Assessing Nursing Standards for Suicidal Inmates Undergoing Substance Detox

This case study explores the standard of care in correctional nursing for inmates identified as suicide risks and under the influence of illicit substances, using a real-life scenario involving a 21-year-old who suffered severe anoxic brain injury following a suicide attempt while incarcerated.

ByExpert Institute


Published on February 6, 2024

Nurse treating inmate

Case Overview

This case study delves into a situation involving a 21-year-old adult who suffered a severe anoxic brain injury following a suicide attempt while incarcerated. The individual, arrested for the first time due to a dispute with their sibling, was identified as being under the influence of heroin. He also displayed potential suicide risk.

Despite these factors, they were placed in a segregated unit where they attempted suicide by hanging. This led to significant brain damage from oxygen deprivation.

Allegations have been raised that the individual should have been subjected to suicide watch or detox protocols instead of isolation where self-harm could occur. An expert in Correctional Nursing is sought to review the circumstances and discuss the standard of care expected in such correctional settings.

Questions to the expert and their responses


Can you describe your experience with nursing patient care in correctional settings?

I have been involved in nursing patient care within correctional settings since 1996, initially as a Registered Nurse and later progressing into various management roles within the Massachusetts Department of Corrections.


What are the standard protocols when an inmate is identified as both under the influence of an illicit substance and a potential suicide risk?

When an inmate is identified as both under the influence of an illicit substance and a potential suicide risk, there are specific protocols to follow. These include conducting a thorough nursing intake assessment and screening. These assessments play crucial roles in determining housing placement and treatment upon admission.

Best practices for suicidal patients typically involve a one-to-one watch with daily evaluations performed by mental health clinicians who then determine step-down practices for the suicidal risk watch.

For detoxing patients, they should undergo a Clinical Opiate Withdrawal Scale (C.O.W.S) standardized evaluation every four hours until symptom-free or cleared by a physician from acute detox status.


What is your experience with plaintiff and defense cases in correctional nursing?

My professional experience has mainly been split between plaintiff cases (75%) and defense cases (25%).


Have you ever reviewed a similar case? If yes, please elaborate.

Yes, I have reviewed similar cases during my tenure as a correctional nurse and facility/regional manager. Each case presents unique circumstances and challenges, which require a comprehensive understanding of the individual’s health status, risk factors, and the facility’s policies.

About the expert

This expert has amassed over two decades of experience in correctional nursing, beginning her career shortly after earning a BS in Nursing from a reputable college. They have held significant roles such as staff nurse and charge nurse at a major Correctional Center, and later served as the Director of Nursing and Clinical Administrator at a renowned Medical School. Currently, they hold the position of Director of Clinical Services at a prominent correctional healthcare system in Massachusetts, further solidifying their expertise in this field.

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