Homeless for One Winter Night: A Nursing Student's Perspective

When you hear the word "homeless" what comes to your mind? When you see out of the side of your eye a person holding a sign asking for money, what goes through your mind? Do you wonder if the homeless person is an addict or even crazy? Do you wonder if the person holding the sign is a scammer trying to prey on people's sympathy? Or do you feel compassion, but just are not sure how to help? These are all questions I have at one time or another thought. And while it is good to question what you see, I also think it is good to take the time to learn about what you are seeing and do something to help. It may be true that some people are homeless due to poor choices or that some people try to scam others. But if you think about it, how humbling it is to hold a sign and ask strangers for help, you will find yourself giving that homeless person the benefit of the doubt. Now take this thought a step further and put yourself in the place of a homeless person. A homeless person is just like you and me - they just don't have a roof over their head.

According to the last biennial survey released by the Champaign County Continuum of Care for January 2013, there were 214 homeless people in Champaign County. The number has gone down from 549 homeless in January of 2011. But these numbers are just estimates that depend on the openness of the individuals asked. Plus the term homeless can cover a broad spectrum of individuals - from those with no shelter at all to those who stay on a friend’s couch. Another factor taken into account is how long the person has been homeless. A person is deemed chronically homeless if they have been homeless for over a year or been homeless four or more times in three years and have a disabling condition.

My Experience at One Winter Night:

On the evening of February 21, 2014, I got a chance to experience in part what a homeless person experiences every day. CU@Home's One Winter Night is an annual opportunity for someone used to sleeping in a warm bed to experience sleeping on the street while raising awareness for the homeless. I heard about this even via my college two weeks before it was scheduled to happen and was immediately draw to the idea. I am a nursing student who has very little money, and as a student one of my most valuable commodities is my time. So I decided to volunteer to help raise awareness for homelessness and funds for a day shelter for the homeless in Champaign-Urbana. I had contemplated sleeping in one of the boxes provided for those who committed to raise $1000, but was not sure I could raise this much money in such a short time. So I just decided to volunteer by holding a sign and asking for money for the homeless.

Before I tell you about my experience, I must tell you a couple things about myself that seem off topic but will become relevant. I am a wife and mother. My husband works nights - including Friday nights. I have a wonderful son who is eight years old. That Friday night I planned to have my son sleep over at an aunt's house while I volunteered. I did not think it would be wise to have him come along. At the last minute, the sleep over was cancelled. So out of necessity I brought my son with me. I figured we would stay a couple hours and then I would take my son home. When I told my son the new plan, he was reluctant to come. He thought he would be bored.

As we drove to down town Champaign, I discussed with my son what homelessness is. I explained to him that anyone can become homeless - even children. He did not ask a lot of questions; he just listened. When we arrived, it took us a moment to find out what we were going to do. We walked inside Christ Community CU Church on Neil Street and signed up. We then listened to some instructions and my son got to choose a sign to hold while collecting money. The church became our headquarters for the night. Any time we needed to use to bathroom or just needed to warm up for a moment, the church's doors were open. We became increasingly grateful for this sanctuary as the evening progressed.

After checking in, my son and I walked up Neil Street trying to get people’s attention and collect money. Many volunteers were able to collect money from cars stopped at stop lights. I did not want my son running into the road to collect money, so we focused on asking pedestrians for money. We walked up and down Neil Street. After a while we walked over to Walnut Street and found many people walking around going to and from restaurants. My son soon found he really enjoyed going up to people and asking them to help the homeless. He would see someone walking in our direction and he would run to greet them. Some people donated money while others did not. We were both amazed at how some people walked by like we were invisible and others at their true generosity. My son got more and more excited as he realized how much money he was collecting. We even met a homeless gentleman who thanked us for helping and gave us the few coins he had in his collection cup.

At one point during the night my son met Mayor Don Gerard and got to tour the Champaign City Mayor's Office. My son thought this was neat, but he couldn’t wait to go back outside and collect more money. The hours passed… I would ask my son if he was ready to go home, but he would tell me not yet. After a while he started asking to sleep in a cardboard box like some of the other volunteers were doing. He wanted to spend the night. Some of the volunteers let my son try out their boxes and said he could sleep in a box if he wished, but Edward was too excited to sleep.

My son continued to help collect money. All the while it kept get colder outside. We would stop in the church to get warm and then head back out to the streets. The noise of the city traffic and people going to restaurants, bars, and music clubs lasted well into the next morning. It finally started to get quiet around 3AM. Around 2AM, I decided that my enthusiastic son should get some sleep. So we walked to our car parked up by the Orpheum Children's Museum. My son did not want to stop helping others and really wanted to sleep in a box. But I explained that he needed to sleep and even some homeless people sleep in cars.

My son fell asleep while I laid awake ponding this experience. It wasn't the coldest night we had had in February, but it still was cold. Even trying to rest in the car I found it difficult to stay warm. Plus the noise of a Friday night downtown made it difficult to sleep. I could not imagine doing this every night. I slept very little. At about 5AM, I decided it was time to head back home. My husband would be getting off from work and there was just one more hour left of One Winter Night. So we did what a homeless person can’t do. We went back to our warm home and crawled into our comfy beds thus ending our One Winter Night experience.

 

As I think back to our One Winter Night, I realize how easy we had it.  We had not experienced true homelessness. We had had a warm building to go into when we got cold and had bathrooms available to use when we need it. In that warm building, there were snacks laid out for us to eat if we became hungry and water and warm drinks if we became thirsty. We had only experienced homelessness in a small way. And yet we were so grateful to return home and back to our “normal” life. My heart breaks for those who don’t have that option.

