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As long as he knows what he is doing. There were times when I knew what my patient needed, what the best practice was and what nursing intervention was required but I then had to navigate the prison and its various rules and practices.
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As nurses we are motivated by care, compassion and promoting wellbeing and health for our patients. At times it may feel that the prison culture is the opposite, motivated by containment and security at best and even punishment at its worse. I will always remember a case where a young man had swallowed a large quantity of an illicit drug. On review he was physically deteriorating, tachycardic, raised temperature and a distended abdomen.
The prison staff told me they could not escort him out as they were carrying out searches on the wings, the prison was in lockdown and they were concerned he was a security risk. I continued to advocate for the patient, escalated my request through their management structure and ended up directing the governing Governor.
It can feel difficult navigating the prison structures in order to provide effective nursing care but stick with it. I think the greatest lesson I learnt during my time in the prison was how important my professional relationships were. For healthcare staff the people we provide care for are patients first prisoners second, for prison staff the opposite is true. The best outcomes were always achieved when I was able to work in collaboration with officers.
As nurses we are taught about boundaries, the need to maintain integrity and ensure we act in a professional manner at all times. As a woman working in a male prison I learnt quickly how to communicate in a confident manner, be approachable and professional but also be assertive when needed. Saying no or challenging unacceptable behaviour can feel scary at first but you will gain respect from both prisoners and staff. Before starting work as a nurse in a prison it is useful to understand some basic theories of institutions, culture and themes of the population. Before working in a prison take time to reflect on the personal and professional support structures you have in your life.
I knew prison nursing would be tough, I knew I needed a level of resilience but I was not prepared for the psychological and emotional impact of working full time in a prison setting. Oppression, routine, distress, anger, fear and survival run through the prison population and a level of personal insight is needed to monitor your own stress levels and emotional health. Take breaks away from the environment, engage with clinical supervision and plan your annual leave to get consistent holidays.
Browse our available Prison Nurse jobs here. Let me know in the comments your thoughts on Prison Nursing and my tips - let's chat there! Registered Mental Health Nurse with 11 years experience.