State health officials are investigating complaints against two of the eight nurses who work at the Spokane County Jail, one of them the medical unit supervisor.
Registered nurse Pamela L. McEntyre and supervisor Margaret Triplett are the subjects of separate investigations by the state nursing board, said Matt Ashworth, a spokesman for the state Department of Health.
Ashworth, citing confidentiality laws, wouldn’t discuss the nature of the complaints.
“There will be a report when and if formal charges are brought,” he said last week.
The investigations are the latest in a string of problems involving the jail nursing staff over the past three years, according to civil service records and jail documents.
County officials have reprimanded Triplett at least three times since 1994, and there is a history of animosity between her and some of her staff, records show.
The jail paid a conflict resolution expert more than $1,600 last summer to counsel members of the nursing staff on how to get along.
McEntyre wrote in a memorandum two years ago that Triplett “has demonstrated a complete lack of awareness of nurse practice issues; has resisted organization of policies and procedures; and resisted following pharmaceutical laws and regulations.”
Triplett later denied all those charges, calling them “libelous.”
Jail nurses are responsible for handing out medications to inmates, treating minor injuries and illnesses, and determining whether prisoners need a doctor’s care, among other things.
Officials and critics worry the ongoing turmoil exposes the county to liability from lawsuits by inmates whose health may be threatened.
It also may lead to higher treatment costs for prisoners whose ailments grow worse while they’re incarcerated, they say.
One prisoner “became acutely ill” in February and was rushed to Sacred Heart Medical Center after an abscessed tooth left untreated by jail nurses led to a infected tonsil, according to jail records. That trip cost upward of $5,000, sources said.
In addition, there is the potential for lawsuits from employees who feel they have been treated unfairly by Triplett, county officials said.
Triplett, who was appointed jail nurse supervisor in 1991, referred questions about her record to the jail commander, Capt. Jim Hill.
“We’re standing behind her as supervisor of the nursing unit,” Hill said Friday.
McEntyre declined to comment on the nature of the nursing board’s investigation into her conduct.
“It’s a minor thing that happened about three years ago,” said McEntyre, who is currently suspended from her job on an unrelated matter.
Information about that suspension wasn’t available, but McEntyre is appealing it today at a hearing before the county’s Civil Service Commission.
She said many of her problems, as well as those of the nursing staff, stem from a “lack of policies and procedures, and a lack of drug controls.
“It’s a real bad situation.”
A consultant who reviewed the jail’s nursing program in 1995 blamed some of the problems on inadequate staffing.
Consultant Bonnie Norman said in her 53-page report that the shortage of staff “is the underlying cause of many of the problems jail nurses are having in meeting acceptable nursing standards of practice.”
Most jails of similar size have a nursing staff of between 12 and 16 employees, according to the report.
Norman said Spokane County jail nurses “voiced their belief that shortages of staff have increased the nurses’ frustrations, caused numerous disagreements, promoted distrust among some nurses and has created a less than positive relationship for some nurses with the nursing supervisor.”
Hill agreed, adding that the growing jail population, which often eclipses 650 inmates per day, is also part of the problem.
But with the current anti-tax sentiment running high, adding staff isn’t likely, he added.
“There are tremendous demands on the nurses,” Hill said. “They’re doing a heck of a job, considering what they face.”
For the past few years, Triplett has faced one controversy after another, according to county records.
In November 1994, Triplett was reprimanded for refusing to obey an order from a jail lieutenant.
In March 1995, she received a written reprimand from Hill for “inappropriate actions as a supervisor.”
Hill said in a memorandum that the disciplinary action stemmed from a meeting Triplett had with McEntyre to discuss conflicts within the medical department.
McEntyre complained that Triplett insulted and intimidated her during the meeting.
“This type of situation exposes the county to high financial liability should the employee affected quit and seek civil remedies,” Hill wrote. Triplett had difficulties with the former jail physician, Thomas Osten.
In a 1995 letter to the Civil Service Commission, Osten wrote that after Triplett was promoted to supervisor “there have been continuous clashes to the point of my being extremely frustrated over who is in charge of the department … and who has medical authority to decide what gets done.”
Osten, who served as the jail’s doctor for 23 years, has since resigned.
Triplett’s problems came to a head in December 1995 when Sheriff John Goldman began actions to demote her from supervisor to line nurse.
The disciplinary proceedings began after Triplett again ignored a direct order from a jail lieutenant by refusing to attend a mandatory meeting, civil service records state.
“The above information and facts indicate a most serious deficiency in your ability to perform the duties and responsibilities as Jail Nurse Supervisor in the Spokane County Jail,” Goldman wrote in a letter to Triplett. “Moreover, such actions, unless explained, undermine the operation of the jail.”
Triplett fought the demotion, saying the complaints against her resulted from miscommunication, a difference in management styles and changes in the role of the jail nurses, who were taking on more responsibilities for inmate care.
“I have a long, unblemished history of competence and positive contribution to my work teams,” she wrote back to Goldman. “I know that my directness and honesty can be disconcerting and challenging at times. The only people who have had real difficulty with my style though, are people who felt threatened by my ability to see things as they really are.”
Goldman was not swayed and demoted her.
Members of the county Civil Service Commission voted unanimously to reinstate Triplett in April 1996, saying Goldman did not prove his case.
The sheriff appealed the decision to Superior Court but dropped the appeal last May. Goldman was out of the office last week and unavailable for comment. Undersheriff Burel Schulz did not return telephone calls.
Hill called Triplett’s past problems with employees and jail administration “water under the bridge” and said he was confident the nursing board investigation would exonerate her.
“The fact that some people have made allegations regarding medical issues doesn’t necessarily mean there’s anything there,” Hill said. “Once the nursing board gets to the bottom of it, I think they will find them unfounded.”