Strong judgment skills necessary
By Dana Simas, Public Information Officer
Studies have shown that inmates tend to be 10 years older physiologically than their actual age, which is a growing concern in California’s prisons as the average age of inmates continues to rise. No one understands the medical needs of these inmates better than first responders, such as Registered Nurse (RN) Leslie Neely.
RN Neely began working as an RN with CDCR at the California Men’s Colony in San Luis Obispo in 2006. She currently works as a vacation relief RN, which means that each week she could be working in a different area of the institution.
“A ‘typical day’ for a hospital isn’t realistic,” RN Neely said. “In the community, you tend to develop a singular niche. In prison, you have to be able to work in the hospital, on the yard, or in the clinic.”
During these visits RN Neely will assess the inmate patient’s symptoms or complaints and then, based on her expertise, develop a care plan. If a prescription is needed, a referral is made to one of the institution’s doctors for the inmate. The visits typically last about 15 minutes, and then it’s on to the next inmate-patient.
RN Neely uses all of her assessment skills to determine a plan of action – whether it’s administering medication or referring the inmate-patient to the doctor or staff psychiatrist.
She also listens for manipulation by those who may be trying to game the system.
“The challenge is trying to make sure you don’t miss something when an inmate fakes it 99 times and then the 100th time it’s real,” RN Neely said. “You have to have strong judgment and discernment.”
She also takes the opportunity to educate the inmate-patient about basic tactics for the prevention of illnesses –washing hands regularly, exercising, treating possible infections, and avoiding risky behaviors that could lead to hepatitis or HIV.
On one occasion RN Neely was working on the yard when a group of inmates called for her over to their friend who was not feeling well and couldn’t communicate. She realized the inmate was diabetic and needed an insulin shot. This is why there are first responder RNs, who respond immediately in an emergency transport vehicle to the yard, or wherever needed, to assess inmates in the field.
“It’s definitely not boring – there’s a lot to keep you professionally challenged out here,” RN Neely said.