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ADVANCE Perspective: Nurses

Global Health at Home

Published August 24, 2015 11:55 AM by Guest Blogger

Editor's Note: This guest post is written by Veronica Gutchell, DNP ‘13, RN, CNS, CRNP, assistant professor, University of Maryland School of Nursing

On any given night, about 3,000 people in Baltimore experience homelessness.  To help with this ongoing problem, University of Maryland School of Nursing (UMSON) faculty members Katherine Fornili, MPH, RN, CARN, assistant professor, and Rosemary Riel, MAA, clinical instructor and associate director, Office of Global Health, and I participated in the Baltimore City Point in Time count last winter.  We worked with both sheltered and unsheltered individuals. The data from the count is used to advocate for resources, plan programs, implement policies to address homelessness, and evaluate the use of existing resources and programs. 

I came upon this opportunity through the Global Health Certificate program at the University of Maryland School of Nursing. The Global Health Certificate program helped me think about my practice through the lens of social justice. It challenged me to understand my own biases and how they impact my practice as a nurse practitioner.  Using the lens of social justice changed the way I work with underserved patients in primary care.

We spent a lot of time in the certificate program focusing on the social determinants of health and then we applied those concepts in a field placement experience. Going abroad for four to six weeks didn't work for my life at the time, so I asked for the opportunity to practice applying the social determinants of health locally.

My assignment addressed the issue of homelessness in Baltimore. Through the faculty's network of contacts, I was introduced to some very talented people at Health Care for the Homeless, a nationally-recognized model for the delivery of health care to those experiencing homelessness. Through Health Care for the Homeless, I was able to work on a project to start up a mobile clinic program. The mobile clinic delivers primary health care to those experiencing homelessness in Baltimore and surrounding areas.

In researching my project proposal, I came across 2013 data from the Mayor's office on the Baltimore City Point in Time Count. After my field placement was completed, and I presented my experience, a colleague talked to me about volunteering for the next Count. I was immediately interested in organizing volunteers from UMSON, so I sent an email to the School's faculty and staff announcing a service opportunity. Nine people responded and three of us ended up being able to participate. The organizers needed most volunteers for the overnight count and it turned out that the three of us were able to volunteer for both nights.

The Count involved conducting a survey to try to better understand who experiences homelessness. For example, from the 2013 Count, 52 percent of respondents reported a history of mental illness, 56 percent a history of substance abuse, and 11 percent indicated they were veterans. This information helps communities determine how to tailor services to those in need.

Questions on the 2015 survey looked at mental illness, substance abuse, Post Traumatic Stress Disorder, and veteran status. Additionally, there were questions about previous experience with trauma and how long an individual had been experiencing homelessness. Almost every person I surveyed agreed to participate. I even had one individual who was sleeping on the street in 27-degree weather say "God bless you."

The experience of homelessness can seem overwhelming. Even so, I feel optimistic about the goal of making homelessness "rare and brief."  Journey Home Baltimore, the organizers of this event, estimates over 300 people volunteered to help with the 2015 count. I'm hopeful because there are a lot of people who cared enough to come out in the middle of two cold winter nights to conduct this important survey. The volunteers were a widely diverse group of community members; for me, there's something moving and promising about that. I am inspired by those who dedicate their professional lives and those who volunteer to make homelessness a temporary experience for individuals and families. It's that work and commitment that keeps me encouraged.


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