Nursing an arresting profession

Published: 10 May 2016

Thursday, May 12, the anniversary of Florence Nightingale’s birth, is International Nurses’ Day – a worldwide celebration of the contribution nurses make to society.

But while nurses who work in hospitals or in the community may well be the focus of attention on the day, there’s one group of dedicated professionals who will probably slip under the radar: custody nurses.

Burnett Road Police Station in Inverness has 42 cells where people are held after being arrested, and is the principal place of work for a team of nurses whose job is to look after those in custody.

Jane MacPhee admits that when she embarked on her career in nursing, the last place she thought she would end up is in a police cell. However, the NHS Highland senior charge nurse views Burnett Road’s custody suite very much as her “ward”, a place where she does what nurses the world over do: tends to people with care and compassion.

Custody Suite Nurse

“Not everyone would want to do this job but it’s essentially the same as nursing in a hospital environment,” she said.

“There are people here who need care and medical attention, and that’s what we give them – without prejudice.”

Jane’s colleague nurse practitioner Fiona Bradley added: “It is no business of ours what people are in here for. We’re here simply to nurse them, and their care is our priority.”

A nurse since 1994, Jane did a variety of jobs before starting work with Medacs Healthcare, the company which provided nursing services in the custody suite. At the time, that involved Jane and a GP being called to the police station whenever their services where needed. However, in 2012, the NHS took over from Medacs and a nurse-led model, with staff based permanently at the station, was introduced.

Today, Jane works with a team of four full-time nurses and several “bank” nurses –  who provide temporary staffing cover – at the station, with one nurse being on hand at any one time, 24 hours a day.

“I absolutely love working here,” said Jane. “I have an amazing nursing team and we have a great relationship with the police. As for the job itself, there are obviously some things about working here that are different to what nurses might do in, say, Raigmore Hospital.”

Fiona added: “People don’t come here to get better. They come because they’re brought here. Some of them will have done some bad things, not all are charged, but very few of them will actually want to be here.”

And the majority of them will have drug and/or alcohol dependence. Some – a growing number – will be using new psychoactive substances, or “legal highs”. Some will be violent and abusive. Some will have a history of self-harming, or have suicidal tendencies.

Many will have health issues associated with a dysfunctional lifestyle.  Some, perhaps those in a cell for the first time, can suffer panic attacks. Others will feign illness in the hope that they will be transferred from their cell to a more comfortable hospital ward.

Custody Suite, Inverness

“There are a lot of vulnerable people in the Highlands, and many of them turn up here,” said Jane. “The police have to be very tolerant and respectful, and we do too. We cannot be judgemental.”

Fiona has worked as a staff nurse and a community nurse on Skye, spent some time working as a midwife in Australia and for a year was a medic on the North Sea rigs.

“Working here, more than anywhere else I have been, has made me appreciate what I have,” she said. “We really do see a side of life not everyone encounters.”

Given the nature of those the team works with, their safety, and that of the nurses, is paramount. There are panic strips throughout the custody suite, which are used to sound alerts if needed. Nurses never enter a cell unattended, and to protect themselves they never approach a cell door hatch head-on.

The nurses’ daily routine is geared largely towards ensuring that those in custody are as well as can be, and certainly well enough to go to court. They may be asked by police to review someone who is in alcohol withdrawal, and medicate as necessary.

They may be asked to see someone complaining of feeling unwell, or patch up someone who has minor injuries; those with more significant injuries may have to go to hospital. They may have to call in one of the GPs who cover the custody suite on a rota basis.

Custody Suite Nurse

“There’s always plenty to do here,” said Jane. “And we have to make decisions quickly. This isn’t like being in a ward, where you get to spend a lot of time with your patients. Here, people may come in overnight and be out the next morning.

“Basically, we try to turn what is often a horrendous situation for some people into one that is tolerable for them. But that’s what other nurses do too.”

WANT TO BE A NURSE?

A good first step is to talk to your school guidance teacher, who will support you to attend careers events and careers programmes. A “So You Want to be a Nurse?” event is run in the Highlands every year. You can also ask about doing work experience with NHS Highland.

The next step is to complete a pre-registration course approved by the Nursing and Midwifery Council (NMC). You can do this at Stirling University’s campus at the Centre for Health Sciences, Inverness, as well as at other universities. Students can choose one of four nursing degree specialisms: adult, children, mental health and learning disabilities. There is also the opportunity to combine two of the specialisms by studying for an extra year.
Successful completion of this degree-level course means you can be included on the NMC’s register and can work legally as a nurse in the NHS.
If you don’t have the required qualifications, by applying for healthcare assistant or assistant practitioner jobs within the NHS, you may be able to do the university course on a part-time basis. Speak to Skills Development Scotland advisers at school about how to study for SVQ qualifications for healthcare assistant roles.

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