Julee Smith is considered a hero, of sorts, at Westgate Correctional Facility. About 15 per cent of the inmates suffer from asthma; the nurse recently took a course to better help them out.

“In nursing school there was only a chapter or two on asthma and its treatment,” she said. “I wanted to learn, in a little more detail, about asthma and how it impacts people. I love being able to help those who need it.”

That concern led her to sign up for a six-month course organised by asthma charity Open Airways.

Ms Smith was one of six nurses in Bermuda who recently spent 300 hours studying asthma medicine and treatment online.

She is now certified to diagnose asthma, an important function in a prison setting where there isn’t always a doctor immediately on hand.

“I love teaching people to use their asthma pumps properly,” she said. “I was on a flight and the girl next to me was using her pump incorrectly.

“I just couldn’t help saying to her, ‘Excuse me but you’re doing that very inefficiently. I’m a nurse, can I show you a better way?’”

The incidence of asthma is higher in the prison population than in the rest of the community. According to Ms Smith, 10 per cent of residents are affected.

Tracy Nash of Open Airways speculated it could be because inmates have greater exposure to common asthma triggers.

“Bermuda, in general, has a slightly higher incidence than the rest of the world, because of the climate and the high prevalence of cockroaches and mould,” she said.

Added Ms Smith: “Stress can also be a trigger. Often, when an inmate’s case is coming up you will see a flare-up of their asthma.”

She said a prison smoking ban in 2005 helped bring the asthma attack rate under control.

“Since the ban, which was before my time, things have definitely gotten better,” she said. “Cigarettes are a major asthma trigger and so is second-hand smoke.”

Ms Smith said inmates seem very interested in learning about controlling and treating their asthma.

“They respond very well to asthma education,” said Ms Smith.

She has been a nurse for nine years and has worked at Westgate for five.

“I always wanted to be a nurse,” she said. “Even as a child I always had a toy stethoscope pressed to my dolls.”

Nursing in a prison has its unique challenges.

“You have to be security-conscious all the time,” she said. “I always have to have a prison officer with me when I am working with a patient.

“I have to be very aware of my environment. Something like a scissors or a pen left unattended can be turned into a weapon, and patients fake illness all the time.

“In the beginning you have to make your standpoint, and show that you won’t tolerate misbehaviour. After a while they respect you and that makes it easier to care for them.”

Despite those challenges in some ways it’s easier to be a nurse in a prison, Ms Smith said.

“On the outside, it might be hard to reach a patient if they don’t have a phone, or they might not be able to pay for treatment. There’s none of that here. If you need to book an appointment for a patient, you just have someone fetch them.”

She said she loved her job despite all the challenges.

“I worked in a doctor’s office, and at [King Edward VII Memorial Hospital] previously,” she said. “It might be more rewarding working here.

“Every day is different. You never know what is going to happen. Sometimes there are lockdowns, for various reasons; sometimes I will see people after their release on the street, and they will say hello and tell me about the job they’ve found or how they are working to better their lives. That is very encouraging to hear.”

• For more information about Open Airways see www.openairways.com or e-mail nurse@openairways.com or call 232-0264.