This week’s infographic, created by Kaiti Stanton, looks at street nursing in Canada.

The historical antecedents of outreach nursing in Canada can be traced to early social reform movements of the early 20th century. Street nursing in Canada, as we know it today, began in 1986 in Toronto. A community organizer and a nurse met with 14 homeless individuals to “discuss the frequently inadequate and discriminatory care they received from the healthcare system”. Nurses were identified as the service providers homeless individuals would feel most comfortable with when seeking healthcare.  Shortly after, the first Street Health nursing station, staffed with volunteering nurses, opened in Toronto. Today, street nurses can also be found across Canada, from Victoria to Halifax.

Street nurses work with those whose lives are characterized by extreme poverty. They provide these individuals with care in drop-in centers, homeless shelters, alleyways and streets. Street nurses often target problems with a preventive healthcare focus. This includes educating the homeless on safer sex practices, and freely distributing contraceptives. Services provided by street nurses include HIV and pregnancy testing, diagnosing various illness, and treatment. Treatment may take the form of injection related care and even abscess care.

Health professionals, in the street and hospital setting, are more than just individuals providing health services. When we consider the high degree of psychological distress experienced by individuals living in homelessness, it’s clear that there’s more to interactions between street nurses and their patients than just healthcare. Positive interactions often result in the development of meaningful relationships between patient and practitioner, potentially reducing the loneliness and alienation faced by many individuals living in homelessness.

Perhaps most importantly, the impact of street nurses can be felt in their public advocacy for the rights of the homeless. Every community needs to have individuals who will help advocate for those who are unable to do so for themselves.

Moving in a New Direction

When we talk about healthcare for individuals living in homeless, the discussion often focuses on what can be done to remove barriers that exist to help these individuals access the services offered to most Canadians. And this is for good reason, a 2010 study conducted in Toronto showed that 17% of homeless individuals, about one in six, reported unmet needs for care.

As important as it is to consider how individuals living in homelessness can access existing hospitals and services, we also have to rethink how health care delivery systems can be designed to better meet the needs of people living in homelessness. This means not only looking at how barriers to services can be removed, but also considering different approaches to service delivery. These responses can take the form of outreach work by medical professions in shelters and dropout centers. It can also mean developing mobile health units and investing more into existing street nurse programs.

Street nursing in Canada infographic