Cancer

When I tell people that I am a prison nurse they seemed suprised. The bad people go to prison and live happily ever after right? It never occurs to most people that inmates get sick and sometimes need very serious and expensive medical attention.

Quite a few inmates at my facility are being treated for cancer. Most go out for their chemo and radiation as a day trip and immediatly return to their wings. After they have a major surgery they might be in the infirmary briefly for recovery, but most will return to their wings quickly. Their dressings will be handled on treatment line, their meds on the pill line, and their follow-ups will be scheduled in the clinic. Most want to get back to their commissary, their school, their jobs, and their boo as fast as possible.

When things get bad though, they come to live in the infirmary. All of a sudden a three year stretch can become a life sentence. Clemency is a lengthy process and rarely granted. I have two terminal cancer patients living in the infirmary at present. One gets out in May, one is down for murder.

For most of the late fall I honestly didn't think that my colon cancer/out in May patient was going to make it to her release. She rarely left the bed, she seemed to be going fast. Then mental health started her on Wellbutrin. After a few weeks on the Wellbutrin, May didn't seem that far away anymore. She was getting up and walking to get her tray, return her tray, get hot water, and get ice. These minor activities were a major turn-around. She has also regained her appetite. She always has a drink going and ice in her pitcher. Now May really seems in reach and I think she is going to make it out.

My breast and ovarian CA/lifer patient is newer to the infirmary. She has been sick for awhile. At an earlier stage when she was still in population she was in the infirmary after her mastectomy. She was actually my very first patient as a professional nurse. She was an LPN herself on the outside, so that was a bit intimidating.

I am still trying to get a feel for how things are going to go with her. I asked her recently if she was trying for clemency, she told me no. I usually initiate a dialogue about end-of-life issues starting with clemency and working toward advanced directives. So far she is very closed.

My cancer patients with shorter sentences have been more open. One I recently saw released back to her family just in time used to asked me "nurse, how do you know when you are dying?" "You stop eating and drinking," I told her. "So eat your breakfast and go get some ice," I followed. My out-in-May patient and I have talked very openly about advanced directives, what she wants and doesn't want if something happens. I have her all ready to sign a DNR if things start to look worse.