THUGville

Liar, liar ... 

  One of the most difficult parts of my job as a correctional nurse is to look beyond the words and try to determine the truth.  It is a daily challenge as most inmates feel that if they tell the truth about their actions it will be held against them.  They mistakenly believe that if they acknowledge to me, their facility nurse, what drugs they have been doing then it will be as good as a confession.  In actuality, my part in their detention stay has little to do with their charges and I never 'turn them in' or reveal their answers.  However, there is always an officer in the room when I do my interview / assessment on the medical intake, which is where I obtain their medical history and attempt to discern what medical / psychological needs they might need attended to while incarcerated.  Once someone is charged with a crime and are under arrest and in jail, their comments while here are pretty much ignored.  What they fail to realize is that when those drugs or that alcohol that they denied taking / drinking start fading out of their system and the withdrawals start hitting, that's when they suddenly realize they need to be up front to me so that I can assist them through the worst of the delirium tremors and symptoms that will make them extremely uncomfortable for several days.  In some cases, it is a medical emergency if withdrawal is not treated / combated.  
  Then there are those that will say that they take More than they probably do simply because they have learned that I will start 'detox meds' which means that they will get some kind of drug to take, doesn't matter what it is, they have to be taking a pill to be satisfied.  Which leads me to the ones who have chronic complaints in hopes that I will continue giving them something that they can take just to be taking something.  These drug-seekers are sometimes hard to determine, but my answer is easy once I realize their complaints are continuous.  No more meds!  I only give the benefit of doubt for so long, through so many sick call complaints.  
  Bragging to other inmates is commonly heard.  Whether there is any truth to their stories is questionable.  They obviously feel they have to sound bigger and badder than the next guy to stay in the 'safe zone' while in the pods with other inmates.  
  Many learn the system, and learn how much power the facility nurse holds over their perceived level of comfort while incarcerated.  Therefore, I often hear sob stories about how bad a shape their back / knee / shoulder / etc... is in and how "terrible" it hurts.  I have the power to order them to be housed on the bottom bunk or bottom floor even.  Yes, many have had rough lives and most likely do have these ailments, but if I restricted top bunk because of complaints of chronic pain, well, we might as well get rid of the top bunks altogether.  It just can't happen.  There are only so many bottom bunks.  But many will still give it their best shot and tell me that they "have to" have whatever it is that they demand.  My best advice to these, stay out of jail.  
  Another common lie that I hear is the claims to having a history of seizures.  This one is more difficult for me, because often this cannot be verified by doctor reports and yet may or may not be true.  I have had some that answer "yes" and give elaborate stories, then on their next incarceration during intake they forget what they told me before and answer "no" even after I question repeatedly to see if they will change their answer.  If they do have a history of seizures, I then determine if the past seizures are in correlation to drug or alcohol withdrawal, or even head trauma.  This is another area they will lie in.  They want their past seizure to be from something other than a self-inflicted condition.  
  Some of the elaborate, well-thought out stories have blown my mind.  I had one woman who claimed to have colon cancer.  She was in her 40's, pale, and knew all the lingo that had me convinced that she was telling the truth.  Her story went bust however when I had her sign a "ROI" - Release Of Information form that I faxed to the clinic, Johns Hopkins no less, and got nada returned to me.  The note on the fax sheet that came in "patient unknown, not a client here, no history" which prompted me to call and make sure that there was no miscommunication.  Sure enough, after about 10 phone calls to all the places that she had claimed to be 'treated' either no one had ever seen her, or it had been years since and it was certainly not for cancer of any kind.  
  Another common lie told to me, because I can also control their 'special tray' diets; allergies.  This is also one that is not always the same answer on every intake.  I never lead them into an answer.  If I know that they said they had a fish allergy on prior incarcerations, and if they don't mention it when specifically questioned multiple times (I will keep coming back to the question) as whether or not they have food allergies, then I consider the previous admission of allergy a lie.  This also is another one that I have difficulty with determining truth, as few have actually had allergy testing or doctor proof.  Most just do not like fish, or consider nausea / vomiting an 'allergy' which is actually an intolerance instead.  I have learned that one of the best ways to get the truth of this is to ask the symptoms, then act like "yeah, right" towards their statements.  For some reason if they interpret that I do not believe it, they will start stumbling over explanations and often out themselves by not just saying yes and shutting up.  But, this is a tough area for me as real allergies can be life threatening; therefore, I have to order the special tray most times, for protection of the inmate and the jail and myself if it is true. 
  And so I spend my days trying to determine truths.  Sometimes easy, sometimes frustrating, sometimes fail.  But eventually the truth comes to light in most cases.  Most of the lies in here are predicable for cause / effect reasons.  My course of action normally will be the one that keeps them safe, beyond that ... eh.  Liars have become an epidemic, on the inside, and the outside...