. I can’t help you if you aren’t on the up and up. I can’t tell you how many times I have been verbally assaulted and the cursing towards me, and yet, I try to realize that many of the inmates do have real mental diseases that require understanding and not to take things said personally. What the inmates don’t understand is that there are only a hand full of nurses for about 3,000 to 4,000 men and women at these facilities. I will say, please don’t be mad at the nurse when your medication doesn’t show up on the very day that you were told. I do believe that the pharmacies are closed on weekends and holidays and so there is catch-up time. The pharmacies do try their best to get you your meds on time. There are some instances where we don’t carry the exact medication that you are getting on the outside and may offer a generic brand. Understanding and patients is appreciated. When I can, I always write down concerns or questions and research for an answer. I will call the unit Guard back with my answer for the inmate. I don’t know it they are always passed on or not, but I know that I have done my very best to get an answer back to the inmate. I try to encourage inmates daily to take it one day at a time and talk with them about their families or upcoming trials, and offer to pray for them if it’s okay.
I enjoy trying to be different and the kind of nurse who doesn’t judge. Lord know that there isn’t a soul on this earth that hasn’t done something wrong in their life. I’m not here to judge, but please don’t take your frustrations out on us either.
I stayed with a young gal who had 12 seizures in 27 minutes while waiting for the EMS to arrive and take her to the hospital. Myself and a Guard calmed her, reassured her she was going to be okay, sat on the floor and made sure she didn’t hurt her self or choke to death. The Sgt on post was very concerned and stayed with us the entire time. We all asked about her when she returned from the hospital, and the inmates cell room mate pointed me out to her and I know that you shouldn’t hug the prisoners, but she and I hugged and I was so relieved that she was okay.
It is my pleasure to serve not only the Vets at the VA, but the folks who find themselves incarcerated. It touches my heart when I see a little child run up to their mom or dad when they are released. I encourage them to not come back in and make sounder decisions.
My best to all and thanks to those who do make a difference and serve in the medical capacity.

Cathy Lewis
3 years ago

I would like to say on a positive note nacogdoches county jail nurse an Ms Shelia have took a caring professional approach to a delicate situation with my daughters care. I appericate them during this fragil time.