Initiatives Help Nurses Treat People Experiencing Homelessness

• Initiatives have been popping up in recent years at nursing schools and medical facilities to help treat people experiencing homelessness.
• Academic research shows that certain approaches to care — and more education on treating the unhoused — can help improve the quality of life for these patients.
• In 2023 alone, nearly 1 million people in the United States experienced homelessness for the first time.

Nearly 1 million people experienced homelessness for the first time in 2023, and the number of older adults, disabled people, women, and “gender-expansive people” experiencing homelessness continues to grow.

That’s according to the 2024 State of Homelessness report from the National Alliance to End Homelessness. However, “local and coordinated federal efforts” show that solutions exist. 

Enter nurses. 

Initiatives have been popping up over the past few years at nursing schools and medical facilities with the goal of bringing services to the communities that need it most. And academic research shows that certain approaches to care — and more education on treating this population — can help improve the quality of life for these patients. 

Studies on Populations Experiencing Homelessness

A scope of practice review published in 2022 found that nurses treating the unhoused focused on “physical and mental health assessments, pathology collection, wound care, and vaccination.” Case management, health promotion, and health education were also noted in the review.

It also noted the importance of a trauma-informed approach to care.

“Embodying the attribute of respect, engendering trust and adopting a trauma‐informed approach appeared to be critical in engaging people experiencing homelessness,” the authors stated. “Once a therapeutic relationship was established, the skills and knowledge of the nurses’ scope of practice appeared to be vital to optimizing access to healthcare.”

That supports the findings of an earlier study in which those experiencing homelessness reported that mental illness, chronic pain, and addiction were “believed by participants to be poorly treated” due to clinician bias. 

Increasing education about the healthcare needs specific to those experiencing homelessness could benefit patient care, a separate study determined.

Examples of How to Help

The Family Service Association of Bucks County (Pennsylvania) established its Street Medicine Outreach program two years ago, according to a Philly Burbs report. Brandi Stewart, RN, leads the program, which brings healthcare, including wound care, vaccinations, medical supplies, and over-the-counter medications, to the unhoused.

“The people we care for are our neighbors,” Stewart told Philly Burbs. “They’re just trying to make it out there. They’re just trying to survive.” 

UCLA Health also launched a program to help those in their community who are experiencing homelessness. Brian Zunner-Keating, MS, RN, director of the UCLA Health Homeless Healthcare Collaborative, said in a news release that nurses are “essential” to the program.

“They maintain relationships with our community partners, they get to know the patients and they keep track of appointments and any extra care patients might need,” he said.  

In California, the UC Davis School of Nursing has implemented a mobile health initiative that brings essential services to those experiencing homelessness, according to Holly Kirkland-Kyhn, a wound specialist and family nurse practitioner. 

Meanwhile, UNC Greensboro School of Nursing students participated in a simulated environment with actors portraying patients experiencing homelessness. Clinical Assistant Professor Crystal Lamb and Clinical Instructor Sandra Blaha led the simulation.  

“One big change for the students was performing the tasks in a different environment,” Lamb said in a news release. “The students usually equate nursing to the hospital, but through the simulation they realize that they are nurses anywhere.” 

The Bottom Line

The number of people experiencing homelessness in the United States continues to increase, meaning nurses will need the medical and interpersonal skills to treat this population. By focusing on a trauma-informed care approach, and being aware of their own biases, nurses can provide care, build relationships, and serve their community in a different way than they might have anticipated when they began their nursing careers. 

Read More