A day in the life of a ... prison nurse

1 March 2014

Denis Allen starts his working day by heading through a metal detector scanner, picking up a kilo of keys and radio before passing through eight remote controlled doors to arrive finally at the prison health clinic. Find out more about his day

NAME: Denis Allen JOB TITLE: Registered nurse LOCATION: Hawkes Bay Regional Prison, Hastings

6:00 AM WAKE

Usually I wake before the alarm. Today I am working a 7.30 shift. After breakfast, I sort the dog out, feed and liberate the chooks and make a cup of coffee for my wife (who has the task of waking our teenage son up). A quick look out the window and decide to take motorbike and not the car to work today.

7:15 AM ARRIVE AT WORK

I arrive at the prison guard house, proper name ACF (Access Control Facility). Stow my gear and go through the scanner; no metal objects on me, no prohibited items. Head to key room to receive the keys I need today. I also pick up a radio – all-in-all, over a kilo in extra weight to carry around.

I have been nursing for almost 40 years now after going through hospital (both psychiatric and general) based training. I’ve also done military nursing and occupational health nursing. I started working at HB prison in 1995, left for three years to work in occupational health, and then returned in 2007. Some of my clients (and staff) accuse me of being a reoffender. I find prison nursing to be one of the most challenging and rewarding areas I’ve worked in. We are responsible for assessing and managing many acute and chronic health conditions, both physical and mental. I guess I am well-suited to this rather unique environment; it feels comfortable, both professionally and physically.

7:25AM ARRIVE AT HEALTH CLINIC

Pass through eight different remotely controlled doors to get to the clinic. It’s very quiet, the earlier shift are out in the satellite units (where the majority of the over 600 prisoners are housed). I’m on the 0730 shift so mostly in the main part of the jail, which has approximately 180 high security prisoners. Nurse clinic appointments for the day include the usual list of blood tests, new arrival health assessments, and requested appointments. Today is Friday, so also dentist day. Greet the health prison offer and discuss general flow of patients for the day. The next hour is taken up with preparing the morning medications and issuing medications to prisoners who “walk over” from satellite units.

8:40 AM MEDICATION ROUND

Off on my medication round for patients in the main jail. There are six units to cover and many gates and doors to open and close.

9:30 AM BACK IN CLINIC

I’m back with a few health issues from staff and patients, to follow up. The dentist is in full swing. The health officer tells me she has “one for me”, a blood sample to gain. I know this patient. He has regular (28 day) blood tests as he is currently taking the antipsychotic Clozapine. He doesn’t particularly like having blood tests and venous access is not easy. He is very suspicious but has enough insight to know how important the blood tests are. We talk as we walk to the exam room, keeping the conversation light.

12:00 PM CATCH UP & LUNCH?

Morning duties are completed. The midday shift nurse is already here and – depending on new arrivals from court, transfer, or police – we should be able to see the remaining patients on the nurse’s clinic list this afternoon. Time to grab some lunch and catch up with other health centre staff.

12:15 PM LUNCH INTERRUPTED

Well that didn’t last long: the health officer tells me there’s a phone call for me. It’s the DHB with instructions for a patient.

12:20 PM SECOND ATTEMPT FOR LUNCH BREAK

Back to the staff room; nobody there, “Nigel no mates!”

12:30 PM GIVE UP ON LUNCH…

Health officer interrupts again, says she is sorry; not sure about that, but (a wise man once said “always ignore everything before the but”) she has a patient waiting for his lunch-time controlled drug. Lunch over!

3:30 PM SHIFT OVER

Afternoon duties over. The dentist has completed his list of eleven patients, the nurses’ clinic list is mostly completed. Most patients have been seen, some unavailable; at court, transferred, or with lawyers and all have been recalled and rebooked. I have also carried out a physical and mental health triage screen of two new arrivals at the receiving office. One is a patient we know well, returning only a short time since he was released. He assures me he is neither “at risk” of self-harm nor is he contemplating suicide. He says he saw his GP while he was “out” regarding his antidepressant medication but is more intent on obtaining NRT (Nicotine replacement therapy) patches. After a brief discussion, he decides he really isn’t a current smoker and is trying to obtain NRT for ‘currency’. Notice he has ‘pocketed’ my pen following signing a form. He says, “I thought I had it then,” and laughs. Not a bad day at work, very typical for working the 7.30 shift; no “break, break, break” (emergency) calls, a mixture of planned and unplanned activities, and I get away from work on time.

4:00 PM HOME

Great ride home on the bike – a beautiful Hawkes’ Bay day. My son is home already. I hassle him off the Xbox to do his chores (dog and chooks) and homework. I get in the washing, sort, and start preparing dinner. My wife will be home soon, so its nice to sit down for a chat with her before dinner. My son does his chores but is now on YouTube and requires more hassling to start his homework.

7:00 PM

Watch the delayed news and get motivated to turn on the computer to look at the work coming up for the postgraduate paper I am working on at EIT. All I do is answer some forum questions and leave the quiz questions until tomorrow.

9:00 PM

Hassle teenager to get off the Xbox, tell him it’s time for bed.

10:30 PM

Off to bed, should have gone earlier but watched something on TV, can’t remember what it is! Hassle teen to put his book down and turn off light; remind him I love him (he mumbles “Love you, too”).