Nursing CE Central
Nurses dedicate their lives to the well-being of their patients and their community. What does that care look like for patients who cannot access healthcare through typical facilities?
Street medicine allows nurses and other clinicians to serve homeless patients by taking care directly to the patient regardless of their environment. This allows nurses to bring care to over 500,000 Americans currently experiencing homelessness.
Two Denver, CO nurses are advocating for expanded street medicine services by maximizing a nurse’s scope. This article will explore street medicine and how these nurses are pioneering a holistic nurse-led approach to this outreach.
Street medicine is a type of medical outreach that provides health services to homeless patients. These services are specifically designed to suit the needs and circumstances of the patient and are offered directly to the patients whenever they live, including in alleyways, under bridges, or in an urban encampment.
This direct care, regardless of the homeless status of the patient, is what sets street medicine apart from other outreach programs that typically serve homeless patients in shelters. Street medicine allows healthcare providers to eliminate as many barriers to care as possible for their patients.
Trust building is a vital aspect of street medicine. One street medicine group in Nashville does not provide care during the first visit to homeless encampments and instead uses this time to introduce themselves.
The group will then return to the encampments for a second visit. This not only allows the patients to know who will treat them but also allows the providers to bring resources and supplies based on the needs of the patients.
Another nurse named Anna Kern describes her sense of purpose while providing street medicine: “On a street run, I ask patients what their primary concern is, take a more thorough history, and then use these findings to guide my physical assessment. After reporting back to the nurse practitioner and documenting my work, I develop a nursing plan of care and recommend specific interventions.”
Street medicine for nurses like Kern is a natural extension of the direct care they provide to patients in hospitals or other clinics. Each patient has individual circumstances and needs that street medicine programs can help care for without taking the patient out of a familiar environment.
The Street Medicine Institute, or SMI, leads street medicine programs in over 140 cities in 27 countries. The SMI offers services from grants for new street medicine programs, technical training for existing programs, and educational resources for students/clinicians.
Services provided by street medicine may include:
Typically, street medicine programs are focused on physicians, but nurses Kelly Thompson and Kiera Connelly want to explore the benefits of nurse-led outreach. Connelly stated, “We made this presentation to talk about how other programs can incorporate nurses, the benefits of nurse-led outreach, and how to maximize nurse’s scope on outreach. The scope of nursing ranges around the world, as well as the level of other street medicine programs. We could talk to people for ten or 15 minutes and hear about their program, talk about our program, and see what we have in common.”
Thompson and Connelly volunteer their time with the Yahweh Health Clinic’s street medicine group, which began in 2020. Connelly is one of the founders of this program and now uses her position to advocate for more holistic care for homeless patients.
The two nurses attended the International Street Medicine Symposium in London this September and they presented a nursing poster. As their patient care model centers around disease prevention education, it is the ideal model for street medicine programs.
Thompson and Connelly are also looking to expand the current scope of Denver’s street medicine to include new services such as STD testing or a syringe exchange.
Nurses understand the individual needs of their patients better than anyone else on a care team, often advocating for their patients during all stages of care. Nurse-led street medicine allows them to bring this advocacy out of hospitals to patients who need them the most.
Continued research into this approach may follow Thomson and Connelly. The Street Medicine Institute has announced that next year’s symposium will take place in Kansas City, MI on September 15-18.
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