Fayette County jail inmates provided high-quality health care

Marc Gomez is director of nursing for Corizon Health at the Fayette County Detention Center.
Marc Gomez is director of nursing for Corizon Health at the Fayette County Detention Center.

As director of nursing for Corizon Health, overseeing the care of more than 1,100 inmates at the Lexington-Fayette County Detention Center, my job is not a simple one.

And I think it's important that county taxpayers have a clear understanding of the reality behind the headlines — both the challenges and the successes of the health care we provide.

Although shows like Lockup have helped shine a light on some elements of life behind bars, many people don't understand the basics of how prisons and jails operate — much less the realities of providing quality health care in a correctional setting. As you'd expect, it presents unique challenges, not only for the correctional officers, but also for the medical staff.

To start, prisoners on the whole tend to be less healthy. Research shows they suffer from higher rates of mental illness and substance-abuse issues. Many have not received proper medical care in years, and a disproportionately high percentage suffer from chronic conditions like heart disease and diabetes.

What's more, the stress of incarceration itself takes a significant toll on inmates' health.

We also deal with logistical issues that don't exist in normal health-care settings. We can't just call an ambulance or send inmates to an emergency room; they must be escorted and accompanied by correctional officers at all times.

We operate in facilities that were built for security, not the provision of health care. And, sadly, every patient interaction presents a degree of personal risk for our medical staff.

Despite these challenges, the nurses and doctors in Lexington work hard every day to provide quality care that improves the health of inmates and contributes to community safety after inmates leave. For example, by treating underlying mental health issues that may have prevented an inmate from being successful in maintaining a job in the outside world.

We are fortunate to have an outstanding partner in Rodney Ballard, director of the Division of Community Corrections, who encourages everyone at the jail to prioritize patient safety and health.

What most people don't hear about enough are the many successes in medical care at the jail — the countless times that a quick-acting nurse or physician makes a real difference.

A great example took place just a few months ago. One of our patients with no previous medical history collapsed on a basketball court. In less than three minutes, our staff arrived and started life support.

For more than 20 minutes, they worked with diligence and professionalism and by the time EMS arrived, the patient's heart was beating and he was breathing on his own. He was rushed to a local hospital, where the physician who treated him reported he would have likely died if he had collapsed outside of jail.

Just like every other health-care provider, we can't guarantee that every outcome is positive. But overall, our health outcomes are equal to or better than those in the community.

Take diabetes, a disease characterized by frequent hospital readmissions. Research indicates that diabetes patients not in jail have a hospital readmission rate of 20.3 percent; the admission rate for diabetics in our facility is a fraction of that number.

Unlike most diabetics, the diabetics in our facility are assessed, educated and treated by nurses on a daily basis. They are seen by a physician or nurse practitioner regularly to make sure they are being managed properly.

We can manage their diet, observe for potential complications and refer them to outside specialists if necessary. And we use this type of proactive disease management with other chronic diseases, too.

This work isn't simple, but it's work we strive to do well on behalf of our patients and our community.