Homeless

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Health Goals

Access to quality health care services is a crucial goal in the Healthy people 2020 initiative for this aggregate. Gaining access to routine healthcare will impact this groups overall physical, social and mental health (HP2020, n.d.).

I organized a small food and clothing drive at work and delivered the items to the local church St. Patrick’s and split the clothing between the church and the United Veterans Beacon House. I collected tons of canned goods. Since many of the homeless spend nights in our ED waiting room I talked to my manager and security and asked if there was some way we could change our policy of “kicking them out” and let the homeless stay until at least the morning.

HOMELESS

Disparities

How can a community health nurse minimize the disparities of the homeless? While it seems to be a daunting task, the nurse within the community has a great advantage. The nurse has intimate knowledge of the people who live in and around the community. This provides the chance for a more holistic approach to all types of care. The specific needs of the group can be the focus of the care provided. When considering homeless veterans within a community, specialized care is essential. Approximately twelve percent of the homeless are veterans. Many homeless veterans suffer from mental illness along with alcohol and substance abuse issues (nchv.org, n.d.). Veterans along with their medical needs also require job training and assistance. The community nurse can assist by providing nutritional guidance and basic medical assessment. Many homeless people do not receive the follow up care recommended for their healthcare needs and meeting patients in their own environment improves rapport between the caregiver and patient. With better rapport, compliance with follow-up and medical regime is improved (Savage et al., 2006). Nurse managed clinics have potential to reduce non-urgent emergency room visits and improve health of the homeless.

On Long Island there are many veteran helping veteran community centers that try to improve the overall health and well being of veterans. The United Veterans Beacon House has 25 locations that provide the many services that the homeless face. It shares many of goals of Healthy People 2020 in regards to improving the quality of life by providing services to veterans in need. They assist veterans with many health issues and offer alcohol and drug abuse help. They also assist with housing and employment issues. They do extend their services to non-veterans as well. Beacon House attempts to address many of the barriers to health care for the

HOMELESS

homeless. They offer transportation to medical and employment appointments. Drug and alcohol counseling, along with mental health screening is available. They run a food pantry and thrift shop. The community nurse would assist this aggregate in achieving health equity, eliminate

disparities and create healthy social and physical environments. This would assist with meeting the goals set by HP2020 and also reduce the overcrowding faced by most emergency rooms.

I spoke with Pete at the United Veterans Beacon House. He told me that many homeless do not accept the help offered. Many are given temporary housing but refuse to go more many reasons such as they “don’t like the shelter” or “it is too far from here”. They prefer to find their own way and end up sleeping in hospital waiting rooms especially in the winter months. It is as if they abuse the system designed to help them and the facility continues to try.

I spoke with Deacon Frank at St. Patrick’s and met with his coordinator Catherine. They have a soup kitchen that is open for breakfast and lunch from 9:30 am to 1:00 pm and a food pantry. They also offer counseling and advocacy for the homeless. I arrived at 10:00 am and was surprised to see some of the homeless that take residence in our ED waiting room. They were sitting in the church auditorium and eating a meager breakfast. Volunteers at the church brew large urns of coffee and lay out donated rolls, bread and sweet bakery treats. The homeless can request items from the food pantry also.

Community Proposal Project:

Working with the United Veterans Beacon House, a non-profit, charitable organization.

This organization provides services to veterans and non-veterans with basic human needs. They provide counseling services and job training. Drug and alcohol counseling is also provided. Beacon House was incorporated in 1994 and runs 25 shelters. It operates many food pantries and a thrift shop. Since its headquarters and thrift shop area located only a few blocks from the hospital, teaming up with this group would be a tangible goal. To be able to provide clean clothes and laundry vouchers to the homeless that frequent the emergency department would be a step in the right direction to help the homeless with some basic needs. They can also utilize the many programs run by Beacon House in order to help them overcome their numerous addictions and health problems.

Providing basic human needs and services would assist in the prevention of disease, improve the overall quality of life and add years to the homeless life expectancy. Helping to create a balanced state of well being by interacting with all aspects of human needs is the core of community nursing (Coles et al., 2012).

There was no community health nurses at the Beacon House or St. Patrick’s. Initially I thought it would be a valuable addition to the services but I am not sure the bulk of those that are served, especially St. Patrick’s, would heed any advice given. The homeless seem to be content with their lifestyle. If a community nurse gained the trust of the community they may be able to offer health information and a wellness plan.

Summary/Conclusion:

This project has not been what I expected from the beginning. I think I went in with “wide eyes” and a “big heart” assuming that I could institute some type of change. I really did want to make a difference in helping the homeless. What I have learned is it is not easy to make an impact. With that said I have accepted the small progress and achievements I have made during this project. I have gained a much better understanding of the barriers that exist for the homeless. Some barriers exist due to money, however the greatest barrier to the services is the homeless themselves. This made me feel frustrated during this project. It is a shame to have resources