High numbers of people are currently incarcerated in Australia’s prisons. This population is estimated to have a much higher rate of many chronic diseases, such as diabetes, hepatitis C, hypertension, asthma, and skin infections. As well, mental health conditions are widespread. Nurses play a crucial role in ensuring that while in prison these people receive health care that is equivalent to what people would receive in the community. An opportunity exists for nurses to take the lead and improve the physical and mental health outcomes for those who are incarcerated. This timely conference addresses the health needs of people in prison. Topics include:
Sleep in custody – you’re dreaming!
Metabolic monitoring and antipsychotic medicines
The ethics of euthanasia in prison
Death in custody and your duty of care
The psychology of sex offending and much, much more …
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8:30AM Registration for Day One
Acknowledgment of Country
Introduction to Conference
Dr Linda Starr
Behind Bars – Nursing People in Prisons
Nurses working in prisons require highly specialised skills to meet the vast array of professional challenges that exist. This introductory session sets the scene by creating a discussion around the key professional issues that are most pertinent to nurses working, or considering working, in prisons. It includes:
What are the major international standards and local principles that exist for the provision of healthcare in prisons?
What is the doctrine of equivalence and why is this so important?
What are core nursing responsibilities when working in prisons?
Trauma-Informed Care – A Balancing Act?
Understanding the impact of adverse childhood events and cumulative stressors throughout life is essential if we are to create a safe and empathetic environment that aims to minimise re-traumatisation. The origins of trauma-informed care stem from a large study that investigated the correlation between adverse childhood events (ACE) and long-term health problems later in life. This session looks at the concept of trauma-informed care in the context of correctional settings. It includes:
What is a trauma-informed approach to care?
What is the relationship between trauma histories, crime, and incarceration?
How can you incorporate a trauma-informed approach to the care you provide?
Is it possible to apply these principles to systems to overcome institutional trauma?
10:45 Morning Tea
The Neuroscience of Addiction
Addiction has long been recognised as a disease of the brain. Vulnerable individuals that consume these substances exhibit changes to their reward centres in the brain, encouraging drug-taking or other addictive behaviours. Understanding the neuroplasticity of addiction has clinical significance for treatment and enables a more holistic approach. This session will reveal what is happening in the brain when a person is experiencing an addiction. It will also explain how an addiction develops and, in so doing, will reinforce the need to see the person, not the disease. It includes:
How do illicit substances change the brain?
How are the reward centres in the brain stimulated by addictions?
What happens to key neurotransmitters?
Why do some people become addicted and others don’t?
The ABC of Hepatitis B and C
Hepatitis refers to inflammation of the liver. Hepatitis is caused by a number of factors and can progress to cirrhosis, a late stage of liver disease. This comprehensive session focuses on viruses, in particular Hepatitis B and C. It will ensure you are clear on the facts and the recent discoveries in relation to the transmission, progression, and treatment of Hepatitis B and C. It includes:
What’s the difference between Hepatitis B and C?
How are they transmitted and who is most vulnerable?
What are the testing and disease courses/stages of Hepatitis B and C?
What is new about our knowledge of these diseases?
What are the aims of modern treatment?
How do the new medications for chronic Hepatitis C work?
What are the current challenges in the correctional settings for people with Hepatitis B or C?
1:00PM Lunch and Networking
Metabolic Vulnerability and Antipsychotic Medications – What’s the Link?
The range of factors associated with the diagnosis of a mental health disorder can also leave a person vulnerable to a multitude of physical health complications, such as diabetes. Metabolic syndrome associated with the use of antipsychotic medications can create a cascade of poor health outcomes for people in prison. However, with careful monitoring, identification of risk, and correct treatment, the progression to type II diabetes can be prevented. This session explains:
Why is metabolic syndrome linked to antipsychotic agents?
What factors lead to patient vulnerability to metabolic syndrome?
Can we reduce the progression of metabolic syndrome to type II diabetes?
How can monitoring make a difference?
3:00 Afternoon Tea
Dr Michael Nancarrow
The Ethics of Euthanasia in Prisons
There has recently been much debate about whether a person who wishes to terminate their life is able to do so. In some states in Australia, legislation has been passed to give people the right to request a lethal drug to end their own life. The doctrine of equivalence states that healthcare provided to people in prison must be equal to that received by people in the community. Does that mean this right will extend that right to dying also? What are the implications of the increasing privatisation of corrections facilities? Is it time to discuss euthanasia in prison? This final session of day one debates:
What are the issues?
Why is euthanasia in prisons ethically challenging?
Does the offer of organ donation change anything?
How do health professionals navigate the minefield of organisational employment obligations with individual, professional, and ethical responsibilities to prisoners and detainees?
4:30 Close of Day One of Conference
9:00AM Commencement of Day Two
Sleep in Custody – You’re Dreaming, Right?
