Mina's journey as a nurse has been one marked by dedication, compassion, and an unwavering commitment to the well-being of her patients. From her early days working in the NHS to becoming a Custody Nurse Practitioner, her path has been anything but ordinary. As a Custody Nurse Practitioner, Mina plays a crucial role in providing medical care to detained patients—individuals who are often in complex, vulnerable situations, requiring both immediate attention and a sensitive, ethical approach. In this article, Mina shares her personal journey, offering insight into the challenges and rewards of working in this unique role, where medical care intersects with law enforcement and the justice system. Her experiences reflect not only the evolving nature of nursing but also the deep responsibility that comes with caring for individuals who find themselves on the margins of society.
What made you decide to leave ward nursing and become a Custody Nurse
Practitioner?
Leaving bedside nursing was not a one-night decision. It took time since I was considering applying to some speciality however the turning point for me was when I saw all my colleagues who I like working with started to leave one by one. There are a lot of reasons people are leaving the NHS and I won’t speak negatively of the NHS because I learned a lot when I worked there, and everybody knows what is happening anyway.
How did you first hear about the role of a Custody Nurse Practitioner?
I first heard it from one of my patient’s wife. I like talking to my patients as I get to know them more by having a chat with them. It was a usual busy day, I mentioned to them how busy it is now in the ward. She said I should try forensic nursing, I did not get a chance to ask her what the job entails since I was doing a lot of things but it did stick to my mind. So one night, I tried looking for more information about it, but there is none. I saw an opening for a Custody Healthcare Practitioner and decided to apply.
Was it difficult to transition from working in a hospital ward to working in police custody?
The transitioning was not that difficult because I was well supported, and the job is manageable. The only thing I see being difficult or even scary at first was being on my own. I remember on my first few days I always think if I’ve assessed them correctly because on the next day you won’t be able to see them. But I am used to it by now, there’s always a next nurse also to take over. Unlike working in the ward, you will still get to know what happen until they get discharged. It’s also a big help as we have senior healthcare practitioners that can guide you in instances that you are not sure of what to do.
What steps or training did you need to take to prepare for this role?
Honestly, I did not prepare to be a Custody Nurse at all. I never knew about this job till someone told me about it. I got lucky I worked in a short stay unit ward, as I got to experienced taking care of patient from every ward, as they get to be admitted to us, its either they go home, or they go to their specific ward if there is a bed available. I even experienced looking after patients who has mental health issues, which we also dealt with in custody. I would highly suggest that you work in A&E, triaging is one of the skills you can use here so you can mitigate risks. Custody is a risk-averse department, as much as possible we want everyone to be safe to detain.
What are your main responsibilities as a Custody Nurse Practitioner?
As a Custody Nurse Practitioner, I have to ensure the health, safety, and welfare of detainees in police custody. I also need to plan for detainees who have various medical conditions and are likely to be vulnerable as this can affect their fitness to be detained and interviewed. If there is a detainee who is under my monitoring I make sure to guide staff on what symptoms to watch out for and to report to me. I also need to document accurately as we can be called to court as a witness. I also collect forensic evidence to help with police investigations.
How does your day-to-day work in custody differ from your previous role in the hospital?
My day-to-day work in custody is different from the ward and every day is different depending on the sets of ‘detained people’ I look after. My shift is 12 hrs and it’s a pattern shift, 2 days and 2 nights then 4 days off, the very first thing I do is to log on to the computers and then read the handover and check on the system if there is a medical referral that has not been answered yet. Once I'm ready, I will ask an officer to bring the detainee to the medical room, however, sometimes they will refuse to come to the medical room, so I see them in their cell instead. I don’t feel scared to go in their cell since I have someone with me anyway and mostly the officer will advise if it's safe or not. There are days that I call 2 ambulances to transport a detainee in hospital, there are days that I see 13 detainees and there are also days that I only see 2-3 detainees. If there is a detainee who needs to be seen by a liaison and diversion team (they deal with mental health issues), I sometimes chat with them about it as well. Some referrals are as simple as requesting pain relief and some referrals will say that the person has a fracture. I sometimes liaise with the pharmacy if a detainee is on methadone, I arrange for collection, so they won't miss their dose for the day. There are chaotic days but there are calm days as well.
What challenges have you faced in this new role, and how did you overcome them?
I think the only challenge is dealing with aggressive people and self-harmers. The aggressive one sometimes I can only see them via the open viewing hatch, I can only do a visual assessment. I still need to see them as I need to rule out ABD (acute behavioral disturbance) which is a medical emergency. If it’s not ABD, they will settle at some point, and I get to do a full assessment after. People at risk of self-harm will always be on constant watch, because they may harm themselves once you close that cell door. We will know anyway because it will be recorded on the system. There are also times when there is a staff shortage, I am required to cover 2 custody suites, it’s the most challenging task to do. I have to properly plan who I should see first and which custody I should stay for a long period. The travel won’t be a problem since there is a driver who will take you to each custody, but it’s the thing I don’t like doing the most, but it doesn’t always happen.
What do you enjoy the most about being a Custody Nurse Practitioner?
I love working on my own and able to plan my reviews. I like the variety of people that I get to see every day. I got to learn about some laws, get to meet new people and it also opened another career path. I feel valued here as the team are always thankful and sometimes at the end of their shift, some of them pass by the medical room to say thank you. I will also get the chance to study non-medical prescriber and forensic nursing courses.
How has your experience as a ward nurse helped you in your current role?
It did help me a lot, especially having a background working in a Short Stay Unit (SSU). I also worked in a Stroke Unit before but I think my experience in SSU is the one that got me in this job because I was able to show them during interview how I manage and prioritise patients when dealing with a medical emergency because it can happen that you will be dealing with a medical emergency and you have to lead your team, who are trained to assist with emergency life support but are not medically trained, on what to do. I haven’t experienced any medical emergency when I started this job, hopefully, I won't. I also got to experience working in A&E whenever I get pulled out, which I don’t like as much as I always get to be a corridor nurse.
What advice would you give to other nurses considering a career as a Custody Nurse Practitioner?
If you want to be a Custody Nurse Practitioner, get as much experience as you can in the hospital, I suggest A&E, as it will be helpful when you develop skills in triaging. Some of my colleagues here has worked in various medical settings such as A&E, ITU, Paramedics and Mental health. You also must be firm, as sometimes they will try to manipulate you. You must be kind and can act as advocate, when I review my patients, sometimes I don’t even read why they were arrested unless I really need to know because some of them are not totally a bad person, and they just had a bad start in life. There are times when you will see a person who’s done the most awful things you can imagine, but you still treat them as a person who needs a medical attention. This job is very different as you got a lot of autonomy, but if you need help in certain situations, there is always support.
Mina's journey from a dedicated nurse in the NHS to a Custody Nurse Practitioner is a testament to her resilience, passion, and commitment to serving those in need, no matter the circumstances. Her story highlights the powerful impact that Filipino nurses, like her, have in shaping healthcare in diverse and often challenging environments. As she continues to navigate the complexities of her role, Mina remains focused on providing compassionate care to detained patients, proving that nursing is not just about treating the body, but about offering dignity and support to those who need it most.
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