A rewarding role for Kimberley prison nurse
"You get great satisfaction from seeing the men’s and women’s health improve markedly," she said.
"By improving prisoners’ physical wellbeing we contribute to them making better decisions when they’re released. We provide them with a supportive environment where they can begin to focus on their health while they are away from drugs, alcohol and social stressors.
"They’re often grateful for the help they receive in prison from health staff. We work as a team to ensure better outcomes for them. We offer all prisoners immunisations including influenza and pneumococcal where recommended. This not only protects them, other prisoners and staff while they are in prison, but also protects other members of the community when they are released"
As part of the delivery of culturally safe medical care all people engaging with the health staff are supported to achieve optimal health in keeping with their own cultural context.
"We also offer blood-borne virus and STI testing. Hepatitis C is over represented in the prison population and if left untreated can go on to cause chronic liver disease. We can provide support and a structured environment to complete Hepatitis C treatment."
Belinda said another important aspect of her role was education: "This can be challenging as many prisoners have low literacy skills, some because they have chronic ear disease that has prevented them from learning. For some prisoners English may be their second or third language," she said.
"We encourage them to give up smoking and it is a real breakthrough if they are actually able to leave prison as a non-smoker. We also talk to them about the importance of exercise and a healthy diet. However, it can be difficult for them to buy fresh fruit and vegetables, especially in the more remote communities where fresh produce can be up 50 percent more expensive then it is in Perth.
"We try to impress on them how important it is for them to continue taking their medication when they’re in the community – it’s not just for when they’re in prison. We educate our patients about their medications, their actions and the importance of taking them, and about health conditions and prevention of further illness."
A typical shift starts at 7am where the first nurse starting receives a handover from the Senior Prison Officer and discusses any health issues that may have arisen overnight and if anyone needs to be seen urgently. The nursing team consists of three full-time and two part-time nurses.
"We then have the medication parade, where prisoners attend the health centre for regular medication," Belinda said. "Any diabetic prisoners requiring insulin come to the clinic for their blood sugar monitoring and insulin.
"We assess all people admitted to prison to ascertain whether they are fit for custody or if they have any urgent health needs. We are kept busy with admissions and can have five or more admissions a day. A health check and assessment is done for all new prisoners.
"We also assess whether a prisoner has any self harm ideation or intent. We have an at-risk management system in place with the Prison Officers for those identified at risk and how to manage them.
"Because of their poor social circumstances, prisoners are often unwell or have untreated injuries when they are admitted. Their own health is often low in priority compared to all the factors they are facing in the community. They may have not been taking their regular medication for some time or be withdrawing from drugs or alcohol or both.
"The prisoners have the same type of illnesses– chronic disease such as diabetes, hypertension, ischaemic and rheumatic heart disease, respiratory conditions, chronic ear health issues leading to impaired hearing and deafness and mental illness etcetera – as in the community.
"We can see up to 15 or more prisoners a day. The rest of the day is taken up with wound dressings, injections, monitoring blood sugar, weight, blood pressure, skin treatments, ECGs and chronic disease management.
"Prisoners can also request an appointment by placing a card in the medical box or informing an Officer they require an appointment.
"As a prison nurse you need to be able to work with some degree of autonomy as we only have a GP visiting for one half day a week, with occasional visits from specialists."
Belinda said with the Kimberley particularly at risk during the early days of the COVID-19 pandemic, she had been impressed and reassured by the Department of Justice’s directions, protocols and updates to ensure the safety of staff and prisoners.
"As nurses we’re used to donning PPE, but this was a new part of the role for Prison Officers," she said. "We were updated on COVID issues as they were emerging on at least a daily basis and often more frequently. We used this information to educate and reassure the prisoners. Understandably they were very concerned for their health and their families.
"We used every opportunity to interact with the prisoners and educate on the importance of hand washing, social distancing and cough/ cold etiquette.
"Prison nursing can be very challenging but also very satisfying. It’s important to be able to strike up a good rapport from the start. I would definitely recommend this job. Patience, flexibility, good problem-solving and communication skills and a sense of humour are important factors of the job.
"Everyone has a story before prison, and it’s not our job to be judgemental."
If you would like to join Belinda as a nurse in one of the Department of Justice’s custodial facilities for young people or adults, visit the jobs.wa.gov.au website for advertised nursing positions in WA prisons and the detention centre.
For more information about nursing in a custodial setting, contact the Coordinator of Nursing on 61 8 9334 6069.
