I'm at the Health Care for the Homeless (HCH) conference in Phoenix AZ. I'm learning a lot and doing some fantastic networking but all of this excitement gets me hyped up and gives me all kinds of energy which I would really like to get out in a run but I'm meeting co-workers for dinner at 6:30 and it's currently 5:55.
Last year was the first time that I came to this conference. At the time, I had been at my job for just under six months and I was incredibly overwhelmed by the conference. It made me realize how little I really knew about the homelessness world even after a half year of working in the field. This year has been a completely different experience; I can read through the list of sessions and know what they all mean, I'm seeing people that I know and people who I have emailed back and fourth with, and I have interesting and provoking questions to add to the conversations. There are still moments that make me feel like I know nothing at all but they are few and far between.
I can't wait to get back and apply what I'm learning to my work... and go for a run.
Showing posts with label health care for the homeless. Show all posts
Showing posts with label health care for the homeless. Show all posts
Friday, June 13, 2008
Thursday, October 18, 2007
Nighttime Rounds with Health Care for the Homeless: The Outreach Van
After we met with several patients the Pine Street Inn outreach van arrived. Jim wrapped things up inside and grabbed our coats. It's currently a mild fall in Massachusetts and although it wasn't very cold the skies threatened to storm so I yanked my two sizes two big pullover on, just in case.
I've been out in an outreach van before but the van I'm used to is nothing like this. Inside there were several boxes, one full of blankets and one full of socks. When you opened the back doors there was a cooler filled with sandwiches, fruit, dry soup, hot chocolate, and two water dispensers, one hot and one cold. The van I'm used to plays more of a shuttle service role, is lucky to have socks to distribute, and giving out food is against program policy (because of health concerns, not because it's a cheap program).
We drove down Commonwealth Avenue, on the mall. I have walked the mall dozens of times, during the day and in the early evening hours, but I had never seen someone who presented as a homeless person there. That night I saw how many people really do call the Commonwealth Mall home. There was a variety of people, from an older men who needed to have an injured jaw taken care of to a young guy in a suit.
Outreach runs continue to be engaging, dare I use the word "fun", experiences for me. Everyone was appreciative of what we had to offer, even though it was only a light meal and some human contact. The staff that I talk with are interesting and passionate about their work and those who aren't are often burnt out and need a vacation that this field doesn't allow them to afford. The only thing that worries me is that the shock of seeing how people on the streets are forced to live is starting to wear off.
I've been out in an outreach van before but the van I'm used to is nothing like this. Inside there were several boxes, one full of blankets and one full of socks. When you opened the back doors there was a cooler filled with sandwiches, fruit, dry soup, hot chocolate, and two water dispensers, one hot and one cold. The van I'm used to plays more of a shuttle service role, is lucky to have socks to distribute, and giving out food is against program policy (because of health concerns, not because it's a cheap program).
We drove down Commonwealth Avenue, on the mall. I have walked the mall dozens of times, during the day and in the early evening hours, but I had never seen someone who presented as a homeless person there. That night I saw how many people really do call the Commonwealth Mall home. There was a variety of people, from an older men who needed to have an injured jaw taken care of to a young guy in a suit.
Outreach runs continue to be engaging, dare I use the word "fun", experiences for me. Everyone was appreciative of what we had to offer, even though it was only a light meal and some human contact. The staff that I talk with are interesting and passionate about their work and those who aren't are often burnt out and need a vacation that this field doesn't allow them to afford. The only thing that worries me is that the shock of seeing how people on the streets are forced to live is starting to wear off.
Monday, October 15, 2007
Nightime Rounds with Health Care for the Homeless: The Night Center
This past Wednesday I had the opportunity to go out for rounds with Jim O'Connell, the founder and president of Boston Health Care for the Homeless. While Dr O'Connell is one of the most humble and down to earth people you could ever meet he's a big wig in the health care for the homeless world and an opportunity to shadow him for the evening was a big deal.
The evening began at The Boston Night Center, one of the many Pine Street Inn programs. The Night Center was a new concept for me, it's an overnight drop in center. The center serves meals, has a tv, and space hang out. An overnight drop in center is the lowest of low threshold services; residents are able to go in and out as they please, they're allowed to be inebriated, and they do not need to accept any services. Because it is not a shelter there are no beds but clients can sleep on the floor and, two nights a week, receive medical services.
Jim brought a backpack full of medical gadgets with him, which included a thermometer, a bracelet-type gadget that takes blood pressure, something that goes on your finger that does something too technical for me, and the classic stethoscope and prescription pad. We saw four different patients, wrote one prescription, scheduled two follow-up visits at the clinic, and gave one person a phone number to call for test results. This was in the span of about an hour in a bustling room full of people.
Somehow Dr O'Connell made the space his own as he listened about the fractured ankle that wouldn't heal because the client couldn't walk with a cast, "How am I supposed to get around? I'm homeless." Clients who are homeless aren't always the easiest people to get along with, often life has gotten the best of them and sometimes that leaves them bitter and snarky. But the snark didn't matter, Jim still listened carefully and examined his patients with the same care one would expect in a hospital room, not in a homeless shelter.
Health Care for the Homeless is not unique to Massachusetts, there is actually a National Health Care for the Homeless Council that stemmed out of a 19 site demonstration project that is now 95 organizations strong. Not all Health Care for the Homeless Services are delivered like what I witnessed tonight, or what I experienced with Jill earlier this fall. The shelter I volunteer in actually also has a health care for the homeless component; there is a clinic on site where health care services are delivered. This isn't quite as exciting as health care on the streets but it still is an important concept; clients are able to meet their health care providers where they already are. Wouldn't it be nice if our doctors held clinics in our workplaces? Homeless services are onto something!
