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Police Custody Healthcare for Nurses and Paramedics (eBook)

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2024
802 Seiten
Wiley-Blackwell (Verlag)
978-1-394-20488-5 (ISBN)

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An essential resource for nurses and paramedics navigating the intricate world of police custody, providing a solid guide for both the novices and the veterans in the field

Across the UK there are on average over 750,000 episodes of police detentions annually, the equivalent of over 2,000 a day. Each one is entitled to healthcare comparable to the wider community. It is estimated on average 54% of these detained individuals are referred to a healthcare professional because of a complex mix of physical health, mental health, medication, substance misuse or social issues. Healthcare professionals working in custody must navigate this complex mix while working within a short-term detention setting.

Police Custody Healthcare for Nurses and Paramedics offers a thorough, accessible introduction to this subject and its key aspects. Nurses and paramedics working in police custody healthcare settings will find a volume that addresses their specific needs, with guidelines for understanding initial patient contact, potential comorbidity, mental illness, forensic sampling, documenting injuries, writing statements, and much more. Aligned to the UK Association of Forensic Nurses and Paramedics' Advanced Standards in Education and Training (ASET), this is a must-have resource for professionals in this growing area of practice.

Readers will also find:

  • The first text written specifically for nurses and paramedics by nurses and paramedics with extensive experience in police custody
  • Detailed discussion of topics including fitness assessment, medicines management, use of force restraints, and much more
  • Pedagogical tools including self-assessment questions, case studies, and learning outcomes

Police Custody Healthcare for Nurses and Paramedics is ideal for trainee or registered nurses and paramedics working in police custody healthcare settings or other detention settings.

Matthew Peel, RN, QN, MSc, BSc, ASET, V300, is an Advanced Clinical Practitioner in police custody across Yorkshire and Humber, previously seconded to NHS England as the Chief Nursing Officer's Clinical Nurse Fellow leading a national project concerning police custody and sexual assault healthcare. He has over a decade of clinical experience in custody, and has published extensively on related issues of nursing and forensic healthcare.

Jennie Smith, RGN, MSc, PGCert, ASET, V300, is President of the UK Association of Forensic Nurses and Paramedics and Clinical Lead for the Merseyside Integrated Police Custody Healthcare and Wider Liaison and Diversion Service. She has over 15 years of clinical experience in custody, and has published and presented extensively on nursing and forensic medicine issues.

Vanessa Webb, MBBS, RGN, MSc, BSc, DLM, DFMS, FMERSA, MFMLM, is dual qualified with GMC and NMC registration. As part of her career journey, she was an Advanced Nurse Practitioner, worked in custody and sexual offences for 20 years and as a Senior Leader, Co-Founder and Trustee, has delivered services across the criminal justice system and continues to be passionate about ensuring that we have a caring and competent workforce that is striving to address inequalities for those we serve.

Margaret Bannerman, SFHEA, MSc, BSc (Hons), RN, Dip HE, Cert Med Ed, PGCert, RM, is an experienced nurse educator with particular experience in curriculum design, developing bespoke education programmes and competency frameworks. She is also experienced in national standard setting, along with accompanying guidelines and policy documents in the areas of forensic healthcare and sexual health.

CHAPTER 1
Introduction to Police Custody


Matthew Peel1, Jennie Smith2, Vanessa Webb3,, and Margaret Bannerman3

1 Leeds Community Healthcare NHS Trust, Leeds, UK & UK Association of Forensic Nurses and Paramedics

2 Mitie Care and Custody Health Ltd, London, UK & UK Association of Forensic Nurses and Paramedics

3 Nurture Health and Care Ltd, Norwich, UK

AIM


The aim of this introductory chapter is to provide a foundational understanding of the multifaceted realm of police custody healthcare in the United Kingdom. This will include the current state of forensic healthcare, the role of the healthcare professional, including training and induction. A broad overview of police custody, including the purpose, standards, individuals working in custody and the relevant legislations, will be provided.

LEARNING OUTCOMES


After reading this chapter, you will be able to:

  • Understand the current landscape and varying levels of consensus in forensic healthcare within the United Kingdom
  • Describe the structural and operational differences in police custody across the devolved nations
  • Identify the key demographics and vulnerabilities of individuals detained in police custody

SELF‐ASSESSMENT


  1. What are the primary roles and responsibilities of HCPs in police custody?
  2. Who are the typical detained individuals in police custody and what are their common demographics and vulnerabilities?
  3. What standards of care and professional conduct are expected from HCPs working in police custody?

INTRODUCTION


Forensic science is guided by Locard's principle: ‘Every contact leaves a trace’ (Locard 1934). However, this ethos extends beyond physical evidence to the compassionate care that healthcare professionals (HCPs) provide to those detained, often in their most vulnerable moments. HCPs must strive to positively impact individuals through respect, dignity and hope. This approach blends assessment, examination and forensic strategy, along with advice, treatment, brief interventions and signposting, aiming to leave a beneficial impact on those they encounter.

This chapter delves into the unique challenges of police custody healthcare, where HCPs work with limited evidence‐based guidance to prioritise patient safety and well‐being. It addresses the diversity in practices, the absence of consensus in certain areas and the crucial role of risk assessment. It emphasises the need to balance healthcare needs and human rights with police procedures; this introduction sets the stage for exploring the dynamic and ethical landscape of police custody healthcare.

