Nursing on the Streets
Suzey is no ordinary nurse. Thanks to the success of a recent fundraising appeal, she is now attached full time to our Street Outreach teams in Nottingham and Nottinghamshire – bringing professional care to street homeless people in often desperate situations.
Because physical and mental illnesses are so common among homeless people, she is now a vital part of our efforts to get people off the streets. We asked her some questions.
What kind of illnesses do you come across on the streets?
Sadly there are a lot of people living on the streets who have very serious illnesses – from acute mental health problems like psychosis and schizophrenia to very serious physical illnesses like cancer and heart disease. Head injuries from assaults and accidents are also very common; so too are ulcers, infected wounds and respiratory infections. There are people recovering from major operations and even people needing palliative and end-of-life care. Inevitably there are also people who die on the streets, in really grim locations with no dignity at all.
How many rough sleepers are affected by ill-health?
I would say that all the people we come across have some form of mental or physical health problem needing further investigation and treatment. In my experience these problems are only made worse by the realities of living on the streets – by the violence, the danger and the sense of isolation that goes with it. People tend to enter a spiral of decline on the streets as their health deteriorates and they disengage further from health services. You end up with very poorly people who are just not getting the support and medical attention they need.
What’s your role about?
My role is to provide a link between traditional healthcare services and the homeless population. Most homeless people have the same right to treatment as anyone else, but they tend not to access it in the same way. Even when they do get treatment, their aftercare can be hugely compromised by the fact they are living on the streets – more often than not resulting in repeated presentations to A & E or hospital admissions. My role is really about bridging that gap and ensuring they are getting the help they need from the most appropriate service.
I assess, investigate, treat and triage and utilise my clinical consultations to advocate for patients. Where possible the outreach team will use the assessments I carry out as a starting point to move things forward and get people off the streets.
Why don’t homeless people just go and see their GP?
You have to remember that a lot of the people we help feel they have been failed by the system time and time again – especially people who have grown up in care. Also, people suffering with mental illness often develop a lack of insight and mistrust. There are those who have been trafficked and people who have developed a drug or alcohol problem. These problems often develop or become much worse whilst rough sleeping on the streets. As a result they are so disengaged from the rest of society that they just don’t access healthcare services at all, let alone a GP. That is obviously bad for them but its also bad for everyone else because it increases the likely hood of them becoming seriously unwell and presenting to hospital in emergency need at crisis point.
How difficult is it to work on the streets?
It can be very challenging because I am often called on to carry our nursing procedures on people in some very gruesome locations, often in the early hours of the morning in the dark. I will take stitches out and dress wounds from surgery in unimaginable locations, where it is very hard to create a clean environment. As a nurse I want to give people the very best possible care so it can be very upsetting to see people in those circumstances. I carry all of my nursing equipment with me in a hiking backpack and I can create a clean field just about anywhere, but things can become increasingly challenging when I need to assess and treat someone in the pouring rain for instance.
What is the best thing about the role?
It’s the ability to help people and get them out of the situation they are in by building trust and advocating for them. I am just a small part of a much bigger team, but I know there are people out there now who I helped to get off the streets and into settled accommodation. It’s also the opportunity to build relationships and have people engage regularly; resulting in some excellent wound healing for instance and reducing the risk of more serious illness developing.
*Suzey is employed by Nottingham City Care but is funded by the Off The Streets Campaign to work full time with the Street Outreach Team.
** Please help our fundraising to keep Suzey at work by joining the Framework Big Sleep Out on Saturday 18th November in Nottingham. Please click here for details.