HMP NOTTINGHAM

JULY 2017

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ARE YOU READY FOR SMOKE FREE?

HEALTHCARE INFORMATION

Welcome to the HMP Nottingham Healthcare patient newsletter

This newsletter will be printed monthly and will be available at reception or from the signpost orderlies on your wing

The aim of this newsletter is to provide you with information on how to access the various health care services offered as well as advice on general health care issues

Healthcare services within HMP Nottingham are provided by Nottinghamshire healthcare NHS Trust. The healthcare team provide primary healthcare, mental healthcare and substance misuse services to people in prison and immigration removal centres

The trust strives to make a positive impact on the lives of prisoners, thereby im-proving their health, securing their wellbeing and reducing re-offending behav-iour

1. Respect and dignity

2. Commitment to quality of care

3. Compassion

4. Improving lives

5. Working together for patients

6. Everyone counts

Head of Healthcare

Phil Griffiths Clinical Director

Dr. Kaul

Psychiatrist

Substance Misuse Matron Natalie

Woof

Mental Health Ma-tron Adeline

Hunt

Physical Healthcare

Matron

Siobhan Whiston

Paramedic

Tim Oliver

Senior Substance Misuse

Practitioners

Emma Bellamy

Richard Gittins

Senior

Substance Misuse Nurse

Mary Gillett

Primary Mental Health Nurs-

es

Tim Hewitt

Jamie Rastall

Dean Spurr

Beauty Madili

Senior Nurses

Leah Thompson

Debbie Edwards

Katy Flynn

Menasi Mupazi

Louise Cannon

Substance Misuse Practi-

tioners

Alana Diamond

Melisa Hasanbegovic

Marianne Hunstone

Mick Morgan

Andrea Ramsden

Keely Start

John Whelan

Substance Misuse Recov-

ery Workers

Janet Brady

Ian McCluskey

Bryony Roper

Jerry Rose Winters

Substance Misuse HCA

Hannah Edwards

Secondary Mental Health

Nurses

Tim Cottage

Trish Turner

James Whitlam

Antonia Hil

Psychological Wellbeing Prac-titioner

Jason Parker

Assistant Practitioner

Julie Roberts

Psychologist Eve Hepburn Pharmacy Techni-

cians

Jen Adams

Stephanie Button

Rachael Crouch

Sophie Peverley

Claire Saunders

Michelle Truman

Healthcare As-

sistants

Richard Archer

Stephen Cockerill

Laura Garside

Rae Groves

Jennifer Hudson

Christine Mc Don-ald

Clare Williams

Agency Nurses

Mzi Mhalanga

Sam Zwankinyue

Matt Connor

Primary health care

nurses

Joanne Baldy

Mark Braddow

Karen Elliot

Mary Gleeson

Evanne Hall

Emma Lisewski

Maria Martino

Samantha Reece

Natalie Thorpe

Advanced Nurse Practi-

tioner

Nicola Haldane

HEALTHCARE WHO’S WHO

Healthcare Admin

Joanne Simpson

Henry Milne

Emma Murphy

Lisa Perry

Deirdre Reidy

Lorna Robinson

Siobhan Walsh

Belinda Watchorn

Joanne Wilson

General Assistant

Peter Sahota

General Practitioners

Dr. Henry

Dr. Lloyd

SMOKE FREE PRISONS

According to recent figures, 80% of the prison population smoke but as you are probably aware, a complete smoking ban is being introduced this month in all prisons to help protect the health of staff and inmates, in line with the UK wide ban on smoking in workplaces

Prisons are places where people live and work. Inmates and staff have as much right as the general population to be protected from toxic tobacco smoke in their home and workplace.

Plenty of patients have voices their concerns to healthcare regarding the ban and how this may impact on their life in prison, including their mental health, anxiety and boredom

We have put together this special edition of the HMP Nottingham healthcare newsletter to help patients who smoke manage these worries and hopefully provide some useful advice and guidance on stopping smoking

WHY SHOULD I GIVE UP SMOKING?

