Careers in Prison Healthcare - National Treatment Agency for

West Midlands Prisons
Young Offenders
Institute
HMYOI Brinsford
New Road, Featherstone,
Wolverhampton,
WV10 7PY
01902 533450
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HMYOI Stoke Heath
HMP Drake Hall
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HMP Shrewsbury
HMYOI Swinfen Hall
HMYOI Brinsford
HMP Featherstone 2
HMP Birmingham
HMP Featherstone
HMYOI Stoke Heath
HMP Hewell
HMP Long Lartin
HMYOI Werrington
HMP Drake Hall
HMP Stafford
HMYOI Swinfen Hall
Lichfield, Staffordshire,
WS14 9QS
01543 484000
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HMYOI Werrington
HMP Shrewsbury
HMYOI Swinfen Hall
HMYOI Brinsford
HMP Featherstone 2
HMP Birmingham
HMP Featherstone
Stoke On Trent,
ST9 0DX
01782 463300
HMYOI Stoke Heath
Market Drayton,
Shropshire,
TF9 2JL
01630 636000
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Women’s
HMP Drake Hall
Eccleshall, Stafford,
ST21 6LQ
01785 774100
Adult Male
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Winson Green Road,
Birmingham, B18 4AS
0121 3452500
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Uttoxeter, Staffordshire,
ST14 8XR
01283 829400
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Hewell Lane, Redditch,
Worcestershire, B97 6QS
01527 785000
HMP Featherstone
New Road, Featherstone,
Wolverhampton, WV10 7PU
01902 703000
HMP Featherstone 2
New Prison
Due to Open 2012
HMP Long Lartin
South Littleton, Evesham,
Worcestershire, WR11 8TZ
01386 295100
HMP Stafford
Goal Road, Stafford,
ST16 3AW
01785 773000
National Treatment Agency
for Substance Misuse
West Midlands Government Office
2nd floor
5 St Philips Place
Colmore Row
Birmingham
B3 2PW
Tel 0121 352 5541
Fax 0121 352 5578
www.nta.nhs.uk
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Printed on Recycled paper
HMP Shrewsbury
The Dana
Shrewsbury, Shropshire,
SY1 2HR
01743 273000
Careers
in Prison
Healthcare
a view from inside
Careers in Prison Healthcare Prisoners have some of the greatest health needs of
the population, yet are often the least likely to be in contact with healthcare services.
Choosing a career in Prison Health offers the opportunity to work within a range of
young offender, women and men’s prisons. Entry to prison work can be from a wide
range of nursing backgrounds and staff are part of a multi disciplinary team, working
holistically with the patient to make a real difference to their lives.
Opportunities exist within a prison for qualified and support staff roles, in primary
care, mental health and substance misuse services. With the opening of a new prison
in 2012, opportunities in this area are growing, and this leaflet aims to give you a view
about what working in prison health is really like.
Wendy Sweeney
Clinical Nurse Manager
02
Can you describe your
career path?
I qualified as a Registered
Mental Health Nurse, but then
left the NHS for a while and
did some work with children
with autism. In those days,
prison health care was solely
the responsibility of the Prison
Service and they needed
someone for some short-term
cover. I thought “I’ll try that”.
Initially I arrived to cover for
three weeks, but 12 months
later the Governor bought
my contract, and I’ve been
here ever since. Nearly 16
years now!
What do you like most about
the job?
For me, the biggest part is
being a good role model. A lot
of our young people in custody
haven’t benefited from a good
role model in their life. They’re
used to communicating
using bad language and
displaying behaviour that is
not acceptable in main society
as a way of getting what they
want. However when they
realise that their behaviour is
not acceptable and that there
are people that don’t behave
in that way, they respond very
well to it.
In my career I have always
had an interest in working
with children and young
people within mental health,
and as soon as I arrived,
literally within the first week,
I thought “Yes, this is for me,
this is somewhere where I can
do some good and I can make
a difference.”
What was the greatest myth
about prison nursing before
you arrived?
My fear was that it was going
to be dangerous and scary.
That there was going to be
all these people locked away
behind doors, and they all
wanted to hurt me. I think my
family had the same concerns
when I came, and that was
blown out of the water on day
one. It simply isn’t dangerous.
I’ve worked here now 16
years, and I’ve never been
assaulted, I’ve never even
come close to being assaulted
or being physically threatened
at all. There’s been a few
comments thrown, as a young
person would (laughter), but
I’ve never at any point felt
physically threatened.
I certainly feel it’s one of
the safest places you can
nurse. We have the support
of trained Prison Officers on
hand. If there is a person that
is displaying violent behaviour,
we don’t have to deal with it.
