Home > Report on nursing in the Irish Prison Service.

Lyons, Suzi (2010) Report on nursing in the Irish Prison Service. Drugnet Ireland , Issue 33, Spring 2010 , p. 23.

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Nurses first began working in the Irish Prison Service (IPS) in 1999. The IPS and the Nursing and Midwifery Planning and Development Unit (NMPUDU) of the HSE Eastern Region collaborated in a recent study exploring the opportunities for the development of nursing services in prisons.  The results of that study have now been published.1  

The study included a literature review on the role of nurses in prison healthcare, a descriptive review of the IPS and the professional framework for nursing in Ireland, and a quantitative questionnaire completed by nurses and medical orderlies working in the IPS (32% response rate). The qualitative components were participant observation and semi-structured interviews with key informants, including prison management and those internally and externally involved in prison healthcare. Focus groups were held with three groups of nurses and three groups of prisoners. Data collection took place between November 2005 and December 2007. 
 
The findings of the study covered a wide range of health and professional issues; this article will focus only on the results related to substance misuse and addiction. In the quantitative questionnaire, care related to substance misuse featured in the 14 most frequently performed clinical tasks, and was carried out on a daily basis by 50% or more of respondents to the questionnaire. More than half of the nurse respondents identified addiction as one of the areas where specialist training should be developed.
 
In the qualitative part of the study, participants highlighted addiction and its consequences as an important healthcare problem. Participants reported that cannabis, benzodiazepines and heroin were the most common illicit substances used in prisons, although availability varied between prison sites. While methadone maintenance treatment was available in most prisons, the need for improved treatment for problem use of other substances, in particular benzodiazepines and alcohol, was raised by many participants. Treatment for addiction was reported to be inconsistent, with a lack of counselling services2 and there was 'some confusion in relation to approaches to detoxification, methadone dose and access to treatment' (p. 82). Most participants reported a need for improved education and training in addiction care for nurses. Prisoners also highlighted the need for peer support and improved discharge planning in relation to addiction care. 
 
Mental health problems among prisoners, especially those who had a dual diagnosis (both a mental health issue and a substance use disorder), were identified as a significant and challenging health issue by all participant groups.  
 
The authors conclude that nurses have a very important role in addressing the health needs of prisoners. They found that there was a strong awareness of the importance of prison healthcare and that nurses did receive recognition and support from all the stakeholders involved. However, they also found that nurses could be used more effectively within the IPS.
 
The report sets out 16 goals for the future development of prison nursing and healthcare in Ireland, each with its own set of recommendations. The authors state that many of the recommendations do not require additional resources or funding, but restructuring and integration of existing services and resources and effective collaboration at all levels.
 
The goals are:
  • Enhance the strategic development of prison healthcare
  • Identify and meet prisoner health needs
  • Develop and implement policies, procedures, protocols and guidelines
  • Develop nursing role:
    • role definition
    • advance capacity for specialist and advanced nursing practice
    • advance skills and competencies
  • Develop professional development infrastructure
  • Support practice with the scope of Nursing and Midwifery Practice Framework
  • Enhance quality and governance
  • Develop workforce planning
  • Strengthen nursing practice – access
  • Strengthen nursing practice – committal assessment and care planning
  • Balance the therapeutic and custody roles
  • Develop prison healthcare infrastructure
  • Implement recommendations
 
1.  Nursing and Midwifery, Planning and Development Unit & the Irish Prison Service (2009) Nursing in the Irish Prison Service: working together to meet the healthcare needs of prisoners. Dublin: Health Service Executive.
2. Since 2008 Merchants Quay Ireland has provided national prison-based addiction counselling services to 13 prisons.
Item Type:Article
Issue Title:Issue 33, Spring 2010
Date:19 April 2010
Page Range:p. 23
Publisher:Health Research Board
Volume:Issue 33, Spring 2010
EndNote:View
Accession Number:HRB (Available)
Subjects:J Health care, prevention and rehabilitation > Health care programme or facility > Prison-based health service
T Demographic characteristics > Nurse
VA Geographic area > Europe > Ireland

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