Tuesday, September 29, 2009

Hey NURSE! Stories from my time at the County Jail

A brief caveat here. This post is a bit graphic. No more so than CSI. But, still, you might want to put down your lunch. It's also a bit long for my taste. But, I promise though, if you can man up and make it through, it's well worth the journey.

One of my jobs at the county jail was "short visit nurse" at the central jailhouse. The jailhouse had an exam room in the basement that I would work out of. It had some medical supplies, a blood pressure cuff, thermometer, some bandages and an otoscope. There was an exam table placed diagonally across the center of the room. The room looked a lot like this.

Every morning I would receive a roster of about 40 inmates. The list would have their name and inmate number. It would usually have one word describing the inmate's health concern. Most of the time it would say, "Rash" or "Cough" or "Blood pressure check". Sometimes it would say, "teeth" or "crack tooth". It was an interesting mix of common inmate health problems.

Either way, I saw inmates in 20 minute intervals and did what nurses do. Which is to assess the patient, determine and execute a course of nursing treatment. All while educating them all about it. I had been a nurse for about five years at that point. I was well schooled in the art of delivering a direct and efficient hit of quality nursing care.

While the job required no grand skills, it afforded me the chance to relax. I only worked every other weekend, nine to five. Plus, I didn't know these inmates. I did not need to hear their whole story, just the bits required to do an excellent job. I was about 7 months pregnant and going to school part time to become a nurse practitioner. My daughter was 3 years old. This easy breezy job was exactly what I needed.

One Sunday morning, after assessing a particularly nasty rash, I was washing my hands and looking over the roster. The next inmate was to be seen for "stitches". This meant he needed stitches removed. I pulled out the sterilized kit. It contained tweezers and a pair of sharp little scissors. I set up the supplies on the exam side table.

Two guards arrived flanking the inmate, resplendent in brown polyester uniforms. He had silver ankle chains attached to a waist chain attached to handcuffs. Standard operating procedure. The inmate was gigantic. About seven feet tall and 300 pounds. Shaq size. He had massive black dreadlocks skimming the waist chain. He carried himself like most the inmates did. A fully formed and upright badass, about the see the nurse.

After the hardware was removed, he sat on the exam table. I thought he was going to break the thing with his massive proportions. I washed my hands again and introduced myself using only my first name. The florescent lighting buzzed overhead. He put his hands on his knees and made poor eye contact. He looked tired. Then I said, "So, where are your stitches?"

In one smooth motion, he turned his palms up. Supination is the technical term. He revealed about fifteen to twenty slash marks up and down each forearm. There was no pattern. It looked like he just hacked away with a very sharp and straight edge blade. Then, I imagine, after he was done with one arm, he transferred the knife to the other hand and began slashing anew. There were about 200 stitches in all. This presented a problem. This was going to take a while. Longer than 20 minutes.

I flipped on the goose neck lamp and got to work. The sutures were clean, the skin was warm to the touch, uniform in color. No drainage or other signs of infection. "Looks good and clean," I said. "Removing the stitches shouldn't hurt that much, it feels like plucking hairs." He nodded, continuing to make poor eye contact. Massive shoulders slightly hunched. I got to work.

I would clip a black stitch with my scissors and pluck it out with the tweezers. Sometimes the skin had grown over the stitch making it more difficult. I would dig, then clip, then pluck. He would twitch or grunt. I would say, "Boy, that was a tough one.", and try to sound encouraging. Mostly though, we said nothing. It was very quiet. The guards were still standing guard, flanking the exam table. I clipped and plucked, clipped and plucked. After about twenty minutes, my back started screaming.

The exam table was lower than my waist. I had a huge pregnant belly. Which meant I was bending at a awkward angle with my big gravida belly hanging forward. I stood up, rubbed my back. "Whew! You're sure making me work here!" I said and smiled. He made eye contact for the first time but didn't change his badass expression. A moment passed. We still had about 100 stitches to go. "Ok, let's get back to it. We're almost done.", I said gently.

Whoever stitched the stitches did a good job. It was fascinating seeing the different layers his skin. He had hacked through a different layers at different angles. His bark brown pigment was just the surface layer. Underneath was gleaming white sheathes of dermis and smooth tendons.

Surprisingly, with all his frenzied hashing, he didn't hit any veins. I could see the vessels pulsing underneath. It was all very fascinating. He took no notice but preferred to stare straight ahead. Eyelids hooded.

After another 50 stitches I told the officers I needed a break. My face was sweaty and my back was down right spasming. There was no room in the exam room for me to sit. I hopped up on the counter next to the sink. After catching my breath I looked right at him. He looked at me, no longer sneering. It was a soft exchange. Then I said, "You weren't messing around were you?"

"No, no I wasn't." He said plainly. For one brief moment there was a window. I saw and felt it. It was right there, standing in front of me like a big red fire truck blaring it's yellow orange sirens. But, I didn't take it. I didn't ask what happened.

"You don't have to tell me what happened. We are almost done here." Then I hopped down and finished the job. All told the job took about an hour. It was the most stitches I had ever removed in one sitting.

13 Left a message at the beep:

Heff said...


But, seriously - I don't understand cutters (I'm assuming he was a cutter, and not in a fight). I mean, if he wanted to kill himself, he could have cut deep enough to do it quite easily. I just don't understand that krap.

Mrs. Hall said...

Yeah, I realize there was a lot of text here. ooft!! I even did some heavy editing. but still.

I promise I couldn't make it smaller.

but, yes, very interesting that with all the cutting he didn't do himself in.

thanks for reading Heff ;)

GeologyJoe said...

i gotta wonder though...if he was trying to kill himself, why not got for the veins?

your crazy hospital-jail stories are great.

Mrs. Hall said...

Ya, I wonder too. But, I'm glad you like 'em Geo-Joe.

I got a million of 'em!

And really, I had almost completely forgot about this one until a few days ago when I saw a Shaq commercial.

That was by far the wierdest trigger for a post thus far ;)

GiGi said...

Okay, that's just crazy - thanks for sharing the story.

Mrs. Hall said...

Welcome to the world of Mrs. Hall, GiGi, it's kind of crazy by default. :)

Susan Higgins said...

I love these stories Mrs. Hall! I don't care how long the post is as long as it's a good read with my morning coffee... this one was a good read.

Mrs. Hall said...

Aw shucks Sue!

Thanks for reading ;)

Candy's daily Dandy said...

You are truly, my new hero...

tireegal68 said...

That was really well written - I felt like I was in the room with you. You handled it really well.
And for the benefit of your commenters, if he was a cutter, he wouldn't have been trying to kill himself, he would have been trying to alleviate the internal pain he was going through - and cutting does that apparently. he probably couldn't have told you what happened. It doesn't make sense to us, but it makes sense to those who do it. It's easy for us to judge the "crazy inmates" but as i am sure you probably know - they are people with histories and pain and suffering just like us.
thanks for sharing that.

Mrs. Hall said...

Candy: aww, now. I did nothing heroic, just pulled out like 200 stitches. ;)

Welcome Tire Gal 68: I suspect a lot of psychic wounds all over those slash marks. I also supspect booze was heavily involved.

At this point I am a fully grown pyschiatric nurse practitioner. I ask for the stories now ;)

Which is what I am going to talk about in future post (next week).

take care and thanks for stopping by!!!

tireegal68 said...

Good to meet you and to learn you went into psych nursing:)

~E said...

Im even more impressed with you now that I was before. I don't think I can work in a jail with huge criminals all the time.

My tender nerves wouldn't be able to take it.

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