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Profile: nursing behind bars

Louise Naughton
Reporter, Nursing in Practice

A prison may not seem like the ideal place for a nurse, with testosterone- fuelled angst at every turn. Emma George, a Senior Sister at HMP Wandsworth, tells Louise Naughton why it is the perfect place for her

Like a lot of people in caring professions, Emma had always wanted to be a nurse from a young age. "I had all the outfits and used to carry around dolls - looking back it is hideous to think of. I should have aspired to do something much more glamor- ous," she giggles.

While studying for her A-Levels at Presdales School for Girls in Hertfordshire, a one day a week placement work-
ing with adults with learning disabilities transformed Emma's childish fantasy of nursing into a real-life career goal and cemented her desire to become part of the profession.
Although a love of caring for people with learning disabilities kickstarted Emma's career in nursing, it was while studying at City University that she began to realise that the fast-paced and high-pressured role of an A&E nurse might be for her.
After university and a brief stint in an acute stroke and medical ward at the Chelsea and Westminster Hospital, Emma got her chance to work in an A&E department at St George's Hospital in Tooting, South West London.

"My learning curve [at St George's] was huge," she says. "I learnt so much, from trauma and minor injuries to acute medical and suturing skills.

"And all this with a great bunch of people. A&E nurses tend to work really hard and play really hard as well."

The unpredictable nature of A&E is what ultimately drew Emma to the role - a trend that has continued throughout her career to date. So how did Emma make the move from an A&E nurse, a role at the beating heart of a hospital cushioned by a team of supportive and loyal colleagues, to a prison nurse? Could it be that unpredict- able nature again?

After a couple of years in A&E, Emma, together with a friend, packed her bags and jetted off to South East Asia, Australia and New Zealand. Recalling the pondering of her future on her return, Emma says, in a somewhat embarrassed way, that she had decided she wanted to "heal the sick". A role in the ICU at King's College Hospital she found "sad and draining", so she decided to return to her comfort zone at St George's A&E department. However, it was all change and a more senior position brought about more managerial responsibilities and less clinical work. Emma's career up to this point had been fast-moving, dynamic and demanding, enough to take its toll on anyone; by her own admission she had become burnt out and it was time for drastic change.

Becoming a prison nurse was something Emma had never entertained, despite working with nurses at St George's who were linked with HMP Wandsworth. They encouraged Emma to visit the prison - an offer that would most likely fill people with dread and fear - and thanks to her ever-present craving for an unpredictable and challenging working environment, she found it to be a perfect fit.

During her first visit back in 2009, Emma discovered it was her interest in the unknown that spurred her on.
"I had heard the horror stories, just like everybody else - that the prison would be like something out of Silence of the Lambs. I was just relieved nobody spat at me when I first walked through the door," she recalls. "It is actually a very normal environment."

She had her first moment of "What am I letting myself in for?" when she walked through the security gates and was greeted by "stern looking" members of staff.

Yet this feeling quickly evaporated as she settled into her role. She is now so in tune with her environment that she can identify changes in atmosphere very quickly. With the frequency of alarms raised dependent on the prison population, an influx of convicted London rioters has not helped the mood seen on the wings recently.

Emma takes the challenges in her stride and says all she has to do is remind herself the aggression is not personal as a way of removing herself from the, at times, threatening atmosphere present on the wings.

"Well, that and a large glass of wine after work helps!" she says.

She also credits her uniform as a way of providing a barrier between her and the prisoners.

On first impressions, Emma found the prisoners to be "nice", "absolutely normal" and "polite", although one violent incident gave her a rude awakening and reminded her exactly where she was.

"I got hit once, but that was me being in the wrong place at the wrong time," she says.

Displaying no lasting signs of trauma, Emma shrugs off the assault. "I don't want to sound like a victim, it was more my fault" she says. "I was trying to help him and judging by the state he was in, in hindsight it would have been better if I wasn't so close to him."

As the lead for nurse recruitment at HMP Wandsworth, Emma is clearly wary of relaying her story for fear of putting other nurses off the idea of working in a prison. She stresses that she feels "more safe" working in a prison than she ever did working in A&E, thanks to the support network she has access to.

Despite the obvious challenges of having to deal with difficult patients, Emma claims the biggest challenges of working in a prison are those of access, the 'unknown' nature of patients and recruitment.

Never one to rest on her laurels, Emma is currently undertaking the Advanced Practice Course at South Bank University covering non-medical prescribing.

She plans to stay at HMP Wandsworth for the foreseeable future and work in the walk-in centre, currently under development. Her dream to live by the seaside means she will not be a prison nurse forever, but for now, it seems, she has found her niche.

EMMA'S WORKING DAY

  • Shift starts at 7.30am, handover from the night staff
  • Take-over on the emergency radio Nurses allocated to all areas on wings, hospital units, screening areas
  • Co-ordinate the shift and deal with any staffing issues that crop up
  • Check emergency response bag
  • See any prisoners refusing to go to court on medical grounds and report back
  • Visit care separation unit that houses prisoners with manage- ment/behavioural problems and provide welfare checks
  • Respond to medical emergencies - this can be anything from a medical emergency (someone feeling unwell in their cell or while they are at work) to making sure there are no injuries following a fight on the wing
  • Respond to all alarms raised on the wings
  • Shift finishes at 6 pm