118: From Secure Walls To Open Halls: A Corrections Officer’s Guide To Safe Hospital Escorts

We walk through the hard truths of hospital escorts: layers of security vanish, complacency creeps in, and small mistakes become big risks. From intel control to room setup, we share a field-tested checklist to keep officers, medical staff, and the public safe.

• controlling timelines and blocking leaks
• gathering inmate intel and risk factors
• conducting full inmate and vehicle searches
• using maximum restraints and wheelchairs
• hospital reconnaissance and secure entry points
• room layout, line of sight, and door control
• protecting medical staff during care
• anti-fatigue tactics and accountability
• professionalism in public and clear communication
• training needs and administrative support

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Chapters

• 0:00 Welcome & Sponsor Shoutout
• 2:16 Why Hospital Escorts Demand Vigilance
• 4:29 Layers Of Security Disappear Outside
• 6:14 Real-World Attacks And Escapes
• 8:59 Control The Timeline And Intel
• 11:44 Pre-Trip Intel And Thorough Searches
• 14:34 Maximize Restraints And Use Wheelchairs
• 17:04 Recon The Hospital And Secure Entry
• 18:54 Room Setup And Line Of Sight
• 20:49 Hospital Staff Are Not Security
• 22:34 Stand Up, Stay Awake, Stay Ready
• 24:54 Professionalism In Public & Final Takeaways
• 34:47 Close & Subscribe Reminder

Transcript

SPEAKER_01: 0:34

Welcome there. My name is Michael Peter Pray, the Personal Officer Podcast. If you have not been here before, I welcome you. If you have been here before, I'd appreciate it if you'd take time to go ahead and subscribe or push the like button so that uh we can keep this podcast going. Um before we get too far into this, I'd like to take a moment and thank Pepperball. Pepperball has been the sponsor and is the sponsor of the Prison Officer Podcast. I really appreciate that. It allows me to do a lot more than what I would be able to do on my own. Um if you get the chance, visit www.pepperball.com. Check out many of the new products. If you haven't seen LiveMax yet, LiveMax is uh it's one of the newest products. Uh it's the Pava Powder. Um they call it LiveMax because it's it is the Max. Uh it offers greater distance and accuracy when you put it in a VXR uh shape projectiles, but it is effective. If you're having trouble getting somebody OSL or getting compliance, a LiveMax is definitely an option. So go check them out www.peppleball.com. So today, you know, I thought a lot about whether or not I would even talk about this, um, but I've been working on a couple of articles kind of in the same direction that you'll see on Corrections 1 pretty soon. Um had the opportunity, I won't say the opportunity, I was visiting someone in the hospital a couple of months ago and came upon some correctional officers who were sitting on an inmate. And that's something I did for years. I worked at the Federal Medical Center in Springfield, Missouri. So uh hospital watch or hospital transports were something we did uh every day. Uh it was uh something that was a large part of the job that I did. And so I just took a moment, you know, kind of walked slowly so that I can see what was going on. And one of the things I noticed was that one of the officers appeared to be uh napping. And this is it was middle of the day, uh, so it wasn't like it was uh, you know, off in deep in the shift. I'm not saying he wasn't tired, very well could have been. Um I know what it's like to work 16, I've even worked 24 and more hours. And uh I know what fatigue can do, I know what it's like, but I guess I want to talk kind of a reminder of how important when you're on hospital watch, how important situational awareness is. You, you know, when we're inside a jail, when we're inside a prison, it's built so that we have layers and layers and layers of security. So that if an inmate gets past a door, he's still got to get past another door and two more fences before he can get to the outside. Um if an inmate um you know manages to manipulate something or get to that fence, we have armed patrols outside, we have fence alarms, we have all these layers of security that help us keep these inmates inside, our jail, prison, wherever you want. And I think sometimes, and I know I've seen it in my career, where people get complacent on these hospital trips because they think they have control. Once you go outside your prison, your jail, those multiple layers of security are gone. And it's it's up to you to step up the security, to step up the situational awareness during those times. It's up to you to bring your best game because there's so much that can happen. You know, we don't see it a lot, but over the years we've had outside assaults. We had one recently, a couple of years ago, in Idaho. Uh the inmate had made contact with a former inmate, a fellow gang member, and he attacked the officers, shot two of them, and uh helped the inmate escape, which actually led to two more murders. You know, so it's possible. Many years just before I started, uh, there were some U.S. Marshals who were attacked. I think one of those was killed, and that was during a hospital escort. So these things do happen. But once you get outside that gate, that grill, that Sally port, stop and think about how little redundancy you have in your security measures. I know it feels like, you know, you've got them in, you've got them in leg irons, you got them in a black box, you got them with a belly chain, you got them in handcuffs, so you got multiple layers of restraints, right? Um, but once you put them in the van, then you shut the door. Now there's another layer. But this little contained area of security is a false security. Okay? It doesn't take anything for an inmate who's not being watched. Okay? Restraints are only as good as the person who's watching them, who's controlling them, who's putting them on, who's checking them. Um it is not hard to defeat restraints. If you've worked in jail, if you've worked in prison, if you're if you're a police officer, you know how easy it is to defeat restraints. Um it's something inmates practice. It's something, it's knowledge they pass on. So the restraints are there, but if you're both sitting in the front, or if you know two of you are escorting and you're both sitting in the front looking out the windshield, it's somebody watching the inmate. It's somebody watching those restraints. It's pretty easy for them to get loose. And once they're free of those restraints, you have one level of security left, and that's either the lock on the door or nothing. Right? If they get out that door, you have an escape. If they can get to you when you stop, you have an assault. If they have outside help, it's even worse. Right? So so much goes into this. Understand that you don't have those layers. So you have to be uh extra aware. You have to take more time, you have to do your searches more carefully. So let's walk through just a little bit of of some of the things we need to think about when doing hospital escorts.

