Shank you very much

Wikipedia defines a shank in several ways, including a poor golf shot or a cut of meat, but in prison, a shank is a makeshift knife fashioned by prisoners. Because of these shenanigans, all of an offender's property is meticulously catalogued by the property department. All medical supplies like wrist braces or hearing aids must be inspected and then engraved with the prisoner's ID number. Shanks and other contraband are taken very seriously, and due to the past month's events including the discovery of a shank, we were placed on a full lockdown today.

For me this meant, that all of my patients were cancelled, which caused me to squeal in delight. (Yesterday a nurse saw my schedule and basically told me to brace myself.) Instead, I got to catch up on some chart reviews and chase down missing consults. I did see two emergency visits...one vomiting teenager and one woman who had, as they say in Spanish, fallen pregnant. Oops. Apparently she became incarcerated during the fall and had a few negative pregnancy tests at a county jail, reportedly. Then she was transferred to our prison and had not been seen in the medical clinic since she arrived. Her growing abdomen roused her own suspicion, but denial is an extremely powerful force, as I learned in residency with another pregnant patient. It's been a while since I've gotten to do prenatal care so I enjoyed trying to remember what to do with a 31 week pregnant lady. Basically, she will be transferred out of our facility as swiftly as possible and will deliver at a Denver Hospital. On the bright side, at least she did not become pregnant while in prison. I've heard that has happened and that is, well, frowned upon.

While I was seeing my two patients today, the inmates underwent strip searches looking for other contraband. The entire facility is being searched from top to bottom. I hear the lockdown may last for sometime. Emergency medical visits only.

Our Warden stopped by the medical staff meeting today. She is a dynamic, no-nonsense woman who spoke about the "evolution of the prisoners" and how prisoners are becoming more brazen. She reminded us that the offenders are not our equals and that we must not become complacent. It is a good reminder to stay vigilant, which is probably the biggest difference in working in prison compared to the outside.

The most humorous exchange of the day was between me and a new agency nurse, who is studying to become an RN. I asked her if she had given the tylenol and the phenergan to the vomiting teenager yet. She had not, so I said, "you can probably just give those tonight, prn." She looked bewildered and replied, "I don't think I can given a suppository through the cell window." Apparently, she thought I had meant "PR," which is per rectum, instead of PRN, which means as needed. It reminded me of some medical jargon misunderstandings of my own when I started my clinical rotations in med school, which I know caused a few chuckles and smirks on rounds.