I am a public health practitioner working on a range of projects, but as a former mental health nurse, I miss working with patients and being part of their journey towards improved mental and physical wellbeing.
When I was approached to work at our local prison with staff and prisoners on the implementation of the smoking ban in all Scottish prisons on 30 November 2018, I jumped at the opportunity that would enable to me to draw upon both my psychiatric nursing and public health skills and knowledge.
I was under no illusion that this work would be easy after all we know that both the numbers of prisoners smoking and with mental health problems is far higher than the national average.
While many prisoners thought stopping smoking was a good idea and could see the benefits, many did not and we had a job to do with a very clear deadline.
There is no doubt that prisons are challenging places to work but that was one of the attractions for me. Yes, there are very specific rules and regulations that need adhered to around safety and security but they are not dissimilar to those in a psychiatric hospital.
I could see parallels between this work and when I worked in a busy adult acute psychiatric ward where patients are reluctant to take medication and abide by the restrictions placed on them to ensure their safety and the safety of others.
It made sense for me to approach this piece of work in the same way that I approached my nursing – in a way that was person-centred, flexible, accepting that things don’t always go to plan and that situations can change without warning and treating people the way you would want to be treated yourself.
Throughout my nursing career I came across many challenges. Prisons are no different – they are institutions with regimes and people who would rather be elsewhere. Yes, there were times when I did feel stressed and intimidated by the situation, but I never felt unsafe as officers were always nearby and I had completed personal protection training.
Thinking back on my nursing career, my best experiences were where I felt part of a team, so I worked hard at being accepted as part of the prison team by working with many different departments, such as the health centre, media unit, family centre and library and getting my face known by both staff and prisoners.
“I knew the importance of being flexible and not getting too upset when things did not go according to plan”
I look back on my two years working a couple of days a week at the prison and feel very privileged to have been in that environment which, let’s face it, only a minority of the population actually see and most have their own ideas of what it is or should be like.
While having a background in mental health was not a pre-requisite, I definitely feel that it helped in that I had experience of working with challenging people with very complex needs. I knew the importance of being flexible and not getting too upset when things did not go according to plan – as was often the case. Mental health nurses (or maybe all nurses) are often known for their “black” humour, which I do think is our way of coping with serious or difficult situations.
Many of my public health colleagues could not understand why I enjoyed my prison work so much, but at the end of the day, not all prisoners are bad people – although I agree that some do not deserve to see the light of day again. Many of them have had difficult upbringings and sadly for some, they are following in the footsteps of other family members, while others have just been in the wrong place at the wrong time.
Carole-Ann Duff is public health practitioner, NHS Grampian Public Health Directorate