STOPPING SMOKING HELPS YOU BREATHE EASIER-People breathe easier and cough less when they give up smoking because their lung capacity im-proves by up to 10% nine months after giving up

STOPPING SMOKING GIVES YOU MORE ENERGY-Within 2-12 weeks of stop-ping smoking your blood circulation improves. This makes all physical activi-ties such as running and walking easier

DITCH THE CIGARETTES AND FEEL LESS STRESSED-The withdrawal from nicotine between cigarettes can heighten feelings of stress. As the stress of withdrawal feels the same as other stresses, it is easy to confuse normal stress with nicotine withdrawal. So it can seem like nicotine is helping with stress when it actually isn't. In fact, scientific studies show that people’s stress levels are lower when they give up smoking

STOPPING SMOKING IMPROVES FERTILITY-Your sperm quality will improve when you give up smoking and will also improve your partners chances of getting pregnant

STOPPING SMOKING IMPROVES SMELL AND TASTE-When you stop smoking your senses of taste and smell get a boost. Your food will taste better as your mouth and nose recover from being dulled by the hundreds of toxic chemicals found in cigarettes

STOP SMOKING FOR YOUNGER LOOKING SKIN-Stopping smoking has been found to delay facial ageing and delay the appearance of wrinkles. The skin of a non smoker gets more nutrients, including oxygen, and stopping smok-ing can reverse the sallow, lined complexion that smokers often have

STOP SMOKING FOR YOUR TEETH AND BREATH-Quitting smoking stops your teeth from becoming stained by nicotine and will give you better smell-ing breath. You are also less likely to get gum disease or lose your teeth

QUIT SMOKING TO LIVE LONGER-Half of all long term smokers die early from smoking related diseases, including heart disease, lung cancer and chronic bronchitis. Men who quit smoking at the age of 30 and 10 years to their life. Men who kick the habit at 60 will add 3 years to their life

P A G E 6

STOP SMOKING TREATMENTS

If you don’t think willpower alone is enough, there are treatments that can be provided by healthcare at HMP Nottingham to help you give up smoking

You may have already started using Nicotine Replacement Therapy (NRT) or be on the waiting list to receive this. But if you haven't used NRT in the past, you might be wondering how it works. .

NRT is the name given to stop smoking treatments that release nicotine into your system to help counteract cravings and reduce other physical withdraw-al symptoms that you might get when you quit (headaches, nausea, irritabil-ity). You can use NRT to relieve cravings once you have stopped smoking completely. NRT comes in the form of chewing gum, patches, nasal spray, mouth spray, inhalator, micro tabs and lozenges. The NRT of choice at HMP Nottingham is patches and lozenges

Nicotine patches are suitable for use by medium to heavy smokers, who smoke throughout the day. They are simply applied to the skin, usually to the upper arm. They work by releasing nicotine throughout the day and are available in three strengths (21mg 14mg and 7mg patches) Some side effects can be skin irritation, itching, dizziness and rapid heartbeat. Patches deliver continues nicotine throughout the day to help keep your nicotine levels stable. Some patches are also designed to be worn at night time however they can affect your sleep and make you have very vivid dreams

Lozenges are designed for when you experience a strong craving, even when you are wearing a nicotine patch (in fact, these two used together is more effective than using one treatment alone) The lozenges are de-signed to slowly dissolve in the mouth. You can use a lozenge every 1-2 hours or whenever a cravings strikes. Some side effects are rapid heart-beat, heartburn or a sore throat

You can put an application in for the New Leaf service if you would like NRT or take part in the wing based clinics that are currently being held

Remember, smoking will not be a choice after the 16th July!

7

HEALTHY LIVING WITH IAN MCCLUSKEY

As many of you will be quitting smoking at the moment it’s worth looking at ways what you eat and drink may help this be less troublesome than it might. I appreci-ate the limits on choice here but this may continue after release to support quitting as the benefits are much longer lasting, and cheaper.

