Inside the walls of Hawke's Bay Regional Prison, the health of 680 inmates is looked after by a 14-person team, who are "nursing behind the wire".

The team provide "some of the most challenging and vulnerable patients" with the same primary health care service as anyone else, except nearly half of this population have mental health conditions, and 32 per cent of them are drug dependent. Last night the work of Health Centre manager Linda Kroot, team leader Nicola Simmonds, and their 12 registered nurses was recognised with the teamwork award at the Hawke's Bay Health Sector International Nurses and Midwives Day awards.

The team are among the first prisoners see when they arrive. Inmates are triaged to address any immediate health needs, such as alcohol and drug withdrawal, and then booked for a health assessment.

Inside the centre's regular-looking treatment rooms everything is secured, with cupboard doors locked, and medical instruments attached to walls because "everything in a prison environment has another use", Ms Kroot said.


She said the challenges presented by the "unique" environment mean teamwork was paramount. Nurses needed to be consistent, and in constant communication so none were signalled out as being "the nice one".

"The health staff have to be aware of their alternative motives," Dennis, who has been at the prison for 21 years in total, said, "They know everything that is happening ... Information is currency." Knowing who their population were made nurses feel safer in the health centre than in a supermarket, they said, but they still needed to be able to resolve conflict.

"You don't hold grudges," Ms Kroot said. "When they're angry there's a reason for it. We're the ones they come to, and they get mad ... but the next day they come to apologise."

Registered nurse Arun, who has worked there for three years, said he had been asked how he could care for criminals.

"We're not here to judge them, they've already been judged," he said. "Our job is to practise health care, because if we can't give them good health care, and can't help their mental wellbeing, they can't be reintegrated out there."

Improving prisoners' health education was also important.

"Every consult we're training them in health education," Ms Kroot said.

"They're thirsting for it and they soak up all the info, they get more in here than they ever had."

Consults did not just happen in the health centre - prisoners could have up to 30 consults a month with a nurse, from an appointment at the centre to a conversation in a corridor. That education improved prisoners' chances of leaving in good health, meaning a lower risk of reoffending, she said.