Briony Wilson compares her job to a cross between a practice nurse at a busy GP surgery and a paramedic dealing with emergencies. As the acting matron for St George’s primary care and substance misuse service at HMP Wandsworth, she never knows what to expect on any given day.
Wilson says: “The prisoners have all the same problems that people have when they are not in prison.” In addition to providing care to patients with minor ailments, nurses in offender healthcare are frequently required to treat prisoners who have self harmed, been involved in physical altercations or are suffering from the effects of substance abuse.
“We’ll be called to the job and not actually know what we’re going to arrive to,” adds Wilson.
Consequently, she says prison nurses have to be practical and adaptable. “We also have to be quite fit. If we get called to an emergency, we have to run from wherever we are and it’s quite a big prison with a lot of steps to run up and down.”
Aoife Cronin, a junior sister and general nurse, agrees. “We have to go on to the wings and find the guys to bring them down for clinics. That can also be challenging if there has been a problem and it’s on lockdown. You also have to be able to build up a rapport with the officers and we work very closely with them.”
It’s a far cry from her days working as a surgical nurse in a hospital, but she wanted a new challenge and moved to the service in October last year.
The transition to offender healthcare was made easier thanks to a supportive team. Cronin, who has had extensive training, and would eventually like to be an advanced nurse practitioner, says: “My nursing friends thought I would be bored when I moved here or would lose my skills, but I’ve done nothing but enhance my skills since I started. You do a bit of everything and it can feel like trauma nursing sometimes. There is a lot of opportunity to develop ... they [St George’s offender healthcare service] are really open to helping you work towards your goals.”
Her shift starts with a handover with the night team at 7.30am. An important part of the job is assessing prisoners when they first come in, going through any medication they’re taking and discussing any existing health issues or wounds.
On an offender’s second day in the prison, it’s a little more personal, with various tests for sexually transmitted infections, HIV and hepatitis. Cronin says: “We can then catch them [the infections] early and treat them as much as we can. A lot of the patients are being treated for these things for the very first time. We also make sure they are safe if they are detoxing.”
As well as general clinics for day-to-day issues, Cronin runs a wound clinic three times a week. “A lot of [the patients in prison] are drug addicts and can develop big ulcers from injecting so much. They take a long time to heal but luckily with all the hard work that everyone has been putting in, we have nearly healed most of them,” says Cronin.
“There is a lot you can do in a prison to help your patients and to change their lives when they leave. It’s a lot different to being on a ward.”
She adds: “When you see someone three times a week for half an hour at a time, they start to trust you and might tell you about other issues they have.”
This opportunity to help change people’s lives means an unusual highlight of the job is when patients are released from prison and don’t come back. Wilson explains: “We tend to get men who come in and out of prison. When they come in again, there’s that feeling of ‘Oh no, what are you doing back here?’ There was one guy who promised me that I would not see him again. I haven’t seen him for a while, so that feels like a success.”
Many of the prisoners are vulnerable. “So many stories do affect you because there are people in prisons who have had very difficult and very challenging lives,” Wilson says. “You’d have to have a heart of steel for that not to touch you – and to [not] want to see them overcome it and stay out of prison when released.”
Having clear boundaries with patients is absolutely crucial, however. For example, comforting patients by putting an arm around them is not allowed. Wilson says: “You have to convey that care and compassion that is part of every nurse’s job through verbal communication.”
Both Wilson and Cronin think many nurses, especially those looking for a new challenge, would enjoy the job. Wilson, who started in offender services as a newly-qualified nurse, having completed a placement in a prison as a student, says: “Working in a prison is generally something people don’t consider, so we lose out on a lot of nurses who would suit the role really well.”
She adds: “I wish more people would be able to get the experience of what it’s like, because I think then a lot more would choose it.”
For more information and to apply for nursing roles at Wandsworth prison, visit:
