Nursing Review Issue 4 | Jul-Aug 2017 | Page 25

workforce interactive online orientation program for students that go out to those placements. Can you tell us a bit more about that? their neck and worrying that it would be an easy target for an angry prisoner to grab hold of and choke them or something like that. Some students found some of the staff a bit confronting. One of the things that also came out was that they found it difficult to develop the therapeutic communication strategy with prisoners, particularly when they were very distressed coming into the prison for the first time, and how to deal with that and manage it in a professional way. Some students did comment that it was a confronting environment and that they felt a bit overwhelmed. Having said that, over time they generally settled in, and at least one of them went back and had a second placement because they started to feel that they’d like to do that as a job once they finished and graduated, and they just wanted to have another go to see how it went for them. I think in the end the majority of them really enjoyed it and got a lot out of it. Several of them commented that it was only towards the end of their placement that they felt comfortable, and that kind of led us to think that we needed to find some way of helping them to adjust to the placement more quickly I suppose, so that they got more out of it earlier in the piece. Some students also said they found it hard to separate the prisoner from their crime and therefore had difficulty in dealing with prisoners. So many of the students commented on the fact that maybe we needed some sort of screening process to make sure that the right sort of student went there as well, which was quite an interesting comment I thought. And what did preceptors have to say about the placements? Preceptors I think were generally happy with the students, but they did comment that they also felt that they could’ve been a bit better prepared for the environment. That led us to think about how we might do that better. One of the things we’re working on is an We went through all the different things that students raised as issues and also the things that preceptors had talked about as being issues. Part of that was educating the students a bit more on the normal processes in the prison setting – you’re going to have to go through a screening, you’re going to have to leave your mobile phone behind, you’re going to have to bring your own lunch because you can’t leave to get lunch. It’s also about the types of conditions that prisoners typically have, so that they could be a bit more prepared and have done a bit of research in terms of what to expect there. We’ve done a lot of work on managing therapeutic communications. We’ve developed some scenarios that we’ve used actors for and videoed them. Then we’ve made decision points within those so that students can practise how they would respond to that kind of situation. Then in the decision tree, it takes you down different pathways and you can see which one works better, because one of the things that comes out in the literature about working in offender populations is the fact that the prisoners can be quite manipulative. There’s an interesting article out there somewhere that outlines how prisoners start to refer to people as ducks, and it sounds a bit weird, but prisoners can deliberately set out to manipulate staff into breaking the rules for them and then getting, I guess, a kind of blackmailing control over staff by doing that. So they set them up and use flattery and various things to try to get people to do minor infringements and then use that as a strategy to get what they want later on. So we put together some stuff around that in terms of the kinds of manipulative behaviour that people might try and how you can address that. Anyway, it’s a work in progress and will be a good resource when it’s finished. We’re collaborating with the staff from the prison health service to put that together. What else could be done to ensure students get the most out of clinical placement in a prison health service and that the right students are learning on the job in the right environments? One thing that came out of our research was that perhaps the staff in the prison health setting needed to be a bit more au fait with exactly what we were wanting for our students, so that they could deliver that better to them. Also, there was a suggestion that we could perhaps do some screening of students to look at their attitudes towards prisoners. One of the things that came out of the data was that there were comments from some students that they had heard others say things like: “Oh, yeah. I’m going to go to prison health. It’s going to be really cool.” They saw it almost as a “I’ll sound really cool if I say that I’ve done my placements in prison health”. Then the reality when they get there is that ‘coolness’ is probably not the thing that we’re looking for. It can be a confronting place, and in turn people need to be serious about it and they need to have the right attitude about why they’re going to be there. In terms of preparation, they need some sense of what it’s going to be like, and for us, we need to look at a way of screening so that we’re getting people who can deal with the kind of setting they’re going to be placed in. ■ nursingreview.com.au | 23