When I look back over my nursing career, the experiences that have shaped me most have often come from places people do not always associate with hope, recovery or compassion. Health & Justice services have stayed with me because they ask nurses to provide care in environments that are not always built around therapeutic relationships, but where trust, dignity and compassion matter just as much.

As a mental health nurse, I already understood that nursing is rarely only about a diagnosis, a pathway or a procedure. Working in secure and custodial environments deepened that understanding. It reminded me to keep seeing the person in front of me, especially when their life may be shaped by trauma, mental illness, substance misuse, social exclusion, poverty, family breakdown or poor previous experiences of services. In those moments, nursing values matter: kindness, curiosity, advocacy and the courage to speak up when something is not right.

My first role in a young offender institute gave me one of my more embarrassing early moments. On one shift, I thought I was cancelling a call bell and instead managed to raise the general alarm. Within moments, the prison response team had descended. It was an unforgettable introduction to prison healthcare.

I then moved into a Head of Healthcare role at a Category B prison, where I was also learning what leadership meant in practice. I was young in post and not everyone trusted that I would stay the course. I later discovered that some of the team had even kept a book on how long I would last; some thought I might last a week.

uring that first week, one healthcare officer made a derogatory comment about a patient. I understood that the work was emotionally demanding and that some staff were carrying years of burnout and compassion fatigue, but I also knew the comment could not go unchallenged. It felt brave at the time, but I needed to be clear about professional standards while recognising the pressure people were working under. Word soon spread that I was not afraid to challenge poor practice, and that helped me earn respect. Incidentally, I stayed for five years, so I am still not sure who won the bet.

A couple of years into that role, I remember one situation that stayed with me. It captured one of the real challenges of prison healthcare: providing clinical care when security, safety and clinical judgement do not always point in the same direction.

A patient was on constant watch because of repeated self-harm risk and serious concerns about internally hidden blades. Understandably, prison colleagues saw constant observation as the safer option. Clinically, however, the formulation suggested that having more people involved was not helping. The level of observation was escalating the behaviour and reinforcing a cycle that was not helping the patient move forward.The challenge was not about one side being right and the other wrong. It was about holding custodial concerns and clinical judgement together without losing sight of the person at the centre. By that point in my leadership journey, I had developed the confidence to speak up for what I believed was clinically right, even when that meant having difficult conversations.

Those early leadership experiences taught me resilience. They also taught me that respect is not given by a job title; it is earned over time through consistency, fairness and staying with difficult issues. As the team began to trust me, we created more honest space for reflection, challenge and shared learning. It also reminded me that staff need care too. If we do not support colleagues who have carried difficult work for years, we cannot expect them to keep offering the best of themselves to others.

Over time, I came to see leadership in Health & Justice as something that is not defined by seniority alone. It is shown in the everyday choices nurses make: challenging poor practice, supporting colleagues, recognising safeguarding concerns and keeping the person at the centre of care. For me, that requires integrity, curiosity and the confidence to look beyond the surface, especially in environments where assumptions can easily shape how people are seen and treated.

Nursing in these settings has reinforced the importance of holding on to my professional identity. Whether I have been delivering care directly, leading teams, reviewing quality or supporting commissioning of services, I have tried to bring a nursing lens that is practical and compassionate. I have seen how decisions made away from direct practice can still shape a patient's experience.

If I were speaking to a nurse considering a role in prison or Health &Justice services, I would say this: it will challenge you, but it will also remind you why nursing matters. It will ask you to be skilled, resilient and reflective. Most of all, it will show you that nursing can bring dignity, safety and hope into places where they are needed most.