Disciplinary Reports

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At least once a year, an inmate gives one of the nurses a hard time and security staff wants nursing to write a disciplinary report. Usually we write information reports and security does the disciplinary report to avoid any conflict. We want a solid answer as to whether or not medical should be involved in disciplinary actions.

Although no NCCHC standard explicitly addresses involvement in disciplinary matters, the principles that underlie standard I-03 Forensic Information also apply here.

Health staff should deal with disrespectful inmates just as they would deal with unruly patients in a community outpatient setting. For example, if a patient yells in a community clinic, staff generally do not call the police, particularly if the patient is confused, upset, mentally unstable, intellectually limited, etc.

In a correctional setting, health staff must respond professionally, stating that such behavior is unacceptable and laying out firm expectations: “I know you are upset, but if you do not calm down I must ask you to leave.” The more that health staff project the neutral yet concerned demeanor expected of a professional, the more that inmates will respond in kind.

Obvious exceptions would be threats or physical contact by an inmate whose behavior is under his or her control and not due to a medical or mental health condition. In such cases, the procedure you describe—health staff write an information report; correctional staff do the disciplinary report—is the appropriate response. But this should be reserved for the most serious situations. In these cases, health staff retain the right to press charges.

For “repeat offenders,” it may be best to meet with the inmate to discuss expectations and consequences. Meeting participants should include correctional staff with decision-making authority, health staff and, if applicable, an inmate corrections counselor and/or a mental health therapist. If an agreement is reached, then all health staff involved and correctional staff assigned to the area must be aware of the expectations so that the plan is followed consistently. For example, an inmate who routinely uses abusive language to health staff “contracts” that should he reply to health staff in that manner, he will immediately apologize and calm down with one reminder by staff, or else will be escorted back to his block and be rescheduled at a future date.

If the facility has an inmate representative body, discussion with the inmate representatives about such problems can be very helpful.
— From CorrectCare Volume 20, Issue 3, Summer 2006