An inmate with schizophrenia does not respond when the guard tells him to ask the desk officer for a mop and bucket, then get water from the shower area and mop the center aisle. The guard becomes angry and cancels the inmate's recreation break

Question

Which response by the corrections nurse would be most appropriate? a. Document the patient's response as indicating that he is resistant and would benefit from a behavior modification plan.
b. Suggest to the jail psychiatrist that when he next does rounds, he reevaluate the patient's medications and talk to the inmate about cooperating.
c. Explain to the guard that schizophrenia makes it hard to follow multistep instructions, and suggest assigning one action at a time.
d. Do not intervene, because it would be inappropriate for a corrections nurse to serve as a patient advocate.

Answer 1

C
Although many forensic nursing roles require that the nurse remain neutral or act in a capacity other than a patient advocate, correctional nurses, like most direct-care nurses outside of corrections, do have a professional responsibility to advocate for inmates regarding needed care. A psychiatric nurse would have an understanding of schizophrenia and would recognize that the patient's ability to process multistep instructions was impaired, leading her to advocate for the inmate by educating the guard so he would not misperceive the reason the inmate did not respond. Documentation is needed for all nursing activities, but as stated here, it does not involve advocacy and suggests that the nurse does not understand how schizophrenia affects volitional activity. Involving the psychiatrist might be of some value but is at best a passive form of advocacy, and again, as worded here, suggests that the nurse does not understand how schizophrenia contributed to the inmate's not responding to complex instructions.