What do you think it takes to
work in a prison?
When we look for staff,
naturally we want people
that are suitably qualified and
that have some experience.
However we do take nurses
direct from training and we’ve
had student nurses come
here that have subsequently
been employed by us. We’re
looking for a level of maturity,
a good sense of humour and
more importantly, the ability
to communicate with young
men (because in this unit we
hold young men between
ages 15 and 21) that is both
appropriate and respectful.
Also we are looking for people
that are not judgmental
in any way. We want staff
that understand that every
human being has the right to
good healthcare, to respect,
to privacy and to dignity.
And that they won’t let any
preconceived ideas bias the
care that they give.
Is it a worthwhile
career move?
Increasingly nursing, within
the prison is becoming
more recognised which is a
good thing; and it’s certainly
becoming better known.
Five or six years ago, a lot
of people didn’t realise that
there were nurses working in
prisons, whereas now we’re
an integral part of the PCT.
We sit on all the PCT boards
and their committees; we’re
represented very well in the
PCT now. No longer do you
hear, “Ooh, do they nurse in
prison?” Now people know
about the job and see that
from a career perspective it
can bring you personally
great value.
Nursing in prisons covers a
wide and diverse remit of
nursing. We do everything
from emergency care, mental
health care, primary care and
nurse led clinics. We’ve had
staff that come in and up
skill on nurse led clinics for
example. It is a very positive
career stepping-stone, as well
as being hugely rewarding.
As soon as I
arrived, literally
within the first
week, I thought
“Yes, this is for me,
this is somewhere
where I can do
some good and
I can make a
difference.”
Can you think of a
time when you’ve made
a real difference to
someone’s life?
We had a young man who
sadly had had a bereavement.
His mother died whilst he was
in custody and it was a very
sudden death, so he hadn’t
been able to see mum prior to
her death.
I did a lot of one-to-one work
with him around bereavement
issues. There were a lot of
emotional issues within the
family prior to his mum’s death
and he had had a very troubled
childhood. He was in for quite
a long sentence, and I would
see him on a regular basis and
we’d do some work with him.
He went back out into the
community and about 12
months later, he called to say
that he was in employment;
he had turned his life round.
He rang because he’d been
to his mum’s grave that day.
He said, “And I just stopped
and thought about you. I just
wanted to ring and say I really
appreciated the time.”
A thank you goes a long way,
with young people. He was
a young man that managed
to turn his life round. We
can’t change everybody, but
occasionally we succeed and
you think, “Yes, actually I did
make a difference.”
What would you say to
someone considering a
career in prison nursing?
It’s fantastic. It’s a whole new
world and it’s diverse. Come
and find out about it.
Vacancies
For details of current
healthcare vacancies, visit the
NHS jobs website or contact
the Head of Healthcare at
your local prison.
www.jobs.nhs.uk
03
Wesley Lee
Health Care Assistant
For me it’s simply about care. I don’t
want to know why they’re here and I’m
non-judgemental. It’s about me looking
after their health needs. If they want to
tell me, that’s fine, but I never ask.
Susan Raines
State Registered Nurse
Can you describe your
career path?
I am a State Registered Nurse,
but I was also a Paediatric
Nurse for thirty years and I
worked for Child Protection
for NHS Direct. Basically I was
going to retire, but I got bored
so I went and worked for a
nursing agency and I
got involved doing some
prison work.
The medical wing is divided.
Upstairs it is nurse-led care
like a G.P. surgery, plus we run
dental, opticians, pharmacy
and asthma clinics. Downstairs
we’ve got an inpatient area.
I love the work. It’s diverse and
challenging, but also we’ve
got fantastic camaraderie and
teamwork here.
What were your
first impressions?
When you first arrive, you get
your induction regarding the
security process, and once
you’ve had that you don’t
feel threatened. You know
that the Officers will always
protect you; we’ve got radios
and you’ve only got to hit
the button and they’re there
within seconds.
04
What is your approach
to working inside the
prison environment?
For me it’s simply about care.
I don’t want to know why
they’re here and I’m nonjudgemental. It’s about me
looking after their health
needs. Therefore I don’t want
to know about what they
might have done; if they want
to tell me, that’s fine, but I
never ask.
What have you gained most
from prison nursing?
Both experience and
knowledge. Obviously
paediatrics ranges from
nought to eighteen, but since
coming into the prison two
years ago, I’ve also learnt a
lot about mental health issues
because we work alongside
the mental health nurses. I’ve
also learnt a great deal about
diversity issues - different
religions and cultures.
You never stop learning here.
The work area involves
balancing care within a
challenging environment
which brings its own personal
satisfaction and reward.