SPEAKER_00: 7:15

And I'm gonna I'm gonna start way back. What what's taking the inmate to the hospital? Is this an appointment?

SPEAKER_01: 7:26

Is this something that um a nurse or a doctor inside the prison has talked to them about? Now they're gonna go out for an x-ray or a CAT scan or whatever it could be. Inmates have this knowledge now, right? They know they're going outside. They know that they're gonna have the opportunity to be outside those layers of security. But it's so important that we understand and that our medical staff understand you cannot compromise that timeline. Nobody should know when that's gonna happen. When you go to pick up the inmate that morning or that afternoon, whatever it is to take him to, that should be an absolute surprise for them.

SPEAKER_00: 8:11

And if it's not, we've got a problem. So that's the first step. Making sure that the information's not getting leaked.

SPEAKER_01: 8:21

And today it's even more important. How many cell phones are in your prison? How many did you find this year in your jail? A bunch, I bet. Because it it's a rampant problem throughout all of our institutions is these cell phones coming in. Well, now if they know when they're going downtown, right? Because somebody said, Oh yeah, you got an appointment next Tuesday to go to CAT scan. Right? If they know when they're going downtown, now they can make contact, now they can set up an outside assault, now they can have escape paraphernalia planted in a certain place, they can they can do all kinds of stuff with that information. So a couple of things we need to do. One, and one of the one of the problems we had for years was before you have, let's say, a CAT scan, and they're gonna run dye through your veins so that they can see what's going on. Well, one of the things they're gonna do is probably make you nothing per aura in PO. That's what the medical field calls it. They call it nothing per oral, which means you're not gonna eat or drink anything after midnight. And if you've been to the doctor and you've had tests, you know all about this. But if I lock the inmates in at night, and I go to this one inmate and go, hey, I think, you know, don't eat or drink anything, what did I just tell him? He knows he's got a CAT scan coming up sometime. And now I've just told him it's coming up in the next probably 12 hours. So the moment we know that we're gonna take him out, a couple of things should happen. One, if he's not secured, he should be secured. If he's in a dorm, he needs to be locked up so that he can't talk to others so that he can't communicate. His mail needs to be limited, stopped, held for a day. And phones need to be turned off. Inside phones, so that he can't make a call to his mother and say, hey, come down and see me at St. Agnes Hospital, right? I'm gonna be there between 12 and 1. If you're in the hallway, you'll probably get to see me. Has that happened? It absolutely has happened. I've had it happen to me. So that's where we start, right? We we control the information. Number two, we need more information. If you're gonna take somebody, and whether it's a court trip or a hospital trip, whatever it is, if you're gonna take them outside the fence, outside the wall, you need to know everything about that inmate. You need to have gone through his record, you need to take a look at his security status, you need to look at recent incidents and figure out who this is, best that you can tell. That's gonna help you when it comes time to make decisions, to understand his motivations, to be aware of possibly things that could happen while you're out there. So the second part of it is to get information for yourself.

