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What it’s like to be a prison nurse

Against popular belief and how it is portrayed on TV, work as a nurse in a prison is much the same as in any other area that provides care.

One reason for working in a prison is the ability to develop and use all the skills and experience gained over the years. Every area of the prison – no matter what its purpose – will contain patients with a wide diverse range of health related problems: medical, surgical, orthopaedic, mental health drugs and alcohol abuse to name but a few. The nursing team have the responsibility for assessing individuals and developing strategies to manage their care.

My own area is mainly concerned with providing Palliative and End of Life care. However, we also take care of the more vulnerable in prison life. Our patients cover most areas of practice, orthopaedic, surgical, medial, dementia and learning disability. We also manage diabetic patients, patients with gastric complaints, mobility, nutritional, cancers and mental health.

Treating prisoners as patients who are individuals actually can change and enhance lives. Sounds heavy, but some of these patients will have been living rough on the streets, they go through the system, and some have long histories of abuse from others or against themselves. We may be the first person in a long time that isn’t judging them, and may have the opportunity from that interaction to have a positive outcome. We are not there to be discipline staff. We take the time to talk, listen, offer support and advice, point them in the right direction for help, and we make a difference.

The challenge is to work with them and build respect. And this then could help them in their rehabilitation.

As a medical practitioner, my experience and confidence has increased managing this diverse group of individuals as I use all my skills and it requires flexibility.

It’s no secret that the main obstacle to working in a prison is the occupants, but no more so than what I’ve experienced when working in A&E on a Friday night! Once you learn how to deal with every given situation in that setting, it becomes less of an issue.

Working alone sounds daunting in a prison setting. However, radios are worn and prisoner contact is monitored by prison officers at all times. Support is always available and concerns should always be escalated to a more senior nurse. This is also covered over the weekend with our on-call system.

We maintain our standards and we work within the prison regime, it reduces the risks for all medical and prison personal. We know who to contact, we lock doors and wear radios. That may seem very different, but all hospitals have security and use personal alarms – they just may not be as obvious!

Working in Prison relies on all of the skills that you have built up. Patients are of all ages, from all ethnic origin and diversity. These patients have many healthcare requirements, they come from all walks of life with questionable healthcare which may not have been attended to for some time. It is at that point your skills come to the fore. We work with our local agencies, and our care planning shows no difference to anything you would experience in other healthcare settings. It is really important to us to build relationships with other agencies as it supports our decisions and helps form a professional relationship between one care facility and another.

On the wings we take responsibility for developing working practices. My area has been recognised as having high standards of care by the Care Quality Commission.

Daily life in a prison is complex and at times extraordinary but each day’s challenge builds on your experiences and knowledge and builds you confidence and job satisfaction. At the end of the day, that is all I actually want.

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