Can you think of a time
when you’ve made a real
difference to someone’s life?
We had a guy who came in
and he was very confused
personally; there were lots of
issues in his life, and he was
continually self-harming. We
had him on a constant watch
and by all of us working as
a team, and by that I mean
the mental health nurses,
the CAMHS, the officers, the
YOT team, even down to the
chaplaincy as well – we all
came together and through
that process, he is actually
now well enough to be back
on the wing.
It’s rewarding because now
he’s out there and he’ll say “Hi
nurse, how are you doing?”
and it’s brilliant to see him. So
to me that’s the reward. It’s a
multi-agency here and we all
work together.
There are some that you’ll
never turn their life around
and you know that quite
quickly. However there’s a lot
here who’ve simply been in
the wrong place, at the wrong
time and you can make a
difference. I think that’s why
I’ve stayed.
What would you say to
someone considering moving
over to prison nursing?
Give it a try because you will
genuinely become a member
of the team. There’s nobody
here that protects their
practice - we are all quite
happy to help each other.
We’ve got experience from
A & E nurses through to
mental health nurses. It’s
almost like a microcosm of all
the skills, but whereas out in
the community you probably
would never get to work with
all of them, here you will.
So I’d say, come on board
– not least because it’s a
wonderful atmosphere and
we have so much fun. We are
not only a team, but we have
real friendship here. We have
to because of the challenging
work. I love it.
What previous experience
did you have before
coming here?
This is the first time I’ve
worked in a healthcare
environment really. I came
straight from college, after
doing a bit of travelling;
however I had family working
within the prison service so I
was aware of the potential.
Were you nervous about
working in a prison?
I’ve been here nearly for five
years now, and I find it a very
safe place to work. Help is not
more than 30 seconds away
if anything crops up, but I’ve
never felt threatened in any
way, shape or form.
Are there medical training
opportunities available?
Yes. I’m doing my NVQ at
the moment, Level 2 in Health
and Social Care to help me
with my skills. I’m about 80%
of the way through it and will
complete the qualification
within a year. Once I’ve done
that, I’ll be able to aid more
in the nursing clinics, such as
the smoking cessation clinics.
Possibly go on to taking
bloods and generally support
and assist with the workload
of the registered nurses.
I’m doing my
NVQ at the
moment, Level
2 in Health and
Social Care to
help me with
my skills. I’m
about 80% of
the way through
it and will
complete the
qualification
within a year.
What do you think it takes to
work in a prison?
A sense of humour is a good
start; and maybe a thick skin
at times! But mainly a good
sense of humour - I’d say
that’s the most important
quality to have.
We do get on well together
here and have a good social
life. Although I lived locally
before joining, we have
had people move from a bit
further afield. One of our
new nurses has just moved
from Wales to come and
work here, and we’ve all
made her feel welcome. It’s a
good team here.
What do you like most
about the job?
I’d say it can be quite
challenging at times. We have
people in here who have had
a difficult upbringing and
have not necessarily been
able to tell other people in
the past about this. To be able
to feel that they can come to
us and confide things, which
they’ve not been able to talk
to other family members or
their friends about is very
rewarding. These issues might
have been the cause of them
getting into trouble in the first
place. Potentially we can help
them turn their lives around.
What does your job entail?
Basically, we’re here to help
the doctors and nurses run the
various clinics or in their roles.
We also have an inpatient
facility where we perform
different activities with the lads
who are down there.
05
Allan Bailey
Community Psychiatric Nurse
Can you describe your
career path?
I worked in the Forensic Services
at the General Hospital, at the
medium secure unit there, for
about four years. I was working
from the acute ward right
through to the rehabilitation
ward and I started to have more
to do with the prison as we
were receiving guys who were
coming from the hospital from
prison on transfer.
Amanda Tunnicliffe
Integrated Drug Treatment System (IDTS)
What was your career path?
I’m now the senior IDTS nurse,
but I’ve been a qualified
nurse for 15 years working in
orthopaedics. In my last job, I’d
got to the top of where I could
go and I fancied a change.
first look round, the very first
impression. But on getting to
talk to people, I just realised
that I was going to fit into
it and this has given me the
professional development I
was looking for.
I was looking really to be a
manager at a senior level. I’ve
also always been interested
in substance misuse as a
separate field; so I decided
to have a look and see what
was out there. Several jobs
came up and Integrated Drug
Treatment System was one
of them. It was brand new
to me, although I’d worked
with alcohol and drugs within
the hospital setting, because
having worked in orthopaedic
trauma, we did have quite a
few cases there.
The work has its ups and
downs but I love it.
What was your first
impression of the prison job?
I came for an interview 14
months ago and immediately
I loved the prison setting.
