Know Your Role with a Prisoner Patient

Approximately 2.3 million people are incarcerated in the United States, and it is not uncommon for them to need medical attention. But the care of the prisoner in a hospital setting can get complicated. Who is really in charge of the patient? That was one of the questions Catherine Hesse and Jana Du Bois of Dignity Health addressed in their Thursday session “Prisoner as Patient: Unlocking the Legalities.”

“Our departments are flooded with patients who have complicated legal issues. Behavioral health patients and prisoners are very common,” Hesse said. “It is important to know swim lanes and role definitions while taking care of these patients.”

Hesse has heard from many emergency nurses asked to fill in as security guards or police, or had bad experiences with prisoner care. These nurses wanted to preserve privacy and prisoner rights, but they had no idea how to do it.

“When I was a nurse, there was no training when it came to caring for prisoners,” Du Bois said.

Based on the responses of session attendees, it appeared there is still very little training.

One tool nurses can use to help assess a situation with a prisoner is the presence of tattoos.

“Tattoos are silent communicators,” Hesse explained. “We use the tattoos to educate the RNs and MDs as to who they are actually dealing with and who might be a violent case.”

Hesse and Du Bois showed pictures of common gang tattoos nurses could use to help identify gang members in their EDs, including those of the gangs MS-13, the Latin Kings, Hell’s Angels, Irish gangs and the Italian mafia.

The presenters covered many other topics during their session, including reasons why prisoners come to the hospital, nurses’ responsibilities and the rights of the prisoner as covered by the 8thand 14thAmendments to the U.S. Constitution.