Prison nursing: opportunities, autonomy and known risks

November 16, 2017

Prisons can be dangerous places but the risks are known and are planned for. And with prison healthcare often nurse-led, there is a lot more to the role than people may realise, writes Lynne Pearce.

If you’ve never considered prison nursing or discounted it as dangerous, it’s time to think again, says Ben Tolley, who is responsible for healthcare at eight prison sites in Northamptonshire and neighbouring counties.

‘Lots of people have preconceived ideas, but the reality is different,’ he says. ‘Once we get people through the prison doors, they understand more. Of course there are challenges, but the opportunity to deliver good quality healthcare is strong.’

A nurse for 17 years, Mr Tolley joined Northamptonshire Healthcare NHS Foundation Trust in 2003, taking up his present role as head of speciality services three years ago. ‘We’re a one-stop shop, offering a range of different interventions all in one place,’ he says.

Extended roles

Among the key attractions is the level of autonomy. ‘Prison healthcare tends to be nurse-led, rather than the more traditional medical model,’ explains Mr Tolley. ‘This gives nurses a lot of control over the care they deliver, and there are also opportunities to do extended roles.’

Rather than focusing on a narrow area of healthcare, nurses are likely to see a wide variety of different health needs. ‘Prisoners tend to have high co-morbidities and are unlikely to readily access healthcare in the community, so can have poor physical and mental health,’ says Mr Tolley.

‘This is an opportunity to try and support them to get on top of their health problems while they’re incarcerated, in the hope they’ll continue once they’re released.’

Preceptorship programme

For those worried about personal safety, Mr Tolley offers reassurance. ‘As healthcare professionals, we’re reasonably well-received by prisoners, who tend to see us as more of an ally.

‘The risks here are known and the working environment fully supports staff. It’s quite different to working in the emergency department, where often you don’t know where the risks will come from. Prisons are set up to deal with risks.’

The trust is seeking to recruit band 5 and mental health nurses to work in prisons locally, whether they are new to the speciality or seeking to further progress their career.

‘We’re increasingly recruiting newly qualified staff,’ says Mr Tolley, adding that they have an established preceptorship programme and also offer student placements.

Good retention rates

The recruitment push is part of the Best of Both Worlds campaign, which highlights the diverse career opportunities for nurses and the benefits of working and living in Northamptonshire.

The struggle to recruit healthcare staff of the right calibre is highlighted in the latest report from HM Inspectorate of Prisons, with the situation exacerbated by an 82% rise in the prison population over the past 30 years.

‘Like anywhere in the NHS at the moment, prison nursing has recruitment challenges,’ says Mr Tolley. ‘But once we get people into post we tend to retain them. I hope this campaign helps breaks down some of those fixed beliefs, making it a more appealing job prospect.’

Written by Lynne Pearce for Nursing Standard