Getting the Sergeants on your side: the importance of interpersonal relationships and cultural interoperability for generating interagency collaboration between nurses and the police in custody suites

Abstract

In this article, I contribute to the literature around interagency collaboration, especially between law enforcement and health care, by reconciling the previous work of Sarah Charman (2014) with the interprofessional teamwork literature. Drawing upon a semi‐structured interview‐based study with 20 custody nurses working in English police custody suites (analysed using Framework Analysis), I explore the ways they are able to achieve interagency collaboration with a particular police officer, the Desk Sergeant. I argue that nurses accomplish interagency interoperability by interacting regularly with the Desk Sergeant, anticipating their needs and limiting their own goals to those that are commensurate with the Desk Sergeant's, notably providing information and avoiding deaths in custody. Such practices are similar to the strategies of ‘Cultural Interoperability’ noted by Charman (2014); however, this study also identifies that such strategies are only available once a successful working relationship has formed between Desk Sergeant and nurse, and as a result, similarly to the findings of interprofessional teamwork studies, the success or failure of attempts to collaborate across agencies is underpinned by interpersonal relations. The paper concludes by commenting on the importance of analysing both the interpersonal and organisation levels when studying collaboration.

The coproduction work of healthcare professionals in police custody: destabilising the care-custody paradox

“…The role of nurses working within police custody is to ensure the health and wellbeing of those detained. While the custody sergeant ultimately has responsibility for all those in the custody suite (detainees and staff), HCPs provide medical expertise in order to assist the sergeant in making decisions about a person’s fitness to be detained or interviewed and to provide assessments of medical needs during the period of detention (Rees 2020 ). Key to HCP decision-making is the clinical assessment of a detainee, as this will form the basis of any further healthcare interventions during the period of detention.…”

“…(Harriet D2) In contrast to the empathic representation of the ward nurse, an HCP needs to develop resilience and the ability to deny treatment until there is clear objective evidence of pain; this means that HCPs become distanced, or ‘colder’ than nurses working on the wards. Some nurses attributed their coldness to seeing ‘the worst of people all the time, not only because of the things that have brought them in there, their behaviour’ (Naomi F NHS), but also because their task was not to heal patients, but rather, in the coproduction of meeting healthcare and legal objectives, to ensure that detainees were fit enough to be detained and interviewed (Rees 2020 ). The framing of care practices (and the classification of detainees) performed by HCPs as part of custody work produced the distanced attitude described by Harriet.…”

“…In NHS-provided constabularies, the police and NHS have developed clear guidance on the way embedded nurse work should be performed, notably requiring HCPs to remain within the medical room with the door closed in order to maintain clear boundaries between medical and police colleagues. Unlike under other governance regimes where HCPs have argued for the benefit of overhearing the checking-in process of detainees, as it helps to anticipate the needs of the police (Rees 2020 ), in Constabulary G the medical room was constructed as a space separate from the rest of custody. It makes sense, therefore, that under the NHS/Police guidance, aimed at emphasising the independence of the HCP, the spatiality of the medical room would be seen as the appropriate place for all healthcare interventions, with the cell being a police space except when dealing with the most unwell detainees.…”

“…The coldness expressed by HCPs was also a product of the different outcomes and objectives that they were expected to meet. Care in custody is not about fixing the patient (Rees 2020 ), but rather about managing risk and ensuring detainees are fit to be detained and interviewed. As a result, nurses expressed the need to maintain a distance from the detainees, which contrasted with other healthcare environments.…”

“…The anxiety around deaths in custody promotes a risk management approach to dealing with detainees, and HCPs have found ways to aid this by performing various forms of anticipatory work. For instance, they mobilise the space of the cell in situations where they expect the detainee to be violent or aggressive, and advise the Custody Sergeant about any potential healthcare risks that might also pose a risk to the custody (Rees 2020 ). In anticipating risks and collaborating with police and detention staff, HCPs’ coproduced practices assist the custody team in the accomplishment of all custody objectives.…”