Cathy Crowe: Street Nurse Backpack
Whitnie Irving and Kimberly Galazka
UNB-Humber College Bachelor of Nursing Students
The job of a street nurse is unique to say the least. The term “Street Nurse” is a term coined over 15 years ago by a homeless man at the corner of Sherbourne and Dundas in downtown Toronto. A Street Nurse is essentially a community health nurse who might be employed at an organization as a mental health nurse, a nurse practitioner, or an outreach nurse. Street nurses care for the most vulnerable members of our society - people with limited or no access to health care and who are living in poverty and without adequate shelter, i.e. housing. The nurse uses a backpack in order to transport all the necessary supplies to the street. The workplace of the street nurse is different from other nurses as she/he works with people right “on the street” where they live or spend time: literally outside, in day time drop-in centres, in shelters or in rooming houses or squats. One of the primary goals of the street nurse is to develop trust, respond to immediate health issues and help people gain access to the health care system and other social supports. The street nurse is working towards the day when there will be no need for street nurses. An important job of the street nurse is to deal with upstream issues, i.e. why people are homeless in the first place, and to ensure we start providing adequate and truly affordable housing for people.
Energy bars, nutritional materials:
Ø A street nurse may carry energy bars and cans of Ensure because she/he may encounter someone who is hungry or malnourished. Food can help to establish trust and the nurse may then be able to offer other assistance to the individual. In the summer she may carry several bottles of water, in the winter several juice boxes.
Ø A thermometer and thermometer covers are included in the pack for taking temperature.
Ø A stethoscope and blood pressure cuff are very important diagnostic tools for nurses. With these tools, a nurse can look and listen to the chest, heartbeat, and check someone’s blood pressure. An otoscope allows examination of the ears.
Ø A flashlight is an essential part of a street nurse’s bag and serves many different purposes. The flashlight enables the nurse to see clearly outside at night or in a poorly lit squat. It also allows for the nurse to examine the individual.
Wound and skin care:
Ø Dressing materials: Sterile and non-sterile bandages including regular bandages, 2 x 2 and 4 x 4 gauze pads, Telfa Dressings, Kling, and Jelonet are used for covering areas where skin is damaged. Tape that is waterproof is used to secure dressings in place.
Ø Q-tips are used for cleaning wounds and scooping and applying ointments from tubes and containers.
Ø Steristrips are used to hold skin together. If there is a cut in the skin and both sides do not come together on their own, the steristrips hold them together to promote healing.
Ø Sterile water or saline is used to clean damaged skin. Hydrogen Peroxide is also used.
Ø The sterile towel/drape is used to cover areas of skin that is not being worked with during a dressing. It helps to maintain some sterility while working on the street.
Ø The blue absorbent pads are used to try to keep the nurse’s work area as clean and dry as possible.
First Aid and Other Medical Items:
Ø The tensor bandages are used for sprains of the ankle, wrist, and knees. They are also used for wrapping legs.
Ø The slings are used for securing an injured arm
Ø A staple remover is included so that the nurse can remove staples from a healed wound.
Ø The tongue depressors have multiple uses. They are used for scooping cream out of jars, for inspecting a patient’s throat, and for spreading creams.
Ø Because there may be limited access to water or soap, a hand sanitizer is included. Hand washing is the most important step in preventing the spread of illness and disease.
Ø Non-latex gloves are used during all contact with wounds and body fluids to prevent the transmission of disease.
Ø Since SARS…..It is important that the street nurse include a N95 mask in his/her backpack. Many infections are passed by droplet and the only way to avoid inhalation is with a N95 mask. This keeps the nurse safe from infection and able to do his or her job.
Ø It is also important that the street nurse carry an airway in her bag. This is used to cover the mouth and nose of the individual receiving CPR. It prevents any fluids from the mouth or nose coming in contact with the nurse.
Ø Tampons, maxi pads, socks, underwear, toothbrushes, toothpaste, soap, shampoo, hand cream, sunscreen, lip balm and deodorant, Q-tips etc. are all staples of personal care that we take for granted. People living on the streets do not have access to these essentials, so the street nurse carries sample size products to give out. This is a good way to build relationships and rapport with individuals. It is important to meet the most basic of needs in order to provide total care.
Ø Alcohol swabs and antiseptic towels, in individual packages, are useful for cleansing hands and small sores.
Harm reduction supplies:
Ø The street nurse carries condoms and lubricant so that people without access to these items can engage in safe sex practices. A crack kit is also included to hand out as necessary.
Ø The 1 cc needles are given out to individuals to prevent the transmission of hepatitis and HIV/AIDS .
The street nurse carries certain medications that meet the most common needs and problems that are seen on the streets. There are not necessarily brand favorites – choice often depends on what has been donated, or the lowest price. They are as follows:
· Tums for heartburn
· An inhaler for acute respiratory emergencies
· Decongestant for colds
· Lipactin for cold sores
· Fucidin which is an antibiotic topical that is applied to open sores and wounds
· Antifungal antibiotics for athletes foot and jock itch
· Acetaminophen and ibuprofen for headaches and pain
· Vitamin C. Since many homeless individuals do not have a diet rich with this vitamin, offering this supplement helps to prevent scurvy, anemia and many other deficiency related illnesses.
· Multivitamins to supplement the diet
· Bradosol lozenges for sore throats
· Rub A535 for sore muscles
· Tiger balm for sore muscles, headaches, and congestion
· Calamine lotion to soothe itchiness
· Athletes foot powder to cure and prevent athletes foot
· Bactroban and polysporin to be used on wounds to prevent infection
· Oragel for toothaches
Ø The street nurse includes matches, which have a multitude of uses, from lighting candles to lighting fires.
Ø A cell phone is another essential item in the pack. This is used for calling shelters, an ambulance, food services or street outreach vans.
Ø The street nurse backpack will also contain bus tickets and tokens. These will be given out so people can get to shelters, clinics, soup kitchens, or to other appointments.
Ø Usually a business card, emergency contact numbers, shelter information, health bus information, and Street helpline information.
Ø Cathy Crowe carries 1% buttons to give out. The buttons are representative of the 1% solution. This solution for the homeless crisis calls of all levels of government to spend an additional 1% of their budgets on affordable housing. This would create $2 billion in new funding for social housing.
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