As part of my new role as the Professional Lead for Children and Young People's Nursing, I was invited by Dr. Liz Walsh, the Professional Lead for Justice and Forensics Nursing to come with her to Feltham Young Offenders Institute and see what nursing care looks like in this setting. What I found surprised me: I was expecting starkness, minimal ‘home comforts’ and strict regimen. What I was not expecting was the emotion that wrapped around it.

I was shown around by a Registered Children's Nurse who had a background working in paediatric critical care and now enjoys the autonomy and diversity this role offers her. These nurses are the first point of contact when young people arrive and assess health needs- physical, mental and emotional; advocate tirelessly for their health needs; organise and negotiate appointments; determine which young people need closer observation; attend incidents where emergency clinical care is required; ensure procedures such as restraint are managed safely. I would argue the role goes far beyond these activities though, it's about building trust, advocating for equity, and supporting rehabilitation too.

Young people in custody frequently present with complex health needs. Many have experienced trauma, neglect, or abuse, and a significant number live with mental health conditions (1 in 5 have depression for example (Inspectorate of Probation Services 2021)). Neurodiversity and unmet physical health needs are also common. Prison nurses are often the first consistent healthcare professionals these young people encounter, making their role pivotal in early intervention and long-term wellbeing. However, the environment itself poses unique challenges with nurses navigating the constraints of security protocols while maintaining therapeutic relationships. This makes consistency in managing health needs challenging and arguably places some children at risk of physical and mental deterioration which has already been identified as an unacceptable risk (Ministry of Justice 2021). The triaging, reprioritisation and negotiation to achieve care giving were some of the key skills I heard being used time and again throughout my visit.

The nursing team also work collaboratively with multidisciplinary teams, including psychologists, social workers, teachers and custodial staff. All of those I met demonstrated a passion and commitment to these young people to ensure holistic care and striving to provide opportunities for growth, rebuilding of esteem and restoring a sense of self which is positive rather than destructive. What I also saw and heard was a resignation in knowing that when back in the community, services to maintain this is lacking, and reflected on the resilience needed to continue this work despite few options for sustainability.

Understanding the impact of adverse childhood experiences requires recognition that young people can respond adversely to situations they may find threatening or triggering. I asked my guide about this and whether she struggled with treating young people who might respond in an inflammatory manner. Her response was swift: she listens without judgment, offers stability, and creates safe spaces where young people can begin to trust again. It embodied the ethos of nursing to meet people where they are.

Despite the challenges, I sensed that youth prison nursing can be a deeply rewarding career as they witness moments of growth, resilience, and transformation. Their work highlights the importance of seeing the person beyond the offence and recognising the potential for healing and hope. However, the emotional labour of prison nursing cannot be underestimated: there is constant exposure to moral conflict and distress; a persistent need to defend the right for even the most basic of health interventions; vigilance for escalations of behaviours which put yourself or others at risk ever present. This is one of the reasons Liz has developed a reflective practice workshop to encourage all nurses working in prison services to have a safe space to work through the moral injury and emotional burnout that can happen as a result.

Prison nursing is not just about healthcare. As I witnessed, it is about humanity, showing up for the most troubled of young people and believing in the possibility of change.