I work in healthcare in a notorious men's prison. AMA

[TexasTyson]

People generally find my job interesting and have a load of questions.

I'm a paramedic and I've given up working on the road (I.e. on ambulances) to work in a men's prison.

Thank you, I'm glad you find it interesting. Up until about 3 years ago, I had no idea this was a career option!

Do you do nights?

I could if I wanted to but no. There are always healthcare staff working at night though.

Really interesting OP. I supplied care staff to a prison and it was a nightmare. Not just the long winded security checks (avg 3 months) before anyone could work there but the process of getting the carers in and out 2 or 3 times a day which was soooo slow. Although the hourly rate from the local authority was much higher than in the community it just didn't make financial sense to continue. The LA paid for the care hours but not the faff of actually accessing those who required daily care, one of whom even with 2 carers present required a PO to be with them at all times for the carer's safety due to the inmate's reason for being incarcerated. It would have made more sense for the prison to have onsite carers which sounds like your site does.

so- given you enjoy it,to the point recommend (at least considering)do you feel-EVERY prisoners health care need is met?

The team does their very best, but just like on the outside it involves the patient engaging, mental health is generally hard and we do at some point have to rely on the NHS.
Buy generally it's better inside then outside.

Hi! This is a really old thread. I’m looking at jobs within in the prison as a paramedic but I’m only newly qualified so I don’t know if I would be successful and I’m a little bit apprehensive. However I’m not enjoying front line it doesn’t suit me any more lots of factors in my life has changed. Do you think they would only take on experienced paramedics? Do you still feel supported ? I’m aware an NQP out on the road is supported through the nqp process of course prisons don’t have this. Also did you get access to all extra training needed ? Did you have to do any other clinical training? Thanks you might not see this but worth a try.

Hey! My prison and the company that supply healthcare do not have a specific requirement for length of time qualified. In fact, I was an NQP when I got my bank contract (I was a tech for 8 years prior though tbf). One of my nurse colleages (same team as me) did placements as a student at the prison and got employed straight out of uni.
No specific extra clinical training required, but ive learned to suture and glue ans been on a minor illness course. The company and mt managers are very supportive.
Like you, I don't think the road was for me. I love this job and I think I will have a successful career in this field. I highly reccomend it!

If a prisoner is diagnosed with something like cancer... are they still able to access things like the very latest treatments and trials, like someone would on the outside? Are is it limited to the very basics?

Yes .. prisoners still access all secondary care
We must provide healthcare that is equal to the care provided in the community

yeah you’ve missed Dental Nurses 😶

Yes, they go to outside hospitals for treatment. We have a couple of inmates with cancer at the moment and we facilitate chemo etc. We also have a few guys on dialysis who have to go out once a week.

Oh I'm so sorry... but we don't have a nurse! We have a technician sometimes who deals with dentures and occasionally helps the dentist, but generally our dentist has to fly solo!

Bump- someone on the "what's your job" thread requested an AMA but I've already done one. Here it is!

Do you treat a lot of injuries caused by fights/ general violence ?

Yes, lots! Also loads of self harm.

Are new arrivals routinely screened for neurodivergence; ADHD, autism, etc?

Are there high numbers of ND people in the prison?

How's the literacy programme?

I used to do it mid 90s but tbh I hated it. Sounds like things have changed though. I found all I was doing was locking and unlocking doors and dishing out methadone. A lot of the officers were ex military and it showed, it was very military. I think the inmates were treated better by the officers than by the police tbh but some of them had a very much ‘them and us’ attitude.

Do you know what crime your patient has committed?

Everyone is screened on arrival for both physical and mental health. They self report any issues and if they agree, we have access to their SCRA.
We do have an ADHD programme and it's quicker to get assessed inside than outside.

Yes lots of ND people. One wing has a floor dedicated to ND prisoners with a slightly different regime and officers with special training.

There is a full education department with literacy classes, but we have a very transient population so they may not have time to really get going.

Very different now. I don't have cell keys!

Generally no. I'd have to go out of my way to find out and I prefer not to. Also a lot of it isn't that interesting.

However. Like anyone, I sometimes get curious and find out.

And there are some prisoners who have been in the press etc so I know about them.

Or they rock up on 24 hours in police custody!

I'm not healthcare but same environment. I personally like to know what they’ve done

I think if you're in healthcare it's different. You have to treat everyone the same and I think I'd struggle with that for some crimes.

We are mostly drugs and gangs though.

When I was there, mid 90s, Prison Service Nurses (PSNs) had just started. Prior to that healthcare was provided by Hospital Officers. There was 2 ways to be a HO. A qualified nurse could do Prison Officer training (about 3 or 4 months iirc) or an officer could go and do HO training for 6 months to give a basic grounding in healthcare. The PSNs got training in restraint techniques and basic security and that was that. There was a lot of resentment from the HO that we were ‘taking their jobs’. Many expected us to do the same job as them even though we weren’t trained for it eg they expected us to respond to alarms or search cells even though we weren’t trained or experienced to do so and were often quite vocal when we said we weren’t able to. I remember having an argument with one of the HOs who wanted me to do searching etc. I suggested that for example he wouldn’t expect a normal prison officer to check an inmates obs before bringing them to healthcare. He said, of course not that officer doesn’t have the knowledge or skills to understand when obs were out, which was exactly my point… I didn’t have the knowledge or experience to be able to safely or effectively manage a riot situation or to know how to properly search a cell. But many of the HOs seemed to think we should!

im genuinely pleased to see things have changed but when I was there nurses were treated quite poorly and negatively by their peers amongst the officers. I ended up very depressed and stressed and started getting migraines and sleepwalking. I was under stress outside…I was getting married, then my lovely dad died suddenly and shortly after that we bought our first home. But as soon as I left the prison service my migraines and sleepwalking stopped. I don’t regret doing the job but I certainly don’t regret leaving! I was there 2 years all in.