Now to put on my nursing student brain and look at homelessness from a healthcare perspective… As a nursing student, I have been taught many important things – among which a nurse is to provide holistic, patient-centered care to the patient regardless of differences of view and walks of life. A nurse is the patient’s advocate. This means regardless if a person is homeless or not, they are still treated with respect and are given the best care a nurse can give.

So what are the health needs of the homeless? For this information I asked those who actually have worked one on one with the homeless – both Melany Jackson of the CU@Home organization and Melissa Miles MSW, LCSW a clinician with Community Elements. Both ladies work with the homeless in different and important facets. What I came to understand is that when a person is homeless, their primary focus becomes survival – food and shelter. Long term needs are often neglected. So things like dental visits, check-ups, and eye exams are often not done.  There are a few reasons preventative care is not met. Some homeless individuals move from place to place - whether shelter to shelter or town to town. Without a permanent dwelling place, it can be difficult to contact a homeless person and establish regular check-ups. Another reason can be a lack medical insurance. Some homeless do have insurances like Medicaid; while others don't. And even those with Medicaid usually only use it after a condition becomes extreme. An example Dr. Miles shared is that of a patient who came in with extreme ear pain & an ear infection. After more than one Emergency Room visit, it was determined that the under lying cause of the ear infection was due to a severe tooth infection. The patient qualified with Medicaid for an emergency dental extraction and the tooth was removed resolving the medical problem. If preventative care had been given and the patient's teeth had been better cared for, the patient would likely not have had the ear infection that caused the patient so much pain.

Most healthcare interactions with the homeless are for exacerbated condition both acute (sudden) and chronic (long term). The stress of a homeless life can be very hard on a person's health. Living on the streets in the elements (drenching rain, summer heat waves, & artic freezes of winter) can put the human body through extreme conditions that the body was never meant to go through resulting in heat stroke or hypothermia. The lack of healthy food, clean water, and a good night's sleep can lead to physical problems of malnourishment, dehydration, and apnea which if not treated will lead to worse complications and eventually death. Just the constant stress of being in survival mode can wear the body down. Common chronic conditions of the homeless that Dr. Miles sees are Diabetes, COPD (Chronic Obstructive Pulmonary Disease), HIV (human immunodeficiency virus), and back pain/arthritis. A number of patients that Dr. Miles cares for have a history of substance abuse which also adds to the health problems both physically and psychologically. The homeless also can have chronic mental health problems such as PTSD (post-traumatic stress disorder), depression, mood disorders, and anxiety issues. Some of these conditions can be part of the cause for being homeless. But it is also important to note that some of these mental conditions started after become homeless due to the stress of being homeless. Never assume that a person became homeless because of a mental condition or substance abuse. This is stereotyping and is not true for all homeless people. Some just had some really bad luck. As a nursing student, I always try to keep this in mind. I am not there to judge the patient; I am there to care for the patient and help them reach their healthiest self.  

We have established that there are health needs of the homeless. So here in Champaign County, what is being done to help the homeless? I was amazed to find out how many different organizations there are to help the homeless. In the medical community, places like Carle Hospital have Community Care Programs. Frances Nelson Health Center offers a sliding fee scale and accepts Medicaid. Presence Covenant Hospital will refer people to Frances Nelson Health Center. Frances Nelson also sends a nurse practitioner to Community Elements once a week to provide care. Other organizations like Community Elements include CU@Home, the Canteen Run, Daily Bread Soup Kitchen, the TIMES Center for men, Salvation Army Stepping Stones men’s shelter, Restoration Urban Ministries, Prairie Center for Addiction treatment, SAFE House and Life-line Connect for people coming out of addiction, Center for Women in Transition, Crisis Nursery, & St. Jude Catholic Worker House. All these organization help the homeless or those in transition. Once a month the CSPH (Council of Service Providers to the Homeless) meet to discuss ways to help the homeless in Champaign County. When I talked with some of the different people who work for these organizations, I could hear the passion in their voices for the work they do. I am very grateful for people who are doing something to help the homeless.

So what can a student like me do? I could of course give money and supplies such as blankets, clothes, shoes, & food to these organizations. A lot of the organizations appreciate volunteers to come help out. Also educating myself to the needs of the homeless and what resources are available will be helpful for when I become a nurse. I was also encouraged to share with others what I learn & to be an advocate for the homeless. I was told that as a nurse it is important how I treat my homeless patients. I need to treat them with the same kindness and concern I would treat any other patient, and to build trust with my homeless patients to encourage them to seek healthcare and take better care of themselves.

I believe that while I volunteered for one evening to help raise awareness for the homeless, this has begun a much longer journey for me. I am not merely satisfied with living a sheltered life while others need a home. I want to help people who are homeless. I want to see their health needs met. I want to see them thrive. Most of all, I want to let them know I see them as a person who has value and desires love and caring too. This is what I hope to bring to the healthcare community on my journey to becoming a nurse.

 

 

Bibliography:

Benson, L. (2013, April 29). Urbana-Champaign Continuum of Care. Agencies Com - Illinois Public Media. Retrieved May 4, 2014, from will.illinois.edu/nfs/2013memosurveyresults.
Interviewed: Melany Jackson M.Div. Chair, Council of Service Providers to the Homeless/CU@Home
Interviewed: Melissa Miles, MSW, LCSW PH-ACT Clinician at Community Elements