SPEAKER_00: 11:24

So what's on the third? Let's talk about the third. Third. Searches.

SPEAKER_01: 11:33

And people drop this a lot. Well, we're going out. They're not bringing anything into the jail, they're not bringing anything into the prison. But what are they taking out? Okay. So we need thorough searches, and it starts with the inmate. That inmate needs to have a visual search of all of his clothing needs to be taken from him, shoes and everything. You should have, and if you don't, it's something to talk to the administration about, you should have transport clothing that you know what's, you know, what's in it, what's what's been altered about it. The inmates never had access to it. So we need that transport clothing. He should be changed into that transport clothing, including shoes. And you can buy those cheap shower shoes, you can buy whatever. If it's winter, make sure they got stocks on. I mean, uh common sense, right? But we want to make sure that they don't have any of their own clothing. We also want to make sure that we've done a good visual check. And a good visual check involves a flashlight and it involves checking everywhere. Okay. So after I've done that, now I want to search this vehicle, this mobile little prison, this mobile little jail that I'm going to put this inmate in to transport him from my jail or my prison to the hospital. I need to go through that fan from one end to the other or car, whatever it is. One end to the other. A couple of reasons. One, if he knew that he's going, another inmate, and I know your inmates never touch this stuff, except when they go to the uh garage or when they go out in the public and they get their oil changed. Not everybody has access to a controlled environment only done by staff. Could be something planted there, could be something left there. And police officers know this well. When you put somebody in the back of a car and they've got something they don't want you to find or don't want you to know about, they're going to ditch it in that car. And that may not have been a plan to give it to the next person, but that doesn't mean it's not in the vehicle when he gets in. Okay? So searches. We're going to search the inmate, we're going to search the vehicle.

SPEAKER_00: 13:54

The next layer that we're going to work on is restraints. Restraints are dictated by your policy.

