Jackson West Medical Center Forensic Staff Orientation

Welcome to Jackson Health System. This information is being provided to familiarize you with our hospital procedures in order to assure quality patient care. With this information, we are confident that the patient’s therapeutic goals can be met while maintaining safety for the public. Administrative restraints must be used at all times by forensic staff. At no time will forensic staff leave inmates unattended. Forensic staff must be awake and alert at all times and maintain the inmate in their field of view either directly or by window. If at any time you have questions, please direct them to the Charge Nurse or Nurse Leader of the unit where the patient’s care is being administered. A designated hospital administrator will be available for all shifts. The Charge Nurse, hospital unit secretary, or staff can assist you in contacting the appropriate individual.

Numbers are site specific and not to be used for other locations
Internal (66-6111) External (786-466-1111)

You may reach the campus security at any time by calling the appropriate facility extension listed above. JHS campus security personnel will assist you whenever possible. However, they are not authorized to take custody or responsibility of the inmate at any time. This includes times when you may need to take a short personal break. However should you need additional assistance with securing the inmate, security personnel will respond without hesitation. Campus security officers are under shift supervision at all times. The shift supervisor can be reached by calling the above number. In the event that the shift supervisor cannot satisfactorily resolve your problem, the Operations Manager or Director of Security can be paged.

Numbers are site specific and not to be used for other locations
Internal (66-1397) External (786-466-1397)

In the event of a Cardiac Arrest, a “CODE BLUE” will be called. You can initiate a call for a medical emergency by dialing one of the extensions listed above based on your current facility location. Medical and security personnel will respond to the location to attend to the patient and assist with crowd control. If it is your inmate that is in cardiac arrest, please step away (but stay within sight of the inmate) so that healthcare providers can work freely in stabilizing the patient. Be prepared to remove shackles during this emergency if requested by the physician. Re-secure the shackles immediately after medical staff has completed their stabilizing efforts.

Numbers are site specific and not to be used for other locations
Internal (66-1397) External (786-466-1397)

During a Fire Drill, or if a fire should break out in the hospital, you will hear a fire alarm sounding throughout the building. It is not our policy to evacuate the entire building, but only those areas necessary to move occupants to safety, i.e. beyond the nearest smoke barrier. Unless the fire is in your room, close the patient’s door and remain in the room. If the fire is inside the patient’s room, remove the patient to safety and pull the nearest fire alarm or call the appropriate facility extension listed above. In the event the fire is located elsewhere on the floor where you are located, the nursing staff will give you specific instructions. It is your responsibility to remain with the patient at all times during this process. The nursing staff will announce an “All Clear” when it is safe to resume normal activity. Hospital staff are trained using the “RACE” concept. (R)escue those in immediate danger; (A)lert others by pulling the alarm; (C)onfine the fire by closing doors and windows; and (E)xtinguishing those blazes where possible.

Pursuant to life safety code requirements, posted officers (Police or Corrections) must, at all times, maintain a clear path of travel to allow the safe exiting of patients, visitors, and staff. Posted officers may only be positioned on one side of a hallway, aisle, or corridor.

