Nursing homeless people in Ireland

Nurse Ann-Marie Lawlee mostly works with the many homeless people who come into Dublin’s St James’s Hospital. 

The hospital normally has around 20 homeless in-patients, who have all had different experiences – often traumatic. “They have all been affected in different psychological and physical ways. It’s important for us to build a rapport and make them feel comfortable within the hospital environment.” 

But it’s not just a case of looking after people while they are in hospital. Leaving hospital, when you don’t have a home to go to, can be very challenging: “It’s important to plan their discharges carefully. I try to be aware of where people are going so I go and visit a lot of the hostels.” 

It’s also important to keep in touch with former patients to ensure that they get follow-up treatment. Under a  new scheme called “inclusion health” Ann-Marie and her team keep information flowing between social workers, community health workers, nurses, GPs,  treatment centres, and the other major hospital in Dublin. This is vital because a lot of patients go from one hospital to the other. The scheme is also building up a set of drop-in clinics where people can access nurse specialists in various illnesses as well as social workers and other team members. 

28-year-old George says he appreciates the support he is getting from the system. He spent much of his childhood in care and has been in jail or homeless since he was 17. He’s been struggling to give up drugs and is cautiously optimistic. He has a social worker and he’s following a community employment scheme. The course is five days a week, all the other participants are trying to get clean too, and George says he loves it. “But then I leave at 4 o’clock and I’m back to the hectic state of homelessness.” 

George was in hospital to have a blood clot treated, but he also needs regular medical services to treat his hepatitis and epilepsy and to give him the methadone he requires. He tried to discharge himself but Ann-Marie and his social worker encouraged him to stay. “She said she could link in with my key worker and all of these people from homeless services to hopefully get something sorted so when I get back out I’m not going straight back out to the hectic-ness… When you’re on your own it drains you, you need someone to give it a bit of push, someone to fight for you and say: ‘This man needs help.’”