SPEAKER_01: 14:03

I can't tell you exactly what you need. It's dictated by your policy, it's dictated by uh custody levels. So you're going to have to read your policies. But the maximum restraints that you're allowed should be the minimum restraints that you use. How's that? If they allow you to look use leg irons, if they allow you to use belly chains, black boxes, anything that I can put on this inmate that controls him, and I know we get these, uh I've been there before. Oh, he's a he's an out custody inmate. He can be transported without any restraints. No. No. That's a layer of control that I'm losing. If I'm allowed to put a set of handcuffs on him, then I'm going to put a set of handcuffs on him. If I'm allowed to put the full range of restraints, that's what he's going to use and wear outside the hospital. Another thing I want to think about with restraints, once we restrain them, once we put them in good restraints, it's harder for them to walk, right? And I need some way to move this inmate, whether it's an emergency or whether it's just for his and my own comfort. So I almost always, if I can, travel with a wheelchair in the car or the van. If not, then I want to know where at the hospital I can get one. Because that's what I want to do first. A couple of things. One, I want to sit him down in the wheelchair so that I can move him, I can control where he goes. It also gives me an extra second of reaction time in case he decides to do something. And the other thing is, I'm probably going to cover his lap with a coat or with a blanket, with a sheet, whatever, and make those restraints not quite so visible. People know, the public knows that inmates go to the hospital. They see them. They see them out there, they see them moving through the hallways and stuff, so they know that they're there. But the public often has an emotional response to seeing someone change, to seeing restraints on them. As a correctional officer, it doesn't phase me to see that. I'm used to it. I've spent 30 years looking at people in restraints. But for someone who doesn't normally see that, it can bring about an emotional response. And I don't want to have to deal with the public when I'm when I'm doing this. I don't want them drawing my attention away from the situation at hand. So get a wheelchair. Now the other thing is when I go to the hospital, the first time you go to a hospital, unless it's just an emergency or something's out of the ordinary, this should not be the first time you've been to the hospital. If you regularly take inmates to a hospital, to a certain hospital or to certain ones you want to go visit. Should be on official time. I'm not telling you to go do it on your own. The boss should want you to be aware. And you should do an advanced reconnaissance of that hospital. You should know where the exits are, you should know where the main entrances are. Somebody should, it doesn't have to be you. Somebody in charge should have talked to the hospital about where they want inmates brought in through. You know, coming in through the front door and sitting in the emergency room with 30 other people is not the best thing to do when you're transporting someone. Especially this person's coming off drugs, got mental health issues, anything like that, right? If they're violent, I don't want to be in the middle of a in a in the middle of an emergency room dealing with that. And most hospitals understand that. They don't want that for their other uh customers or patients. So there's probably an entrance that's less used, and that's where uh we're gonna bring the inmate in. One of the things that makes hospital trips a little more dangerous is that we don't control access to people. We don't control uh we're replaced completely. We don't we don't control uh you know staff moving around. So they're gonna place us somewhere. Hopefully it's been worked out ahead of time, and they're gonna place us somewhere where we can close the door, pull a curtain, do something, not be seen as much. And this is the most dangerous part. Okay. And it's not the most dangerous part because violence is most likely to happen, but I've seen it over and over, and I've seen it myself. We get rolled into a room, we get the inmate to bed, we get in restrained, and now what does everybody do? They're comfortable. I control this area. This is my little jail, right? I control this area. You are sitting in the middle of a hospital that you don't contrain. This is not a safe spot. This is not a, what do they call it today, a safe space? This is not a safe space. This is a place that you cannot be seen, yet you cannot see anything approaching. So your situational awareness shouldn't come down at all. Matter of fact, it shouldn't be heightened. Once you've got that inmate restrained to the bed, always restrained to the bed. Um maybe I should go through that a little bit. But once you've got that inmate restrained to the bed, it's time to figure out how you're going to keep this room secure or this area secure. So a couple of things. When you walk into a waiting area, when you walk into a hospital room, if you will look around, it is set up for the comfort of the people visiting the patient. And it is always set up so that the people coming to visit the patient are looking towards the patient. And that's a great thing. One of you should be doing that. One of you should move a chair. And that chair should be facing the door, the entrance, the exit, and it should be between the inmate and the door. If it's the armed person, that's where I would want the armed person. Uh if there's if they're both armed, that deals with your policies and and how that's dictated. But you need to don't fall into the complacency of using the furniture the way they have it laid out. And if there's a problem. I mean, you have to be careful when you're downtown. You have to be careful when dealing with the hospitals and medical personnel. Be respectful. Sometimes you might have one who comes through and says, Oh, you can't move that piece of furniture. Well, that's something that I would want to call back and talk to my supervisors about. Me controlling the security of that room is extremely important. And I should be able to move the furniture. As long as I'm not tearing stuff up, as long as I'm not making a problem for them. So we've got them in the room.

SPEAKER_00: 21:10

What are some of the other things that we need to be thinking about?

SPEAKER_01: 21:15

First thing is this hospital, this entire hospital, is full of really good people who work really hard to try to care for people. Right? People who are sick, people who have illnesses, people who have diseases. Their job is to care for them.

SPEAKER_00: 21:34

The hospital's job is to care for people. They're not there for security of that inmate.

