“ You have to be tough . Because then on the next day you go down to see another woman who ’ s maybe been using drugs and she ’ s high and she ’ s screaming at you , ‘ You need to do this for me . You need to do this . You have a duty of care to do this ’.
“ You ’ ve got one extreme to the other , you ’ ve got the women who have poor health literacy . They don ’ t understand their body , so they ’ re talking about something that , to them is the most important thing , because that ’ s all they ’ ve been able to think about because they ’ ve been locked down for 14 hours ; they don ’ t see anybody until the very next morning .”
There is often the “ clash of care and custody ” as she puts it .
Another example might be if someone becomes unwell and needs surgery or hospital treatment . Unlike in the outside world it can be quite an arduous task to get a prisoner to a hospital in an emergency . Forms must be filled out and legislation followed before anyone can be considered for a trip outside .
“ Because you can ’ t just stick someone in an ambulance or an Uber , they ’ ve actually got to be legally permitted to go in a vehicle and go to the hospital .
“ Of course , they ’ ve got to have two staff with them as well if they ’ re a normal prisoner . If they ’ re a high risk of escape , that ’ s a whole other gambit . They could have two officers and a dog handler and someone who ’ s armed with them as well , if they ’ re a high risk of flight .
“ From my point of view , I might say , ‘ They need to go to hospital now .’ Corrections will say , ‘ We ’ ve got no staff , can they wait ?’ Well , no , they ’ ve got cellulitis on their lower legs from injecting , it can ’ t really wait . They really need to go and have that treated . Or maybe it ’ s a boil and it needs to be washed out in theatre and they need antibiotics .
“ Corrections will just take their sorry time and gather the staff . They take their time about it , sometimes you ’ re up against that kind of thing .”
It is these insights and experiences that Bloice wants more of as she embarks on her PhD . Bloice wants to use nurse stories to try and keep people out of prison and ultimately , stay healthy .
“ As a nurse who ’ s been there for a long time now , I ’ m seeing the same familiar faces coming back into prison . When they leave they ’ re only given seven days ’ worth of medications , and the expectation is ‘ you ’ re now a mainstream person , you can go to your own GP and fill your script ’.
“ Off they go , out into the world , and let ’ s face it , often these people can ’ t cope with it . They don ’ t follow-up , they don ’ t go and get medication . They fail to attend their outpatient appointments . They end up in emergency because it deteriorates and that ’ s what you do .
“ I would like to keep them out of prison , but most of all I ’ d like to make them healthier . I ’ d like to make sure that they have a good discharge plan . My research to date is leading me to the nurse navigation model or the case manager model , whereby they ’ re assigned someone in the weeks leading up to their discharge , where we have a chat , get a forwarding address , maybe a mobile number – a lot of these people don ’ t have credit , don ’ t have mobile numbers – just so we can keep in touch with them , so that somebody can say , ‘ Now , you remember , you ’ ve got a cardiac investigation ’ or ‘ you ’ ve got an echo ’.
“ There are strict boundaries , which is really difficult when you ’ re a caring , nurturing person .
“ They often fail to attend , but if this navigator , case manager was to follow them up , pick them up even , take them to the appointments …”
While the study was originally focused on the direct experiences of women who have been in prison , Bloice explains that a new perspective around health care workers will assist in creating sustainable corrective health service models .
“ My research journey took a turn when the barriers became insurmountable to interview women directly . My supervisor suggested that I ask navigators to be participants and to seek their experiences of caring for the women rather than the women themselves .
“ This led me to a new focus whereby I hope to gain insight into the lives of women as experienced by the navigators ,” she says .
Bloice believes the research will be life-changing for some women with additional support in place once they are released from prison .
“ Health services will be able to improve the women ’ s transition back to the community and aims to improve on the current model of care .
“ I hope that all women prisoners leaving prison will benefit from support for their health and therefore reduce emergency department or hospital admissions , avoid missed care or follow up appointments .” ■
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