Senior nursing students of Saint Anselm’s nursing program are a couple of weeks into their clinical rotations at varying locations for their hands-on experiences in healthcare. One of these locations, the New Hampshire State Prison for Men has a lone student completing their clinical in the prison’s Secure Psychiatric Unit (SPU).
The SPU is a distinct section of the prison that “serves multiple populations at the most intensive and secure inpatient treatment facility in the state behavioral health service delivery system” (corrections.nh.gov). The patients at this particular location are committed there through the state judicial system “due to mental illness and dangerousness…rare individuals committed under the state’s sexually violent predator law” (corrections.nh.gov).
The particular student completing their clinical requirement at the SPU, remaining anonymous, said that the location has been on a hiatus for the past few years of allowing students to complete their clinical requirement there. Whether that was a decision made by the nursing department at Saint Anselm or by the establishment itself is unclear.
At a higher-risk location for clinical, safety measures and precautions are taken for the protection of the student. “They have security there all the time, [and] usually the residents are in handcuffs if they are one-on-one,” the student said.
“It’s a locked unit, so anywhere you go you have to be let in by security,” said the student. Before beginning clinical, “they had an orientation to prepare all of the people that go to the prison setting,” said the student. The orientation gives a “good overview of what they can or how they train their employees before they go there,” the student said.
The biggest preparation for the student while completing their clinical at the SPU is mostly about “having awareness of the things that could happen,” said the student.
Before the start of clinical rotations, “I was definitely nervous before going into it, but I feel like that would be the case for anyone going somewhere like that,” said the student. The unfamiliarity of the type of location caused some hesitancy about the work that would be done there.
Though having pre-clinical nerves, “the more I go there the more comfortable I feel,” said the student. “All of the staff that work there are really good with everything, and the staff is what puts me at ease the most,” the student said, “because they know all of their residents very well.”
With safety preparations and a staff well-versed in the particular populations at the SPU, the student feels that if danger were to be present, “they would have the proper [employees] there to know how to deal with” those types of situations the student said. “The unknown of it” is what scared the student the most about the SPU, but “Yes, I feel safe there,” the student said.
Though the student did not request this particular location to complete the clinical requirement of this semester, interests are taken into consideration regarding the type of care that students are looking to pursue.
Dr. Carrie MacLeod, the Director of Undergraduate Nursing and an Associate Professor of the Nursing Program said, “Location and unit experience are determined by incorporating student requests as best as possible with clinical institution availability.”
Nursing students are given opportunities at clinical sites and preceptorships for different experiences and medical focuses. “The locations and unit experiences vary widely, including community placements to intensive care units and emergency departments,” MacLeod explained.
Though there is one student at the SPU, “in New Hampshire, there is a maximum of 8 students per clinical unit,” MacLeod said. Determining clinical placements uses “specific guidelines from affiliated clinical institutions, the Board of Nursing recommendations, and the Centralized Clinical Program.”
For the student at the SPU, and all students completing clinical rotations in the nursing program, “the safety and well-being of our students is our number one priority,” MacLeod said. Clinical instructors for the college are committed to working with students “to maximize the clinical experience while considering student input regarding patient assignments.”
The safety of all students in the nursing program is highly considered, and concerns and feedback are taken into consideration when completing clinical assignments.
Abigail Edwards ’25, another student in the nursing program said that “the nurses who I work with in my clinical rotations, either clinical faculty from Saint A’s or the nurses on site were very mindful of us being there and made sure that we were in a safe environment.”
“I always knew the procedures for staying safe [at clinical],” Edwards said, and “I never felt unsafe at clinical.” Edwards said that instructors and nurses are always there for communication if needed, whether for feedback or concerns.
Although clinical sites vary and risk levels according to patient populations differ amongst nursing students, the consideration for student safety and well-being reflects well in the success of the Saint Anselm Nursing Program.