My first impression was “Its
like Porridge” as it was quite
an old Victorian prison. It
was a bit daunting on the
06
What do you like most
about the job?
IDTS is challenging – the client’s
very mindset needs work.
When they come in, they’re
already problematic drug users
and they want to continue. The
hard work goes into actually
changing the client’s mind and
focussing on recovery.
We need to make them realise
that there is more out there
than taking drugs. It’s hard
work, but when you see a
client start to become very
motivated and begin looking
at the future, it is rewarding.
There are clients that have
actually changed their
behaviour and mindset to
realise that there is light at the
end of the tunnel.
If there’s one person that
If there’s one person that you know
that you’ve got drug-free, then that one
person is worth all the hard work.
you’ve got drug-free, then
that one person is worth all
the hard work.
What would you say to
someone considering
moving over to IDTS?
It’s rewarding and hard work
but if you’re willing to put
that hard work in, the benefits
outweigh anything else. Drug
working now is completely
different to how it used to
be. There is the psycho-social
aspect, as well as clinical
nursing and you get to focus
on both. It is so rewarding,
at the end of the day to
actually make a difference to
someone’s life.
I think because drug use and
alcohol problems are so rife
out in the community, that
if for some reason I decided
to leave prison work, the
experience, understanding
and empathy I have learned
here would be invaluable.
What was the greatest myth
about prison nursing before
you arrived?
You hear things in the news;
but when you arrive you
realise that security is in place.
As long as you are aware of
what could happen and what
the procedures are within the
prison, you’re quite safe. I’ve
never felt threatened.
Of course you do get the
odd client that will play up,
especially if it’s a treatment issue
that’s not popular with him.
People react in different ways,
but as long as you’ve got a
procedure in place and a policy
that you follow, you are fine.
So I started to build some
relationships with the prison
nurses and the community
teams and I thought, well,
it’s extension of what I was
already doing. Still forensics,
but moving into a more
specialist field.
Years ago, the prison used to
be seen as the last place you
wanted to work. However
that was before government
commissioned reports into
mental health provision in
prisons. Since then much has
changed and it is now seen as
more of a career progression;
more of a recognised specialism.
And first impressions?
That it’s a great team-working
environment. That’s evident
in whichever prison you go
to. It’s a difficult and complex
environment to work in,
primarily because you’re trying
to deliver a service within a
service. Which always raises
complex questions… not
least the old question, as
to whether it is ‘patient or
‘prisoner’? So you have that
dilemma to work through.
What does your job involve?
I work for the Prison In Reach
Team which is a service that is
based on a community model
but placed within the prison
setting. Our role is to carecoordinate the guys when
they’re in prison, if they’ve
previously been under the care
of community mental health
teams, to ensure that that
care continues. If they haven’t,
and they require continuing
care, then we coordinate that
care in the community.
We’re a multi-disciplinary team;
we’ve got social workers,
occupational therapists,
psychiatrists - effectively we
mirror a community team. Our
main focus is to facilitate a
smooth transition back into
the community.
Are there career
opportunities?
Certainly. For a newly-qualified
psychiatric nurse, they get the
chance to specialise and look at
different ailments. For instance,
my speciality is adult ADHD. I’ve
been able to pursue courses
around adult ADHD, go on
conferences, forums, national
and local forums, and then
transfer that learning back
into the workplace.
I also lead on prison transfer,
so I work closely with the local
MAPPA team (Multi Agency
Public Protection Arrangement),
whose role is to ensure that the
public is protected. So I work
closely with the Ministry of
Justice, and if somebody needs
to go to hospital for treatment,
my role is to ensure that this
happens in a timely manner,
within government guidelines. I
also facilitate the movement to
either a private or NHS facility,
and we work closely with
the MAPPA teams to ensure
There’s no two
ways about
it, working in
the prison is a
demanding role.
It is a complex
environment, but
when you make
a breakthrough,
or you make a
difference, that
difference is
massive which is
highly rewarding.
that there’s no restrictions
on patients going to certain
areas. It is both incredibly
rewarding and demanding.
There’s no two ways about
it, working in the prison is a
demanding role. It is a complex
environment, but when you
make a breakthrough, or
you make a difference, that
difference is massive which is
highly rewarding.
What would you say to
someone considering moving
over to prison nursing?
If you want to enhance your
clinical and care-coordination
skills, and to really experience
multi-disciplinary working,
then the prison environment
is the place to do it. You’re
not just experiencing
multi-disciplinary working
in a clinical setting, you’re
experiencing it in the truest
sense of the word, working
with another service. You’re
working with probation,
prison staff, psychology – a
broad range of people that
you would never get to work
with elsewhere.
07