• All Forensic Officers entering the procedural and operating room areas will adhere to JHS Perioperative Services Policy 130 – Surgical Attire Policy and JHS Policy No. 400.124 – Operating Room Visitor/Observer Policy.
• Before entering the restricted area of the operating room, the Forensic Officer(s) accompanying the inmate patient will don proper attire that covers uniform which includes but is not limited to hospital provided jump suit, head cover, mask and gloves as indicated.
  • Weapons worn by the Forensic Officer(s) will remain with them at all times.
  • Personal Bags brought by Forensic Officer(s) should not be taken into the procedural/operating room areas.
    • Check in with the Operating Room Front Desk or Charge Nurse prior to entering the procedural areas.
    • Bags may be left in a designated storage location or covered by plastic bag provided by nursing leadership.
  • No food or drinks are allowed in the procedural and operating room areas.
• Forensic Officer(s) will remain within direct visual observation of the inmate patient during the preoperative, intra-operative, and postoperative phases of an inmate patient’s care.
• The Forensic Officer(s) will accompany the inmate patient into the operating room. The Forensic Officer(s) will remain in the operating room with the inmate patient until the patient has been sedated or fully anesthetized.
  • The circulating nurse will show the officer where to sit or stand in the operating room during the anesthesia phase of care.
  • At the direction of the anesthesia provider or circulating nurse the Forensic Officer will be asked to remove the shackles from the inmate patient after the patient has been deemed safe and fully anesthetized.
    • At no time will shackles be removed by anyone other than Forensic Officer(s).
    • The Forensic Officer will call their Supervisor and communicate that shackles are being removed.
  • In the event the inmate patient is not under general anesthesia, the Forensic Officer(s) can apply non-metallic flex cuffs in place of metal shackles.
    • The Forensic Officer and the Anesthesia Provider confer and use their discretion whether or not the Forensic Officer(s) will need to remain in the operating room during the surgical procedure.
• The circulating nurse will provide a chair and show the Forensic Officer where they will wait during surgery.
  • The Forensic Officer(s) will have direct visualization of the inmate patient at all times.
  • Forensic Officer(s) can remain in the sub-sterile scrub sink areas, or directly outside the operating rooms.
• At the completion of the surgery the circulating nurse will request the Forensic Officer to return to the operating room to replace shackles back on the inmate patient prior to emergence from anesthesia for safety.
• The Forensic Officer(s) will accompany the patient to the Postoperative Care Units during their recovery and will remain with the inmate patient at all times.
  • Once the patient has met discharge criteria, the Forensic Officer will accompany the inmate patient to their final destination.

You should take no action during a disaster drill unless you receive specific instruction from the nursing staff on your unit. If a community-wide disaster has occurred, you may be asked to vacate an area should that unit be mobilized to care for incoming disaster victims.

In the event of a bomb threat, hospital staff will begin an immediate search of the areas involved for any suspect packages. Security and hospital administration in conjunction with the local police authority will evaluate the threat and information available. Should it be necessary to evacuate the inmate, the nursing staff will notify you. Should you have any apprehensions, you may request the assistance of security in evacuating the patient/inmate to another secure location.

In the event of an incident requiring security presence, JHS security will be called. No action will be required of you unless the security incident is occurring in your area. Should security personnel feel that the incident poses a threat to you or your inmate, you will be notified immediately and security officers will be dispatched to advise and assist you.

The incarcerated patient will be treated with respect like any other patient at our facility. The exceptions are that inmates are not allowed to interact with other visitors, patients, and inpatients and are restricted to their room except when being transported to other areas of the facility for testing and/or procedures that cannot be administered in the room. Transportation within the hospital facility will be via wheelchair or stretcher by transportation services. The forensic officer must accompany the inmate at all times and keep the patient under administrative restraint. For increased security measures and to reduce the interaction with other patients and visitors, inmates will be given priority. Access to exam rooms, tests, and other procedures will be expedited whenever possible. Hospital staff will communicate the dates, times, and locations of all tests and future appointments only with the forensic officer. This information will not be revealed to the inmate.

Forensic patients are considered to be under administrative, rather than clinical, seclusion and restraint. Administrative restraint methods that may be deemed necessary by forensic staff do not fall under the same guidelines as clinical physical restraints. A licensed healthcare provider with demonstrated competency in the use of restraints must authorize the use of clinical restraints, and obtain a time-limited order from a licensed independent practitioner.

The inmate/patient will be transferred back to the facility from which he/she was incarcerated in the care of forensic staff. Written discharge instructions will be provided to the escorting forensic officer to ensure continuum of care and will include written instructions for follow-up care.

In the even that, while the inmate/patient is being treated, the forensic staff officer is relieved by other forensic staff personnel, nursing staff (Nurse Leader or designee) must be notified so that orientation of newly arriving forensic staff can be conducted.