Water

This is simply, and often, your best and easiest choice in any detox including ciga-rettes. Maybe everyone already knows this but there are other benefits – I’ll ex-plain! You will experience cravings and many people turn to sweets or snack foods as a replacement – which usually causes us to gain weight - but having a drink of water handy easily replaces this and also tells our brains we’re actively doing a physical action very similar to we do when we smoke. This calms the craving and over time these pass so it helps with many of the physical aspects of quitting smoking.

Food

You can gain additional benefits from fruit, especially oranges (Vitamin C) and green vegetables (Vitamin E) which your body is starved of when smoking and these replacements also reduce cravings. Also high fibre foods, so breakfast mainly, help with detox and have some other medical gains like helping prevent colon can-cer.

Exercise

Again, this might be obvious but you will benefit well beyond quitting smoking by

exercising regularly. Exercise makes you sweat which releases the toxins and dam-

aging chemicals that have built up in your body due to smoking. Exercise burns up

the nicotine in your system and boosts your body’s metabolism rate while raising

body temperature and supply of oxygen. As you start exercising more you’ll begin

to regain the lung capacity you lost while smoking and all of his keeps your im-

mune system working perfectly.

P A G E 8

SMOKING CESSATION UPDATES

The prison will officially be go-ing smoke free on the 16th July. This will meant that to-bacco items will no longer be available on the canteen and you will not be allowed to smoke anywhere In the pris-on, including your cell

Pharmacy Technician Rachael Crouch has been part of the team that have been heading up the smoking cessation clinics

“We have been conducting Smoke Free groups for 2 weeks now although we piloted this on F wing with much success. The reason F wing works is that the room we are using is on the wing so we have little or no trouble getting our patients to attend. This can’t be said for the groups we have been running for the rest of the prison! At the moment we run ABC wings in Education which has caused us issues as we have no allocated officer so getting the guys back from the groups after the route has closed is proving challenging! We have also had guys sent to Healthcare instead of Educa-tion due to confusion on how the Regimes lists are worded!! We have worked hard with re-gimes to try and rectify this but it’s definitely a work in progress!

Our E wing groups have been less challenging as the patients are on the wing however we have had to intercept them again as according to the regimes list they are due in Education!!

All good fun as you can imagine and a also a massive headache and the prison doesn’t actually go Smoke Free until 16th July so more problems to come I’m sure. It’s a mas-sive project not sure the prison or patients think it will actually happen but it’s happening so we need get prepared for more headaches and fun in equal measures!!

If you are listed to attend the smoke free groups then please at-tend! It is important that you get the support you need to quit smoking before the ban comes in-to place

P A G E 9

GIVING UP SMOKING TIMELINE

From the canals of your ears to the intricate blood vessels of your circulatory system, smoking can harm almost

every part of your body.

For those addicted to nicotine, giving up can be a daunting task and it is easy to feel that the damage has already

been done.

But research shows that your body benefits just minutes after you draw a cigarette from your mouth and stub it out.

Here is a timeline of what happens to your body from the minute you stop smoking.

20 minutes

As you inhale, smoke and nicotine enters your bloodstream and the substance raises your blood pressure and

heart rate. After you finish the cigarette, your heart rate and blood pressure return to normal.

8 hours

Carbon monoxide, the poisonous gas that kills over 40 people in the UK year if it seeps from faulty appliances in

large quantities, is one of the 4,000 chemicals which enter your body when you smoke burning tobacco.

Nicotine and carbon monoxide start to leave your body and oxygen levels return to normal eight hours after your last cigarette

24 hours

A day after your last cigarette, your lungs will begin to clear out the mucus and debris caused by smoking.

