Older prisoners bring health issues to Washington County jail

It's not a job for everybody, but tending to older and sicker inmates has become a grim reality in Stillwater, where jailhouse illnesses now require the attention of seven nurses.

Prisoners bringing mental health issues, drug addiction, diabetes and various other maladies — mirroring baby boomer trends in civilian life — have arrived in increasing numbers at the Washington County jail.

"They've lived a hard life and they're also falling prey to old age," said Jodie Klewwe, the jail's head nurse. "They tend to gravitate into the prison system, into the jail. It really is a reflection, I think, of societal issues."

Many of the 160 or so prisoners won't disclose their illnesses, and others don't know why they're sick, but it's clear to Sheriff Bill Hutton and everyone else at the jail that the trend is worsening and costing more. The county hires nurses accustomed to dealing with traumatic situations and people in custody.

"It's like they've been dropped off at an emergency room," Hutton said. "It's the closest thing a nurse would experience in a high-volume ER setting."

The county recently hired two more nurses because of so many ailments needing attention. Hutton said it's not a question of the county coddling prisoners, but of meeting legal requirements for basic health care and preventing outbreaks of communicable illnesses. In addition to managing physical sicknesses, officers and nurses working in the jail need assessments of mental health to keep everyone safe.

It's not easy to hire nurses to work in jail. The county's Sue Hedland, a health manager who oversees the jail's nursing division, said jobs sometimes can't be filled without aggressive recruitment. In the most recent posting, she said, 22 nurses applied for the two positions.

But the work is not for everyone.

"Finding that individual with the right temperament and the right skills can be very difficult," she said. "This is not part of the curriculum of any nursing schools."

Until two more nurses were added to the staff, Klewwe said, it was a scramble trying to handle daily medical needs, much less build "discharge planning" medical files that follow prisoners to state prisons or — when they're released — to private clinics.

Jail commander Chuck Yetter, who also has worked in the Stillwater and Oak Park Heights prisons, has watched prisoners' health worsen over the years. Professional medical treatment in the jail, he said, has helped alleviate public concern about taking prisoners to clinics and hospitals outside the bars.

Officers are trained in crisis intervention. They also are trained to administer medications once nurses document illnesses and prepare doses. Officers and nurses recently saved an inmate having a heart attack, Klewwe said.

Nurses do initial health screening in the jail's intake area, where street cops take the prisoners after making arrests. That's where "those pointed questions, the red flag," as Klewwe describes it, determine what comes next.

Many prisoners arrive sick, drunk or under the influence of drugs, and nurses have triage procedures by which they sort out problems needing immediate attention.

"If there are difficulties, they're addressed quickly and in a constructive manner," Klewwe said.

Health care is ongoing, too. Nurses work in the jail from 6 a.m. to 10 p.m. on weekdays and from 6 a.m. to 6 p.m. on weekends. A doctor comes to the jail three times a week. Dental clinics are held Wednesday afternoons.

"It's a constant, fluid, busy day," Klewwe said.

"We're not a drive-in clinic," Hutton said.