Nope. Not cost effective at all. Each prisoner will need to be monitored by a doctor who might be able to handle 600 prisoners. Comatose prisoners will require gastric tubes for nutrition and hydration and some prisoners will require nutrition and drugs via IV. IVs must be monitored by qualified RNs every 15 to 30 minutes for the inevitable collapsed veins and subcutaneous infusion due to overuse. All drugs will have to be administered via IV by an RN. Each patient will have a urinary catheter that must be monitored and inevitable unrinary tract infections must be dealt with. This may require prophylactic antibiotics. Inevitable infections will require antibiotics. This will take a staff of 24/7/365 RNs ($40/hr min) and LPNs ($25/hr min) which are much more expensive than prison guards.
The paperwork on a comatose patient often takes even more time than it does to actually care for them—and must be done by the person actually administering the service on the shift the care was administered. It is heavy work so the hourly wage may be even more than that stated above. A full head-to-toe assessment must be made on each prisoner at the beginning and end of every 8-hour shift for status report purposes, then documented and signed off by the nurse manager. Some prisoners may require airway intubation and airway monitoring and care.
A staff of CNAs ($16/hr min.), which are about as expensive as Florida prison guards, will have to turn each prisoner every 2 hours to avoid bedsores. If this isn]t done, systemic infections will occur. Their bowel movements will have to be cared for by the CNAs within minutes of occurrence. All urinary cath bags must be emptied thrice every 8 hours. I/Os. which is the monitoring and documentation of all fluids in and out of the prisoner can be carried out by the CNA, but signed off by the nurse manager. The prisoners must be closely monitored for regurgitation in order to avoid drowning in their own vomit.
There is more, but it’s been too long since I cared for these patients to remember everything involved. It is heavy work. It takes two people to turn a patient safely. Many of these patients will become obese which might require more manpower. Obesity will bring on diabetic, circulatory, renal and coronary complications requiring more care, including dialysis, and more drugs.
If these things are not done, it would constitute cruel and unusual punishment. But if that hasn’t been an issue before this policy of induced coma for prisoners came to fruition, it will certainly become an issue when the body begins to rise as it certainly will.
So, a team of one RN and two LPNs and two CNAs per 8-hour shift might be sufficient.for every ten out of 2,220,300 adult prisoners in America. Triple that for three shifts per 24-hour day. Would you like to include the juvenile population as well? Sure, Herr Himmler, we can do that. But pediatrics require even more manpower and heavier monitoring because they crash so fast.
There will be a nurse manager for every eight teams and above them will be a Director of Nursing. The DON will be laison to both his or her nursing teams and also the staff of MDs. And that is just for the static, stable patients. There will have to be different specialized departments requiring more skilled staff such as Cardiopulmonary, ER, a rather large infections and infectious disease department and quarantine, orthopedics, pharmacy staff, risk management, obstetrics and gynecology, layers of admin staff and bean counters, unit secretaries, etc, etc, just like any huge hospital.
Then you have support staff such as environmental (cleaning and supply staff), quality control, cafeteria personnel for staff, ethics commissions—the whole nine yards right down to HVAC and plant maintenance and control. These people, while working in a healthcare environment are different than in other buildings and institutions—right down to the special type of filters used throughout the plant and the frequency they are changed.
But none of this will be done properly because America does not give a shit about prisoners and therefore there will be a plethora of enormous legal actions against the responsible government body or subcontractor—and you and I will pay.
Therefor, my guess is that it would be much, much more expensive than the lax and cruel system we have now—and that does not include civil rights and ethical violations which would not only be costly, but threaten to destroy the medical professions in the States.