48 hours

Nicotine, a toxic liquid, is the chief active ingredient in tobacco and is highly addictive. Smoking also dulls your ability to smell and taste. Two days after you stop smoking, nicotine is eliminated from your body and your senses

start to improve.

2 to 12 weeks

Smoking affects your blood circulation, making physical activity much more difficult. This in turn impacts your

overall health. Stopping smoking makes exercise easier and improves breathing after a few weeks.

3 to 9 months

Months after you stop smoking, your health continues to improve. By this point, coughing, wheezing and breathing problems caused by the harmful chemicals in smoke are reduced as your lungs repair.

1 year

Smoking damages the lining of the arteries, and causes a fatty substances known as atheroma to narrow the ar-teries. This can cause heart attacks, strokes and angina. 12 months after you quit your risk of coronary heart dis-

ease is now half that of a smoker.

P A G E 1 0

HOW TO MANAGE CIGARETTE CRAVINGS

Remind yourself of your reasons

for quitting! To be healthier, live longer and not wanting to get

into trouble for flouting the ban! Keep your mouth busy! Chew on

sugar free sweets and drink plenty of water

Do something else-when

a craving hits, stop what you are doing and switch

to something else. Simply changing your routine

may help you shake off a

craving

Most importantly, don't

give up! Do whatever it takes to beat the urge to

smoke. Keep trying differ-ent things until you find

what works for you. Just

don’t smoke, not even one puff!

Get moving! Try exercising in your

cell or walk around the wings during association. Make the most of exer-

cise time to walk around-you will probably find you can breathe easier

and enjoy it more now you’re not

smoking

Take slow, deep

breaths and breathe through your craving.

Inhale through your nose and exhale

through your mouth.

Repeat this 10 times or until you are feeling

more relaxed

There are some wordsearches in

this newsletter-use these to distract yourself when a craving strikes

P A G E 1 1

P A G E 1 2

Dear Dean Every month, RMN Dean Spurr is here to answer your questions. Please send any questions to Dean via the healthcare application system

Dear Dean

I’m really worried about the smoking ban coming in and how it’s going to affect my mental health-I think I’m going to crack up without burn! Why do the prison think they can do this to us? Do they not realise how much it will affect us? It’s the only thing I have that helps with my anxiety!

Do you have any advice

Thank you

Please please please be reassured that we are running 2 x stopping smoking groups each day currently in education ,please sign up through the substance misuse team or new leaf , the help is available to all in the prison , We fully understand the stress and anxiety the impending smoking ban provokes , NRT ( Nicotine replacement therapy ) is availa-ble and will help so sign up now

Thanks for writing

Dean

P A G E 1 3

“When I first heard about the smoking ban coming into prisons I thought, you must be f*****g joking mate!

I thought there was absolutely no way that it would ever happen. I re-member kicking off with my drug worker, Andrea, telling her that my hu-man rights were being taken away! She told me that nicotine wasn't a human right but it got me thinking...nicotine isn't a human right. Its en-joyable and there have been plenty of time when I don’t think I would have coped with prison life without it but if the ban was coming in (and trust me, it is) then I needed to do something about this

I signed up for New Leaf and went to one of the meetings on the wing-I blew in the carbon monoxide measure and nearly blew it up! I was given patches (21mg) and lozenges. The patches were great, they really helped me feel level throughout the day. The lozenges were ok, they helped when cravings got bad but they don’t taste very nice and gave me a headache

I've haven't had a smoke for nearly 3 weeks now-there have been times when I've thought that I cant do this anymore but I've muddled through and I do actually feel a lot better for giving up

I hope I don’t go back to smoking when I'm released but never say nev-er. Its all about taking it one day at a time. But if I can give up smoking, trust me you can too”

BEST OF LUCK AND REMEMBER IT IS HAPPENING!

We always welcome contributions/feedback from patients to this newsletter. If

you have any personal experiences that you would like to share or any feedback

on how we can improve this newsletter, please send an application to Andrea

Ramsden in the Substance Misuse Team