SPEAKER_01: 21:42

You are the only person who is fully committed to the security of that inmate. So don't forget that. Don't get lax and let your brain tell you, oh, well, they wouldn't do that because they know he's an inmate. They don't understand. I can't tell you the number of times, and I worked a lot at downtown hospital. I can't tell you the number of times that I told the nurses, the desk, or food service, don't bring metal utensils. Commonly in the hospital, they bring metal utensils, glass plates, all that on the little tray when the people eat. Well, that's all fine and dandy, except if it's an inmate, I don't want him having a six-inch butter knife, right? Or a fork. I want plastic utensils. And I don't think they do it on purpose. I don't think there's somebody sitting there going, hey, watch this. I'm gonna screw with these guys. I don't think they have. I think they do a job, they do it over and over and over again, and it never crosses their mind what could happen with a steel knife or a steel fork or a steel spoon. They don't live in that world. We do. We're the ones that understand that. We're the ones that know. So the other thing is medical staff. Love them to death, hard workers. But they don't think about security either. And I can't tell you the number of times I've seen them come up and draw blood, right? And then lay the needle on the blanket within reach of the inmate, right? Or turn their back away and leave some instrument laying there. So we have to be aware of the lack of security-mindedness of those around us. You're the only one who is there strictly to care about the security of that inmate.

SPEAKER_00: 23:34

Now, here's one of my pet peeves.

SPEAKER_01: 23:39

I see nurses walk in a room, or you pick, you pick, you know, nurses, physical therapy, somebody that works at the hospital walks in the room. You got one or two officers sitting in a chair, and TV's on. And the nurse walks up to the bed, starts interacting with the inmate, and both officers remain in the chair. Your job is not only the security of that inmate, your job is the security of the people around that inmate, right? He's not in prison for being a super nice guy. There is the opportunity, there is the possibility of violence. So, let me put it bluntly. Get out of your chair and provide security, which is what your job is. Provide security for that nurse, for that doctor, for whoever's entered that room. You should be standing there next to the inmate, ready to react if they do something. I'm not getting involved in what the doctor's saying. I'm not telling the nurse what to do, but I am ready to react. It's not going to take me three steps to get up out of my chair and get over there if something happens. I'm going to be there providing security, and they deserve that. Their job isn't to find inmates. Their job isn't to be insulted. Their job isn't to have an inmate get crazy, loud, uh, obnoxious, whatever. Their job is to come in and provide care. And my job is to provide security so that they can provide that care. Sleeping at work.

SPEAKER_00: 25:24

Have you slept at work? Have you? I have fallen asleep at work.

SPEAKER_01: 25:33

Sitting there and bunny punching and I can sorry about that fourth, 16-hour ship this week, and it's starting to kick my ass, right? But there's a difference between falling asleep at work and going to sleep at work, and I've never went to sleep at work, right? Not too long before I retired, um, I was doing downtown hospital rounds, walked through, walked in the room at 7.30 in the morning, and the officer, there's one officer and one inmate, and the officer's asleep. I wrote him up, turned it over to investigations. Um he was very upset. Why are you doing this to me? I fell asleep. I can't believe you're doing this. It's not like you've never fell asleep, fell fallen asleep at work before. Well, he didn't fall asleep. He had taken his lunchbox, put it on the end of the couch, had folded up sheets on top of it, and then laid his head down on it and went to sleep.

SPEAKER_00: 26:40

I might have a little bit more, and I do. I give people a little bit more credit if they fall asleep accidentally.

SPEAKER_01: 26:51

Going to sleep, I have nothing for. That deserves punishment. Had an officer where I worked before, uh, who literally, when we went to go look for him in the morning, morning watch couldn't find him, the inmates pointed to a closet, and he was, had an inmate mattress and a pillow, and was sleeping on the floor in the boiler room. I have nothing for that. Fire him. There's no coming back from that. You put people's lives at risk on purpose. That's not an accident. You didn't accidentally fall into a mattress in the boiler room. You didn't accidentally lay your head down on your lunchbox with sheets on it to cushion it.

SPEAKER_00: 27:35

Right? So I followed through with that, they were punished, and caused a little bit of a rift. Okay? People, some people thought I was too hard on that. Going to sleep accidentally is something you can work on.

SPEAKER_01: 27:56

There's just a couple of things that I've learned over the years. One, stand up. That's all there is to it. Stand up. When you find yourself falling asleep at 3 o'clock in the morning, working hospital duty, go stand up against the wall. Your body will not let you hit the floor asleep. If it does, I would go see a doctor. I think you've probably got a larger problem than just being tired, right? Just because you're in a hospital room does not mean that you have to sit down. Stand up. The other thing to do, if you're tired, is make sure the people around you know that you're tired. There's nothing wrong with that. Hey, bud, keep an eye on me. If you see me drowsing, you know, punch me in the shoulder.

SPEAKER_00: 28:47

That's a good thing. Caffeine isn't the best thing for you.

SPEAKER_01: 28:54

It'll only keep you awake for a little bit and then it will put you back to sleep. Because as soon as you run out of that energy, it's going to fall off again. Hydration. You need to be hydrated. Movement will keep you awake. These are things that you can do. The other thing that you can do, and that falls back on the other guy, don't get comfortable. If they've got a recliner in that room, don't lay down in it. Don't lift the feet up. Don't lay all the way back. Don't put a pillow behind your head. You know what's going to happen? You're going to go to sleep. We had an escape at one of the places I worked at, and the inmate had open heart surgery, so they didn't figure that he was a problem. Right? So they didn't restrain him to the bed. And then these two guys, unfortunately, both of them were ready for retirement, leaned back in chairs with pillows and sheets and went to sleep on midnight. Because the inmates not going anywhere. He had open heart surgery. Well, guess what? The inmate got up and walked out the room. They woke up, nobody there. They go running out in the hall. They're looking for this guy. When the investigators got there, right? When the supervisors got there to the hospital because of this escape, which we did catch him shortly, when they get there, they walk in the room, there's still pillows and sheets in the chairs where these guys, these officers were. No excuse for that. They both quit. But the investigation they caused got dozens of other people in trouble because it did show that people weren't, you know, doing your checks, calling into the institution. But they basically got away with it.

SPEAKER_00: 30:49

Finally, professionalism.

SPEAKER_01: 30:53

Professionalism when you're out in the public means a lot to me. How professional you are in the public means a lot to me. You know why? Because I spent 30 years in this career, and I don't like the way corrections is portrayed on TV. I don't like the way that they're portrayed in movies. And I don't need people being unprofessional in public and making that worse. So if you're going to go out in public, if you're going to be on these hospital trips, if you're going to be on court trips, whatever it is, be professional. Have a good uniform on. Make sure it's crisp. You are the institution's advertisement for what a correctional officer is or a deputy is.

SPEAKER_00: 31:49

So make sure that you look good. Make sure that you act good.

SPEAKER_01: 31:58

These people downtown have a tough job like you do. Yes, I've had nurses and doctors that I've had to have confrontations with. But stop and think. They have stressful days also. They have days that they're, they put up with a lot of the same people we do. The people who are, you know, a lot of the people who are hooked on drugs and alcohol and mental health that we deal with in our jails. If they're not at our jail when they're having problems, guess where they're at? A hospital. So these people have tough days too. Work with them. Do your best to be professional with them.

SPEAKER_00: 32:43

It means a lot to them, and it means more to your profession. So that's my soapbox for today. Didn't know if I was going to go there, but I needed to after uh what I saw the other day.

SPEAKER_01: 33:01

So I hope that helps you. I hope that gives you things to think about next time you take a hospital prep. If you're an administrator, I hope that gives you kind of a checklist to make sure that your staff are ready to go.

SPEAKER_00: 33:15

You know, this doesn't happen without training. Come up with some training.

SPEAKER_01: 33:21

Help your staff understand how important this is. Help your staff understand the steps that they need to take to provide security outside of a secure area. It's not just train. It's not just easy overtime, gravy overtime. Oh, I'm gonna work the hospital.

SPEAKER_00: 33:41

It's just me and one inmate instead of me and dozens of inmates. It feels that way.

SPEAKER_01: 33:50

It feels like we're secure. But if you open your eyes and you look around, you'll understand you're not. You're doing one of the most dangerous jobs in corrections because you're outside the fence, you're outside the wall.

SPEAKER_00: 34:08

That's it for me today. Hope you guys have a great day.

SPEAKER_01: 34:13

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