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Bill Klaproth: (Host) Hospitals in the U.S. are challenged with managing the homeless patient population in their emergency departments, as well as in their inpatient population. So let's talk with Anna Kiger, system chief nurse officer at Sutter Health as we talk about how Sutter Health's Street Nurse program delivers care to the homeless population.
This is Today in Nursing Leadership. A podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth, Anna thank you so much for your time. So what prompted Sutter Health into addressing the homeless patient population issue?

Anna Kiger: (Guest) Well, in 2015, it was clear that, in the communities that we serve, there's a large growing population of individuals who are homeless, friends and neighbors, family members, individuals in our communities, just a tremendous amount of individuals with no place to seek shelter, no place to get a meal and really no place to get access to care.

Host: So, Anna, you started the street nurse program to deliver care to the homeless population. Can you tell us about the street nurse and what that is?

Anna: Sutter Health partnered with a local federally qualified health care center here in the Sacramento area, to employ a nurse who happens to have emergency room experience. And we wanted that nurse to be out in the community, where the homeless population lives. Many of them that were coming to the emergency room really didn't need to come into the emergency room. They just need access to someone who could talk to them about where to get shelter, someone to talk to them about food and securities, and someone to answer some simple medical and nursing questions about, taking care of themselves while living on the streets.

Host: And what have the results been so far?

Anna: Four years later, we've been very successful with street nurse program in California. Our original nurse in the Sacramento market has now granted two registered nurses working in the downtown Sacramento area, they literally are out on the streets of Sacramento helping the homeless population with various questions and issues they have. We've been successful enough to take this program into the Central Valley area in Modesto and are beginning to work on a program in the San Francisco market.

Host: So now that we're in a pandemic, how does that impact the street nurse program, and what has this program meant to the homeless population?

Anna: I'm really grateful that Sutter had the foresight to start the street nurse program back in 2015 to recognize the homeless population needed some help where they live. But I'm really proud to see how the program has flourished and helped this vulnerable population during this pandemic. Just imagine, not only did they have housing, food insecurity, and basic access to healthcare, now they're placed in the midst of a pandemic at a time when they had no resources to fall back on. I think the street nurse program has been a safety net program for that population.

Host: So is the street nurse program something more hospitals and health systems should pay attention to, or try to replicate?

Anna: I think that is something they should definitely consider. It was not extremely difficult to implement. The first thing was, what is it, who can we partner with to do it, where can we find that first nurse to actually live out the experience of taking care of patients on the street. There was, things we improved as we expanded it and grew the program. But looking back on it in the last four years, it's been very successful. I would encourage any community that's interested in doing this type of program to contact Sutter Health, we'll be more than happy to hand over how we did it?

Host: So does the street nurse actually travel the streets? That's what I'm imagining in my mind. Do they go to the homeless population or are they stationed at the emergency department?

Anna: So the street nurse is employed by the federally qualified healthcare center. Sutter actually funded the startup of that staff member's salary. The street nurse works under the direction of the federally qualified health care center. And, is literally out on the streets. She has a car that is provided to her to drive around the city. She serves about a one-mile radius from the state Capitol in downtown Sacramento. And she's out of her car or walking on the streets with a backpack, stepping into the home camps and visiting people where they live. They're very open. They're very receptive to her. We did not see safety events that we thought we might see. And the second a street nurse joined her about two years ago, and now they can cover a larger geography of the city.

Host: This is fascinating. So tell us about your session at the AONL conference. What will people walk away with, will you teach more about the street nurse program?

Anna: I'd like to accomplish during my presentation is to make my nurse colleagues aware of how large the homeless population is. And that it can be individuals who might not initially think would be homeless. Family members, neighbors who have lost their homes, or about to lose their homes. Big issues of food insecurity, being able to afford food. I want to educate my nurse colleagues on how this program came to be, the tactics to put the program together in their community. And some of the outcomes that we've seen here in Northern California that I think can be replicated in other communities.

Host: Sounds like a great session, Anna thank you so much for your time and talking with us about the Street Nurse program. Thank you again.

Anna: You're welcome. Thank you.

Host: That's Anna Kiger. And for more information, please visit AONL.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Today in Nursing Leadership. Thanks for listening.