True anecdote, fresh from today!
Me: What kind of treatment did you have before for your psoriasis?
Patient: I got ultra-violated a number of times.
(ultraviolet light treatments are commonly used for psoriasis)
love it. On a form that an inmate filled out for me, under ‘ethnic group’ he wrote “alcoholic”.
He weren’t lyin’, neither.
I was wondering if he’d watched A Clockwork Orange too much…
I think I can ring in from the other side here: although I was not in prison, I am a convicted felon and spent 267 days locked up.
Qadgop: they know about your panic button. Be sure of that.
Inmates are always happy to see the doc, They are one of the few people who don’t (usualy) talk down to you, and at least pretend they care a little about you.
In my own experence, one inmate kept complaining to the COs that he was having chest pains. He was told to lie down–repetedly, and finaly died of a heart attack in his bed. Thankfully, the offending guard was fired.
The toenail thing was pretty common in the facility where I was, there were no nail clippers available. I had one that got so infected that I had to go to the hospital.
Moderator’s Note: Since this thread hasn’t been hijacked into a debate about capital punishment or anything like that, I’m transferring it to IMHO.
D’oh! Sorry to make work for you, MEB. I read the felon thread and without thinking posted my thread without heed to the forum I was in. My bad. Seven days in segregation, away from the other threads, for me!
It’s not a problem. I was just going through the various “Ask the…” threads, scratching my head, and trying to figure out what goes where. Some of the “Ask the…” threads do go in GD (I left the two current “Ask the [adherent to some specific set of religious beliefs]” threads where they were.
QtM - Why all the ingrown toenails? Ill-fitting shoes? That’s just weird. Are you the only physician on staff? How many nurses and PAs do you have working there? Do any inmates work in the infirmary?
StG
Ingrown nails are common in young people in their teens and 20’s. This is aggravated by few shoe choices, and lack of nail clippers.
I’m the full-time doc, we’ve got 4 part-timers, to make up about another 1 and a half full-time docs. A couple of those docs work at other prisons in our system too, to make up their full-time hours. Others float in from other prisons to help out when we’re too behind on our physicals. I’ve one Nurse Practitioner, two Physician Assistants (all fulltime), and we have an opening for another fulltime NP which we haven’t been able to fill.
The infirmary position is a full-time one for another doc, we have 54 beds, and no current full-time doc for the slot, so two docs are covering it part-time, leaving us short-staffed in our unit. Inmates help clean and maintain the infirmary and primary care unit (my home) along with some paperwork, but don’t do any patient care, other than wheeling some patients places.
How hard is it for prison docs to prescribe methadone in the US? If it is pretty restricted, should it be less so?
** Rip out their toenails! **
I know this was said partly in jest,but just how does one go about ripping out the offending toenail? Do you use a local anesthetic?
Thak god for the absence of slim shoe fashion in my life.
I still remember Cal Ripken’s story about drilling the toenail to relieve the pressure.Is it * safe *?
Qadgop, thanks. It’s very interesting to read this thread; I’ve heard a little about the psychology end of prison work from colleagues, and a lot of it sounds similar.
Another toenail question, re: clippers.
If there are no nail clippers available, how are fingernails and toenails kept short and safe (I have dangerous claws in a matter of weeks if I don’t keep my nails trimmed). What alternatives are there? Emory boards?
I can easily prescribe it for treatment of pain, and have done so. It’s no more difficult than prescribing any other Schedule II pain killer.
I do not prescribe it for addiction maintenance treatment. That takes special certification and oversight, and I’m not interested in doing that at all.
*Originally posted by Lure *
I know this was said partly in jest,but just how does one go about ripping out the offending toenail? Do you use a local anesthetic?
Digital blocks at the base of the toe with lidocaine. It takes 5 minutes to numb it completely that way.
*Originally posted by Eats_Crayons *
** Emory boards? **
Emory boards!
Do any of the HIV patients get nasty with you or the guards (or threaten to)? We’ve all heard the horror stories about spitting on guards or splattering them with blood. Is this another Hollywood and TV prison cliche, or does it really happen from time to time?
Great thread, BTW.
A few more:
Anyone ever attempt to bribe you? If so, by what and for what?
How many prisoners are in the prison? How many do you see on an average day? Are you the only physician on staff?
What does your wife/s.o. think of you working at a jail? Was she scared? Were you at first? If so, are you still?
*Originally posted by jk1245 *
Do any of the HIV patients get nasty with you or the guards (or threaten to)? We’ve all heard the horror stories about spitting on guards or splattering them with blood. Is this another Hollywood and TV prison cliche, or does it really happen from time to time?
It happens. A lot of inmates fling body fluids. Some of them happen to have contagious diseases. It’s not pretty. It happens in the Segregation unit mostly, where people who don’t play nice with others get to spend time-outs. I’ve not seen it happen in our primary care unit, tho. But it probably has.
Yes, this is a cool thread.
Do you miss working with children? Do you miss pregnancies? (I mean, you were a GP, right?)
And what the hell–why is the human body designed in such a way that ingrown toenails are common among youth? Sounds like mother nature screwed up.