CONSENSUS


Within police custody, there is a scarcity of comprehensive, evidence‐based guidelines, providing a unique challenge for healthcare providers to navigate this uncertain terrain with the patient's safety and best interests, as their guiding principle. This has given rise to a spectrum of practices, each supported by its own evidence, albeit limited and characterised by distinct advantages and potential risks. The variety in clinical approaches reflects not a shortcoming but rather the complex nature of forensic healthcare, where clinical judgment intertwines intricately with the dynamic interface of police procedures and healthcare provisions. These practices are informed by a multifaceted interplay of factors. Recognising these variations, this text identifies areas where there is no consensus in practice, offering a comprehensive view of the diverse methodologies currently in use. For practitioners keen on delving deeper into the development of standardised practices and understanding how to bridge professional opinions, the National Institute of Clinical Excellence (NICE) provides invaluable resources, particularly its guidelines on managing differences in professional opinion.

FORENSIC HEALTHCARE PRACTITIONERS


Forensic healthcare practitioner (FHP) is the umbrella term for HCPs working in forensic healthcare settings (police custody and sexual assault referral centres), typically doctors, nurses, paramedics and midwives. They are distinct from those working in forensic mental health settings.1 Within this text, we will refer to FHPs as HCPs; however, both titles should be considered synonymous. In police custody, FHPs are more commonly referred to as:

  • Custody healthcare practitioner or professional
  • Custody nurse/paramedic
  • Custody nurse/paramedic practitioner
  • Forensic nurse/paramedic examiner

HCPs work at the front door of the criminal justice system, at an intersection between health, justice and forensics, with a dual patient and medico‐legal responsibility. For nurses and paramedics, this involves working at an advanced practice level with a high degree of autonomy and complex decision‐making (National Health Service 2017).

They have medico‐legal responsibilities, such as advising on fitness to interview. In addition, they are responsible for clinically examining and treating individuals presenting with undifferentiated and undiagnosed injuries or illnesses. They also undertake forensic examinations and sampling, providing written statements and oral testimony in court.

EDUCATION AND TRAINING


While HCPs bring with them several years of post‐registration clinical experience, knowledge and skills, they still require thorough induction, supervision and support. Figure 1.1 demonstrates a path from novice to expert2 (Benner 1984). As HCPs come from a wide range of clinical backgrounds and specialities, induction training programmes should be flexible to meet individual needs.

Induction

The UK Association of Forensic Nurse and Paramedics (UKAFNP) has developed standards for induction for healthcare providers to deliver locally, see Box 1.1.

Ongoing Training

Ongoing training and development are essential following induction across all healthcare settings and forensic healthcare is no different. Ongoing training should include both in‐house training and external training.

Post‐graduate Education (and Exams)

Several stand‐alone master’s level post‐graduate modules will be of interest to HCPs; these include:

  • Independent prescribing
  • Minor illness
  • Minor injuries
  • Mental health
  • Substance misuse
  • Human rights
  • Law

Alternatively, HCPs may undertake a master's level post‐graduate qualification.

Advanced forensic practice (PgCert, PgDip, MSc)

An advanced forensic practice programme,3 aligned to the UKAFNP ASET award (advanced standards in education and training), is available, including a taught and assessed clinical aspect evidenced by completing a competency document and taught and practical assessments of forensic science knowledge, practice and legal skills, including statement writing and providing oral evidence. These courses are a blend of forensics and advanced clinical practice. It is important to note that the requirements for ‘advanced practice’ differ across the different countries.

FIGURE 1.1 Novice to expert.

BOX 1.1 STANDARD FOR INDUCTION


  • Overview of organisation, including local mandatory and statutory training
  • Governance, patient safety, the duty of candour, reflection and equality, diversity and inclusion
  • Resuscitation
  • Medicines management, including patient group directions or non‐medical prescribing
  • Children's Act, Mental Capacity Act and consent
  • Mental Health Act, mental state examinations, including risk to self and others
  • Level 3 safeguarding children and adults; in addition to PREVENT and female genital mutilation
  • GDPR, confidentiality and records management
  • Forensic strategy, forensic sampling (including toxicology), chain of evidence
  • Ongoing continuity of care

Source: Adapted from UKAFNP (2023).

Advanced clinical practice (PgCert, PgDip, MSc)

Most universities offer advanced clinical practice programmes. Most programmes are generic, including a taught element and practical examination.

Licentiate of the Faculty of Forensic & Legal Medicine (FFLM)

The licentiate is an examination and competency assessment:

  • Part 1: A three‐hour theoretical examination of medico‐legal and clinical practice, tested by a single best‐answer paper
  • Part 2: Clinical competency assessment, tested by a 14‐station Objective Structured Clinical Examination (OSCE) and a short answer question paper

Completing all the elements may entitle the use of the post‐nominals LFFLM.4

Diploma of Legal Medicine

The Diploma of Legal Medicine (DLM) is a stand‐alone examination offered by the FFLM consisting of a three‐hour examination with 150 best‐of‐five multiple‐choice questions.

ABOUT POLICE CUSTODY HEALTHCARE


The healthcare provided in custody settings is a critical welfare component, ensuring individuals have timely access to physical and mental health assessments and treatments. This...

Erscheint lt. Verlag 17.12.2024
Sprache englisch
Themenwelt Medizin / Pharmazie Pflege
Schlagworte comorbidity • criminal detention • documenting injuries • ethical healthcare • forensic healthcare • forensic medicine • Health and Justice • Medico-legal • Mental Illness • police custody suites • Restraints • Safeguarding • Substance Misuse • Use of force
ISBN-10 1-394-20488-4 / 1394204884
ISBN-13 978-1-394-20488-5 / 9781394204885
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