We teamed up with International Health and Medical Services to interview Chrisna, a Registered Nurse and Health Services Manager within Immigration Detention. International Health and Medical Services provide primary and mental health care services within the Australian immigration detention network under a contract with the Department of Immigration and Border Protection.

What inspired you to work in Immigration Health?

Hi my name is Chrisna. I have been working in immigration detention for almost 11 years, initially as an RN then TL and for the last 12 months as HSM. I have always had a passion for primary health care and the role has given me the opportunity to grow in this area. I have previously worked in emergency and if found the skill set was easily transferable into the detention network.

What does your day look like as the Health Services Manager of an Immigration Detention Facility?

The role as HSM is very varied and never the same. The day includes attending a variety of meetings to ensure good communication between stakeholders and clinical staff. The role includes managing the healthcare of all the clients in our care, working as a team to ensure the best health outcome. The HSM is responsible for additional HR duties such as rostering and staff management.

The HSM requires critical thinking to manage situations that may present itself during the day. Although some administrative tasks may be the same on the day-to-day level, you never know what to expect.

What are some of the most common clinical concerns within immigration health?

Our clinic operates very similar to a community clinic. The days are never the same and clients present with a variety of concerns. Similar to a GP clinic we offer preventative health checks, immunisations and health promotion, as well as management of chronic diseases and attend to the day-to-day medical needs of all our clients. We have a mental health team that attends to our clients with acute and chronic mental health concerns.

When a detainee has increasingly complex care, how is this managed?

Complex care clients are identified and escalated as soon as possible. We will manage them similar to clients in the community providing additional support as needed.

What are some of the challenges of being a health services manager?

The immigration field is always changing, and you need to adapt to the current needs identified by the detention environment and the staff. We have an amazing team, and we work well with all the stakeholders. This makes the most challenging situations easier. We also have a great management team that is always there to provide support.

What are some of the rewarding aspects?

Working together as a team and dealing with the challenging situations. Reflecting on the situation and learning and improving our practise.

What has surprised you most about the role that you didn’t realise when you started?

The HSM role is very challenging but very rewarding. It gives you the opportunity to grow outside of your clinical field while still using your clinical knowledge to provide the best outcome.

Do you miss clinical nursing?

I still maintain a degree of patient contact and oversight over the clients and their medical needs. I also try and assist when there are medical emergencies and therefore still have some clinical exposure. The management role teaches you a different skill set, and it can be very rewarding.

How do you foster a healthy culture within your teams that you manage?

I maintain an open-door policy and try and resolve minor issues as they present. We are a reasonably small team, and we try and look out for each other. It is also important to give credit and appreciation to staff, especially when dealing with difficult situations.

What advice do you have for junior leaders/managers?

I think to understand that as a junior leader you are supported by your senior staff and management. You are not alone, and you can learn so much by asking for support and advice.

What are some skills that people need, to be working in a position for IHMS such as yours?

Management experience would be ideal. A background in emergency nursing and working with clients from different cultural backgrounds. Critical thinking skills and the ability to adapt and change.