Sleep disruption and disorders are generally under-recognised and, as such, poorly managed.This is despite the increasing amount of research that demonstrate the importance of sleep, not only to physical health but mental wellbeing. In custody, certain challenges exacerbate the nightly struggle that many of us face. This session explores the unique challenges that people in prison face when attempting to get a good night’s sleep and novel approaches to overcoming them. It includes:
What happens to sleep while in custody?
How have we traditionally approached sleep and why doesn’t this work?
Who should be completing sleep assessments and are we?
How can you avoid inappropriate use of sedatives?
Dr Katie Seidler
The Psychology of Sex Offending
It is highly beneficial for all nurses working with sex offenders to understand the psychological evidence behind this deviant behaviour. With understanding comes care that refrains from judgment and a clear picture of what treatment is effective and what is not. This session will provide insight into:
What is the profile of a sex offender?
What is the role of therapy in preventing reoffending?
What other forms of treatment may be effective?
What enables behaviour change?
How do we balance the rights of the offender with the rights of the community?
10:45 Morning Tea
Pregnant in Prison – Promoting Health across the Perinatal Period
The number of females incarcerated in Australian prisons is steadily growing, especially among Indigenous women. A small percentage of women will enter prison pregnant or become pregnant while incarcerated. Clearly, this special population have unique health needs. This session will draw on practical experience and real case studies to demonstrate how we can improve the health of women in prison across the perinatal period. It includes a guide to postnatal care in prison and looks at:
What are the health needs of women in prison?
How does this change during the perinatal period?
What prenatal screening is required?
What subtle signs should raise alarm bells around mother and fetal health?
Are pregnant women still being restrained?
Parenting in Prison – Have we Forgotten the Fathers?
The contact between a child and their parents early in life clearly lays the foundation for relationships later in life. In recent times, increased focus has brought about a number of impressive programs to support the mother-child relationship in prison. While these initiatives are unquestionably valuable, in this discussion have we forgotten the need for fatherhood to also flourish? This lively session will create a conversation around:
What are the parental rights of the fathers?
What obstructs fatherhood flourishing?
What can we do about it?
12:45PM Lunch and Networking
Carla Vernon & Emma Heerschop
Simulation in Incarceration
Correctional Nursing requires the patience of a saint, the nose of a bloodhound and the negotiation skills of a high level diplomat and, as such, we need to find ways to provide education to our nurses that allow them to develop and use those skills at the highest level. To this end a nurse at Townsville Correctional Complex started a program that combined cutting edge simulation training with interagency collaboration resulting in outstanding learning experiences for Correctional nurses and managers. This led to procedure changes and improved resources which in turn improved response to medical emergencies. It also had the knock on effect of improving teamwork with our correctional colleagues as well as improving understanding of what it is that nurses do. This session discusses:
Interagency collaboration between Queensland Correctional Services and Offender Health
Evidence based best practice training for nurses and officers
Improved response to emergencies for both nurses and officers
Dr Linda Starr
Deaths in Custody – Your Duty of Care
Both individuals and the system in which we, as individuals, operate have a duty of care to maintain the safety and wellbeing of those in custody. Despite this, deaths in custody still occur. This interactive session will draw on landmark recent coronial investigative reports and coronial inquest findings to create discussion around the following:
Is death in custody a security issue or a healthcare issue?
Which deaths must be reported to a coroner?
How is the cause of death determined?
How does the law interpret common issues surrounding death in custody?
3:15 Afternoon Tea
Dr Linda Starr
Overcoming Barriers to Care
Custody versus caring is a common source of tension for nurses and other healthcare providers in correctional, justice, and forensic settings. Practically providing health care is surrounded by numerous challenges. While health promotion may be valued, security breaches that cause lockdown often override clinical care opportunities. This practical workshop session will create an opportunity to break out into groups and use common scenarios to look at ways to overcome such barriers.
4:30 Close of Conference and Evaluations
Need for Program
Nurses have a professional duty to ensure the health care provided to prisoners is equivalent to that in the community. People in prisons have higher rates of many chronic illnesses, therefore, the opportunity exists for nurses to improve health outcomes through proactive prevention strategies, assessment, management, and education. But this will rely on having a sound knowledge of the latest evidence for a range of chronic illnesses. Education that is specifically tailored to nurses who work in this specialised area is crucial if the physical and financial burdens of chronic disease are to be reduced.
Purpose of Program
The purpose of this conference is to improve the health outcomes of people in prisons by enhancing nurses’ knowledge about latest evidence-based strategies to prevent, assess, and manage chronic illnesses.
Your learning outcomes:
Provide care to prisoners that is aligned to current standards of professional practice for reducing the burden of disease
Minimise complications and prevent chronic disease progression through improved assessment and management
Improve health outcomes by implementing evidence-based practice in the management of a range of chronic physical and mental health conditions
Enhance professional accountability and maintain scope of practice by understanding legal and ethical considerations of working with prisoners