Hidden Heroes: The Unseen Nursing in Prisons

I am Jay King. I work in a London as a Primary Care Nurse in a Prison. I have been working in prison since 2019. In my relatively short time working in Prisons, I have come to realise that the work we do is vastly more complex than I ever imagined it would be, and our work is poorly understood and little talked about. Prison Officers refer to themselves as the “Forgotten Service” and I see that reflected in the wider nursing community in regards to Prison Nurses. We are hidden behind high walls and there is little glamour or inspiration to the wider public when you nurse people who are often viewed as dangerous and harmful. In reality my patients are complex people, often the victims of deeper issues in society that has led them to being in prison. Few are dangerous, and most are pleasant, kind and thankful for taking the time to see them.

I was drawn to Prison Nursing as I thought it would be a challenge, I enjoyed the prospect of working with some of the most vulnerable and often challenging patients and I was interested in the Primary Care, whilst also gaining some Emergency experience. It became apparent quickly, that I did not realise how far the scope of my skills would be tested and how much I would learn, and also just how nurse led prison healthcare is. Primary Care nursing makes people think of practice nursing, but this is just one facet of my role. We also attend emergencies and care for injuries as much as we are able to, and this can range from bad reactions to illegal drugs such as spice, self-harm and even attempted suicide. In an emergency we are vital due to the added complexity of gaining quick access to the prison. Despite being in primary care and an Adult Nurse, I deal with a high level of mental health, (estimates suggest that 66% of the prison community has mental health issues). Often, I am the access point to mental health services within the prison, especially in the first instance of a crisis. There is also a multitude of prison specific documentation and processes to learn as well as the additional constraints of security and the prison regime.

I find the most rewarding aspect of my role to be working with patients who have often slipped through the net of healthcare services, possibly for years, with poorly controlled long-term conditions and managing to work together to achieve a breakthrough in their care and the benefits this brings them. My manager once told me that in prison where we have taken away a person’s freedom, helping someone to take control of their own health to the best ability is one of the greatest things you can do as a prison nurse and this is always at the heart of my work.

I hope this small insight sheds light on some of the amazing work we do, and some of the complexity of prison nursing, I assure people it is not a scary place, and just how rewarding it is to work in this environment.

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