Our Street Outreach Team is Hiring!

I didn’t learn how to do “street nursing” in school. Like most jobs, I’m figuring it out as I go. (The great secret of life? Everyone’s figuring it out as they go.) I’m grateful I’ve gotten (somewhat) used to having to pivot in the moment to focus on the highest priority.

Before, that meant dropping everything to advocate for a client who had an opportunity to receive housing. Or tracking down a client who required a swift follow-up assessment after an abnormal lab result. Or negotiating with a client who needed to go to the ED for a twisted knee (was it broken? sprained?) — but wasn’t willing to let us alert the fire department of her encampment location.

Although these examples are still pertinent, now our entire model of street outreach is shifting to focus on the current highest priority: protecting people experiencing homelessness from COVID-19.

As part of a county-wide effort, our team is attempting to reach as many unsheltered people as possible within our jurisdiction. Our approach is focused on education (on the current state of the pandemic, as well as strategies to prevent illness), supplies (such as hand sanitizer and other hygiene items), and screening for relevant symptoms. If we get consent, I take a temporal temperature. If someone is symptomatic, we can advocate for a test.

Given the limited testing stock — and the challenges in transporting a suspected COVID-19 case (we can’t use our own vehicles, and it’s unethical to use ride-sharing apps) — unless a client is exhibiting severe symptoms that warrant a 911 call, we will likely be in the difficult position of figuring out how an unsheltered person can “self-quarantine.”

 In California, there should be hotels and motels that we can use for confirmed positive cases, or clients waiting for a test result. But, again, it’s difficult to get tested. I hope this changes soon.

I hope everything we are doing — and everything you are doing — has such an impact that our team will keep monitoring our unsheltered friends without seeing an outbreak occur within their communities. I hope the mask and gloves I wear when I get within 6 feet of a person experiencing homelessness keeps them safe.

When I walk by the empty library parking lot (multi-leveled and covered), the thought occurs to me that this would be a good place to set up a temporary hospital.

I don’t want to increase the collective anxiety, but I do want to encourage everyone to continue following social distancing directives — so those of us who cannot (whether by profession or lack of a home) are a little more protected.

“I love you guys,” she said, in that casual way people say such things. But my ears pricked up at the word ‘love.’ And I knew what she meant.

We had shown up week after week, tracking her down after she moved to another encampment. We kept coming back. And she was always happy to see us.

I shifted to make eye contact with her from where I was squatting in the dirt, retrieving supplies from my backpack. I said the words with intention, slowing my breathing, feeling my feet solid on the ground: “We love you, too.”

She smiled. “I know,” she said.

*Patient’s name has been change to protect identity.

Today, after 3 months of regular outreach, Jennifer* let me hug her. In fact, I think she initiated it.

Today Randy seamlessly repositioned himself so I wasn’t looking into the sun while talking with him. I asked him if that’s what he did. He smiled and nodded and said yes.

Today Tom told me I needed to learn some street slang, then taught me that meth is called “sh*t” as in “do you have any sh*t?”

We didn’t end up seeing Fred today. He saw us from afar, decided we were cops, and headed away from his camp area. I only know this because his wife Janet told us.

Today we met someone new. She said she stays at another encampment and talked about the community there. This was the first time I’ve heard a client describe their encampment as a “community.”

It’s the truth — outreach is always an experience of visiting a community that may or may not accept us.

*Patient’s name has been change to protect identity.

Today Randy* seamlessly repositioned himself so I wasn’t looking into the sun while talking with him. I asked him if that’s what he did. He smiled and nodded and said yes.

Randy, a resident at one of the larger encampments we visit, is also known as Uncle Randy.

We’ve noticed that some residents receive this avuncular honorific, perhaps because of their older age — or more likely because they provide guidance and help to others.

Randy’s a guy you want to have as a friend. He has a car battery — an RV battery — that generates enough energy to allow him the use of a microwave and TV in his area of the encampment.

Every time I see Randy, we give each other a big hug. When he came into the clinic for an appointment last week, he brought me a piece of chocolate. He’s a warm, bright soul that I’m lucky to get to work with week after week.

I asked Randy where he got his pendant, noting that I always see him wearing it. “It was my Mom’s,” he said. She died in an accident when he was a teenager.

“When she died, all 6 of us brothers decided what we wanted to keep of hers. We did it with love. And I chose this. I can’t remember a time I didn’t see her wearing it.”

I asked if it was Guadalupe or the Virgin Mary — or were those the same? I wasn’t raised religious, I said, trying to excuse my ignorance.

“Well I sure do think the work you and your team do is a representation of Him. I don’t think it’s a coincidence that you showed up in my life.” I told him, as I always do, that we’re honored to serve him. I always say ‘God is Love,’ I said. He smiled, and gave me a hug — this time a little tighter than usual.

*Patient’s name has been change to protect identity.