This blog relates to my role of nursing in a prison environment and my reflections on this experience. I discuss the positives and challenges of working in this environment; the humour needed and the opportunities to make a difference.
By Sundar Annamalai
Staff Nurse, HMP Manchester, for Greater Manchester Mental Health NHS Foundation Trust
Sunny has a 17 year healthcare career working across inpatient, acute and prison settings.
I’ve been working in a prison environment and specifically at HMP Manchester for over eight years. I finished my major studies in India in 1989 in Pharmacy and it was when I was working as a Health Care Support Worker that I realised I could provide enhanced care by undertaking Nursing studies.
I joined Access to Nursing, which enabled me to enrol with the University of Salford and undertake a BSc(Hons) in Adult Nursing. After this, I joined Salford Royal NHS hospital on one of their Orthopedic wards and worked there for two years. Whilst working there, I was browsing job opportunities on the NHS website and an advertisement for a Registered General Nurse (RGN) at HMP Manchester interested me as the role specifies in varied nursing activities - compared to routine hospital nursing. I joined HMP Manchester in 2013 and continue to work here.
I enjoy every day of prison nursing. My strengths lie in adult nursing, so I thrive in this environment. Not everyday is the same as the one before it. There are new challenges, new opportunities for meeting new people, which makes you interested to come on duty with enthusiasm to make a difference in the focused patient group.
When we come on to duty, we go to the ‘wings’ to medicate patients, then we come back to Healthcare to see patients in the clinic for their wound care, immunization, discharge planning etc. If I am holding the Hotel 1 (emergency response) radio, I will be extra attentive and alert all the time as we are expected to medicate as well as listen out to the emergencies that may arise. This contrasts with hospital nursing where nurses wear ‘Red Tabard’, which highlights ‘Do Not disturb’ as the Nurse is administering medications.
I strongly disagree when some sections of nursing colleagues say ‘when you join prison nursing - you lose the skills’. In my opinion, we gain skills that are unknown to the typical nursing world. For example, making decisions to resuscitate or not to resuscitate, when to send patients for treatment at A&E, or whether I can treat patients in the limited resources available in prison as compared to the hospital setting. A Prison Nurse has a lot of autonomy in triaging and decision making,
So, what skills do you need working in prisons? Sense of humour is a key skill for a Prison Nurse as sometimes people in prison may shout at staff out of frustration of being under restricted conditions. Nurses can understand and with a sense of humour we can diffuse the situation.
Many people in prison are grateful of what we do and thank us for our work and this feeling keeps us going for that ‘extra mile’. The drawbacks are being in a restricted facility and unable to do what is required as compared to hospital nursing. For example, in a hospital setting if a patient is having hypotension or vasovagal episode we would give them IV fluids and try to stabilize the situation, where as in the prison cell, we need to be innovative with limited resources in the best interests of the patient.
Working in a prison environment does not suit everyone but keeping a sense of humor, a steady and focused mind and not getting frustrated with the restricted environment will serve you well. There are lots of opportunities in this role and positive changes that we can make in someone’s life as we are like their family members whilst they are in prison.