Sample Clinical Guideline: Medical Approval of Personal Footwear

Today’s post is the first in a series of sample clinical guidelines.  These will be placed under the “Guidelines” tab (above) as they are published.  These guidelines are open access; you may use them in whole or in part as you see fit.  I view these sample guidelines as a group effort!  If you have a suggestion, critique or simply a better way to phrase some concept, say so in comments.

This particular clinical policy addresses a common problem in jails (less so in prisons). I addressed the issue of allowing personal shoes in jail previously in “A Quick-and-Easy Solution to those Pesky ‘Own Shoes’ Requests,” (found here).  As a result of that post, I have had many email requests for a sample “Own Shoes” guideline.

Medical Approval of Personal Footwear in Jails

This clinical guideline is intended to be used as a template to help clinicians and administrators create their own policy on personal footwear. This sample guideline must be modified to make it applicable to each unique correctional facility. This guideline is not intended to apply to all patients. Practitioners should use their clinical judgement for individual patients.

Introduction. Inmates housed in county jails are provided footwear by security personnel. Occasionally, inmates will state that they have a medical condition that requires them to wear their own personal shoes. If an inmate asks medical personnel to authorize him to wear his own personal shoes, medical providers should re-frame the question as “does this patient have a legitimate medical need to wear his own personal shoes?” Inmates may desire to wear their own shoes for many non-medical reasons, such as convenience, as a sign of increased status among other inmates and as a way to smuggle contraband. This guideline addresses the question of when inmates have a medical need to wear their own personal shoes. Continue reading

A Quick-and-Easy Solution to those Pesky “Own Shoes” Requests

Sgt. Tracy Cox has permission to wear her own shoes in the jail.

Everyone who works in corrections is familiar with inmates wanting medical authorization to wear their own shoes.  A typical case would go something like this:  “I have chronic back pain and walking on these hard concrete floors makes it worse.  Will you authorize me to wear my own shoes?  You did last time I was in here and it really helped.”

We need to keep in mind, however, that allowing an inmate to wear his own shoes gives that inmate secondary gain.  Shoes from home are, indeed, more comfortable than the typical jail sandals.  Also, any inmate who is granted a special privilege, like wearing his own comfy shoes, gains status among the other inmates.  When we approve inappropriate requests for “own shoes,” we are bestowing prestige upon that inmate.  And we are denying that prestige to those who we refuse.  The unfairness of this is not lost on inmates.  Finally, “own shoes” are occasionally used to smuggle contraband into the facility.  I remember one pair that had an ingenious hollow space carved out of the sole that was not easy to find on a typical security examination.  If you routinely grant requests for “own shoes,” you will inevitably get burned in this way. Continue reading