Pam Fields has more than 16 years of nursing under her belt, many of them in penitentiaries from Oregon to Albuquerque. But even for this seasoned pro, her abbreviated stint at Tucson's state prison was a shocker.
Instead of finding a professional, modern medical unit at the Wilmot Road penitentiary, Fields apparently had stumbled into the Midnight Express.
Her claims: She saw mentally ill inmates locked in isolation. Missing records and lacking medications. A prisoner dangling from a noose as frantic nurses tried to reach him.
"It was dirty, dark and dingy," she says, "and there were several instances where I felt that patient care was not delivered correctly--people not getting medications, no follow-ups." For example, one inmate "was in quite a bit of pain after a surgery. There was obviously something wrong, but he wasn't being allowed to go back to the surgeon."
Another inmate still haunts her, a gaunt 25-year-old man freshly transferred from the Florence prison. "He was a post-chemotherapy patient, being treated for leukemia and very emaciated," Field says. "Two shifts had gone by where he didn't get any medications. He was supposed to get antibiotics and anti-fungal medications, because his immune system was severely compromised, placing him at high risk for infections.
"When I got there, he was scared. He was crying. He said, 'I'm not getting my medication.' So I called the supervisor, and her response was, 'I thought this was taken care of yesterday. You are to go in there and tell that person they are not going to get any meds until Monday.'"
(That supervisor was Kai Jones, the prison's correctional registered nurse supervisor. Jones declined to be interviewed by the Tucson Weekly.)
According to Fields, this treatment was doled out to hardened long-termers and petty crooks alike. "Sometimes, the inmates were just parole violators or whatever. And the fact that they could fall into the hands of some sadistic nurse or officer and not get the care they needed. ... They were going to be out in a year, and maybe not even make it."
Inmates tell similar stories in letters to the Criminal Justice Program, a prisoner-advocacy group run by the Quaker-based American Friends Service Committee. "I hear a lot from prisoners and family members," says program director Caroline Isaacs, "about unsanitary conditions and poor treatment."
One inmate writes of being "told there was nothing wrong with me. ... I had to pee every ... hour. ... The doctors gave me a paper OKing for me to pee in jars. And pills not to make me pee. Within a week, I couldn't hardly walk, from my lower back down to bottom of feet I was so numb I shit my pants four times." Finally, he was taken to St. Mary's Hospital, where he underwent a six-hour spinal operation, and doctors discovered a severe kidney infection.
Another describes injuring his leg in the jailhouse kitchen. "I informed staff of the situation and was told to keep working," he writes, adding that he couldn't see a doctor for six weeks. "The leg has since gotten two holes in it with raw meat exposed, and it is very painful, yet nothing is ever done to heal my leg. ... I have put in at least one request per week since the first one, and I have yet to get antibiotics or anything other than cheap pain medication."
Contacted for comment, DOC spokesman Bart Graves responded with a list of denials. Both medications and medical attention were available in a timely manner, says the spokesman, and the inmate who tried to hang himself was retrieved well within the three-minute time-limit for such rescues. "Nurses responded immediately to the emergency, and were on hand to render the necessary medical care in a matter of minutes."
While medical facilities at the Wilmot Prison are dated, health care there meets accepted standards, says Graves. "We do the best that we can with the resources available to us."
There's no doubt that those resources are anemic. Few politicians ever grew fat championing prisoners' rights, and the state legislature has kept DOC annual budgets hovering around $630 million. Meanwhile, America's prison population has tripled over the past 15 years, a trend many blame on mandatory minimum sentencing. Among get-tough states, Arizona ranks near the top with approximately 30,000 people behind bars. This is a pricey distinction, however; by 2009, the cost of caring for Arizona's bloated prison populations is expected to top $1 billion.
But today's slender budget must pay for everything from walls and guards to nurses and aspirin. The result is obvious, with 75 officers each month leaving the DOC for better-paying jobs. If Tucson's prison lends any clue, the department faces similar hurdles in keeping nurses; currently, the jail suffers a 34 percent shortage of full-time nurses. "With that lack of steady staff," says Fields, "there is absolutely no direction, absolutely no leadership. It creates a very hostile environment."
In that strained and malicious setting, she says, inmates complaining about medical care may have extra punishment added to their worries. Fields recalls one prisoner with a history of seizures who asked for medication. She says Kai Jones responded, saying the "inmate needed to be punished" for supposedly faking his symptoms.
Through Graves, Jones denies the charge. And Graves questions why these allegations are surfacing only now, when Field's two-month stay ended in October. "Ms. Fields did not contact her supervisors at any time to discuss the issues," he says, "up to and including the date she left the institution."
But in fact, the Tucson Weekly has obtained a stack of "information reports" filed by Fields during her brief employment. At least two were submitted directly to Kai Jones. Another, citing Jones' alleged "punishment" remark, was dispatched to a higher-up, and at least one report was submitted to Dr. James Baird, the DOC's medical program manager.
Fields, who left the job willingly, says she never received a single response.
Today, she's just glad her stretch at the Tucson prison is over. But she worries about those still serving their time. "It probably sounds like I'm trying to get back at (prison officials), but I'm not," she says. "The conditions and sense of helplessness among (ill inmates) just really bothered me. They really felt they had no one who was ever going to listen to them."