The evening began at The Boston Night Center, one of the many Pine Street Inn programs. The Night Center was a new concept for me, it's an overnight drop in center. The center serves meals, has a tv, and space hang out. An overnight drop in center is the lowest of low threshold services; residents are able to go in and out as they please, they're allowed to be inebriated, and they do not need to accept any services. Because it is not a shelter there are no beds but clients can sleep on the floor and, two nights a week, receive medical services.
Jim brought a backpack full of medical gadgets with him, which included a thermometer, a bracelet-type gadget that takes blood pressure, something that goes on your finger that does something too technical for me, and the classic stethoscope and prescription pad. We saw four different patients, wrote one prescription, scheduled two follow-up visits at the clinic, and gave one person a phone number to call for test results. This was in the span of about an hour in a bustling room full of people.
Somehow Dr O'Connell made the space his own as he listened about the fractured ankle that wouldn't heal because the client couldn't walk with a cast, "How am I supposed to get around? I'm homeless." Clients who are homeless aren't always the easiest people to get along with, often life has gotten the best of them and sometimes that leaves them bitter and snarky. But the snark didn't matter, Jim still listened carefully and examined his patients with the same care one would expect in a hospital room, not in a homeless shelter.
Health Care for the Homeless is not unique to Massachusetts, there is actually a National Health Care for the Homeless Council that stemmed out of a 19 site demonstration project that is now 95 organizations strong. Not all Health Care for the Homeless Services are delivered like what I witnessed tonight, or what I experienced with Jill earlier this fall. The shelter I volunteer in actually also has a health care for the homeless component; there is a clinic on site where health care services are delivered. This isn't quite as exciting as health care on the streets but it still is an important concept; clients are able to meet their health care providers where they already are. Wouldn't it be nice if our doctors held clinics in our workplaces? Homeless services are onto something!
Friday, August 24, 2007
Take it to the Streets
On Wednesday morning, I had the opportunity to shadow a Boston Health Care for the Homeless provider as she did her street rounds. Back in June, I attended a session of the National Health Care for the Homeless Council conference where my host had presented some of the nifty gadgets that she used on her rounds. The opportunity to see those gadgets in action was a memorable experience! At 9am I met Jill, and a student who was shadowing her for the week, across the street from a busy downtown Boston t-stop. She briefly told me what to expect and we were off!
Not even two blocks down the street we encountered three of her regular patients and by the end of the day we had seen over a half dozen people. Most were on the street but three had secured housing and we visited them in their apartments, two of the three had studio apartments on Beacon Hill (one of the richest parts of Boston) thanks to a housing first voucher program. I hate to admit that I was surprised by how clean the apartments, and their tenants, were but I was impressed. One's apartment was cleaner than my own!
The people on the streets were a different story. They were in rough shape. One had the opportunity to go to a shelter but was nervous that they wouldn't take him because he smelled bad and I'll admit, he did smell really bad. But who can blame him? I smell bad after a day in the park. I can't imagine not having the option to shower after spending an 85 degree day outside, never-mind weeks on end of those kinds of days.
Health Care For The Homeless is a particularly unique type of program, when these programs conduct outreach they often are actually practicing medicine on the streets. It is mainly basic medicine, but they use the relationship that they build to help the individual access specialized services when they are ready. I was impressed with the way that she asked what they wanted and gave them options. No one was forced to do anything that they didn't want to but we got two people off the streets that afternoon (though one was to the ER).
The experience also heightened my awareness of how severe many individuals' alcohol addictions are. As both men who agreed to be transported to services (BHCH has cab vouchers for this purpose) they discarded their bottles of mouthwash first, one handed his off to a friend, the other dropped to the ground with a hollow thud. Mouthwash is the easiest way for alcoholics to get their fix and is an indicator of exactly how bad the disease is.
It was a great experience, I hope to do something like it again!
Not even two blocks down the street we encountered three of her regular patients and by the end of the day we had seen over a half dozen people. Most were on the street but three had secured housing and we visited them in their apartments, two of the three had studio apartments on Beacon Hill (one of the richest parts of Boston) thanks to a housing first voucher program. I hate to admit that I was surprised by how clean the apartments, and their tenants, were but I was impressed. One's apartment was cleaner than my own!
The people on the streets were a different story. They were in rough shape. One had the opportunity to go to a shelter but was nervous that they wouldn't take him because he smelled bad and I'll admit, he did smell really bad. But who can blame him? I smell bad after a day in the park. I can't imagine not having the option to shower after spending an 85 degree day outside, never-mind weeks on end of those kinds of days.
Health Care For The Homeless is a particularly unique type of program, when these programs conduct outreach they often are actually practicing medicine on the streets. It is mainly basic medicine, but they use the relationship that they build to help the individual access specialized services when they are ready. I was impressed with the way that she asked what they wanted and gave them options. No one was forced to do anything that they didn't want to but we got two people off the streets that afternoon (though one was to the ER).
The experience also heightened my awareness of how severe many individuals' alcohol addictions are. As both men who agreed to be transported to services (BHCH has cab vouchers for this purpose) they discarded their bottles of mouthwash first, one handed his off to a friend, the other dropped to the ground with a hollow thud. Mouthwash is the easiest way for alcoholics to get their fix and is an indicator of exactly how bad the disease is.
It was a great experience, I hope to do something like it again!
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