Nurses have been forced to suffer the effects of inhaling Spice, some batches of which have been found to contain cockroach killer, when administering emergency care to prison inmates.

The Royal College of Nursing (RCN) said it has consulted withprison bosses who have agreed to improve the safety of healthcare staff who risk exposure to the deadly drug and other psychoactive substances.

Nurses and healthcare assistants are often first on the scene when inmates need emergency care, and under current guidance they are expected to enter cells before the dangerous smoke from the drug has cleared.

The effects can last for hours, with staff passing out, unable to administer medicine or drive home after shifts.

The HM Prison and Probation Service (HMPPS) has agreed to work with the RCN to update its guidance so it reflects the reality of clinical staff dealing with unpredictable and dangerous psychoactive substances.

This will include guidance around responding to emergencies, particularly out of hours, as well as improved reporting guidelines.

New measures to improve staff safety will also be drawn up in a new best practice paper, with input from the RCN, HMPPS, the Prison Officers Association and other stakeholders.

To tackle the root of the problem, healthcare staff will have more involvement in HMPPS drugs task force, which has been set up to tackle the wider issues of supply and addiction in prisons.

Nurse and healthcare assistants will lead interventions with prisoners and use a variety of therapies to help them recover from addiction, which it is hoped will reduce the demand for drugs.

One prison nurse, who spoke on condition of anonymity, said: “There was a day when three people on my team couldn’t give medication because it wouldn’t have been safe due to the effects of Spice.

“Not only is our health being put at risk, but we can’t do our job properly and other people are missing out on care.

“Recently there was a batch of Spice with traces of cockroach killer in it so we really have no idea what harmful chemicals we’re inhaling as well as Spice.

“At the time your overwhelming concern is for the patient. What would happen if someone died because I refused to go in? It’s a horrible situation to be in. The reality is we’re looking out for our registration not our health.”

A normal heartbeat is 60 to 90 beats per minute but after smoking Spice healthcare staff have seen inmates with heartbeats of 140 to 180 beats per minute, meaning there is a real risk they could die.

Ann Norman, RCN professional lead for prison nursing, said: “The dangers posed by Spice, both to prison healthcare staff and the patients they care for, cannot be overstated, these drugs kill.

“Nursing staff have passed out or been left unable to drive after inhaling fumes in smoke-filled cells. This is unacceptable.

“This meeting is the first step on the road to improving conditions for dedicated nurses and healthcare assistants who are putting their safety on the line in the course of their duties.

“We will be working closely with HMPPS to ensure the safety of prison staff is properly accounted for in the revised guidance.”

A spokesman for the prison service said: “Our discussions with the RCN build on the work we are already doing to protect frontline staff.

“Prison officers are always the first to unlock and enter cells and healthcare staff are not allowed to enter if there is any risk to themselves. Any prison staff who feel unwell will be assessed on-site and treated if required.

“The best way to keep staff and inmates safe is to keep drugs out of our prisons. That is why we have trained more than 300 specialist drug dogs, introduced body scanners and intelligence-led searches, and made it a criminal offence to possess psychoactive substances in prison.