Our Student Nurse Experience of a QNI Homeless Health Learning Event

University of Plymouth Nursing Students, Dawne Jones and Rachael Palmer, attended The QNI’s last Homeless Health Network event ‘Improving Health through Innovation: Better Care for People who are Homeless’ which took place in Bristol on 27th April 2018. In this blog they discuss their highlights from the day and encourage other student nurses to attend The QNI’s next Homeless Health Programme event.

About the Authors

Pictured left: Dawne Jones, a first-year adult nursing student at the University of Plymouth and one of the Council of Deans of Health 150 leaders. Dawne is also a course representative and 2018-19 PALS Leader. For the past 10 years Dawne held a managerial position in the family business of industrial engineering and still works there part time. Married with two teenage daughters, Dawne describes herself as an enthusiastic and passionate student, keen to make her studies as enriched and diverse as possible by ceasing every opportunity. @PUNC17DawneJ

Pictured right: Rachael Palmer, also a first-year adult nursing student at the University of Plymouth and one of the Council of Deans of Health 150 leaders. Rachael is a course representative, 2018-19 PALS Leader, RCN Student Information Officer, and the 2018-19 President of Students for Global Health, Plymouth. Rachael is 18 years old, from a small farm in Somerset and keen to seize every opportunity this fantastic career has to offer. @PUNCrachpalmer

“On Friday 27th April, we took a road trip to The QNI’s Improving Homeless Health Event in Bristol. Having been aware of The QNI’s work, and both subscribing to the homeless health network newsletter, we were really looking forward to the amazing networking opportunities and to learn more about what other organisations are doing to improve homeless health. Nothing gets us out of bed quicker than the prospect of a nursing learning and networking opportunity, even if that means a 5:30am start!

After registering, we were greeted by the lovely QNI team with goody bags, pastries and coffee (what more can student nurses want?) and found our way to a table where we joined two district nurse team leads from South Wales and a student nurse from Cardiff.

It was a packed day full of some really interesting speakers at the top of their field in research and innovation, with some having experienced homelessness themselves, using their experiences to create a service for others, changing the way this country sees homelessness – we were so privileged. With the day being such a plethora of information and being treated to all of these speakers, we’ll give you some of our personal highlights in this blog.

Firstly, Dr Michelle Bishop, Education Specialist at the Genomics Education Programme, delivered a whistle-stop but captivating talk on genomics and its use in personalised medicine in today’s NHS.

Personalised medicine uses targeted therapies that have been procured from the information in our genome to combat disease more specifically and effectively. This is because we know that variants between genes that alter their control or action of proteins can change a person’s response to drugs, whether they’re more likely to develop a disease and based on the molecular mechanism, we can give a more precise diagnosis and therefore targeted drug therapy.

From the sequencing of genomes, we can diagnose rare diseases (there are 3.5 million people living with rare diseases in the UK) and deliver targeted treatment. We can treat people with cancer earlier (as 65% of mutations can be actioned immediately) and find the mutation in the genome that caused the cancer to protect family members if it’s inherited. We can even investigate the sources of outbreaks of infectious disease and diagnose the species of disease for more targeted drug therapy and vaccine development. It’s amazing!

As nurses, we can play a part in how genomics is revolutionising the NHS by identifying individuals who may develop a genetic condition through screening programmes, being observant of signs/symptoms of genetic disease, taking a detailed family history, referral to clinical/social/community support services, gaining consent for genetic testing, giving patient education on what will happen in the process, and supporting patients and their families at a worrying and stressful time.

Later we heard from Clare O’Connell, Primary Care Nurse at Bristol’s Homeless Health Service. We were inspired by her work, funded by the QNI and Oak Foundation, to improve the emotional wellbeing of homeless people who access the service.

It’s an amazing project to address the startling statistic of 80% of homeless people experiencing mental health difficulties including drug/alcohol abuse, depression, low self-esteem and living with effects of childhood trauma. Despite such a high proportion of people experiencing homelessness having mental health difficulties, many struggle to access support due to the significant pressures on mental health services. Many people miss appointments due to a chaotic lifestyle which can lead people to struggle to get out of living on the streets.

Clare’s project used the NEF (2008) ‘Five Ways to Wellbeing’ (connect, learn, be active, take notice and give) as a guide when setting up support groups – each group was themed on one of the five themes and groups took place once a week. There are a maximum of five  service users and two staff at the group where attendees discuss issues, make action plans and do activities such as mindfulness walks. Every group activity has an emphasis on relaxation and light-heartedness.

The project has been an amazing success with regular attendance, enthusiasm and lovely relationships developing between service users and staff.

The last highlight was Amy Varle, founder of ‘Social Property Investment’ which uses innovative housing models for better health. This includes ‘housing first’, a scheme whereby a person experiencing homelessness is housed without pre-conditions, removing traditional barriers to being awarded a permanent home.

It is also person-centred and meets individual needs, with the idea being that poor housing costs the NHS between £1.4-2 billion a year -by housing somebody, they then have a base and steady environment from which support and intervention can be given. Their chaotic lifestyle is reduced, so appointments can be attended and their life can be re-started.

Amy has experienced homelessness herself, so her passion and drive for this scheme has arisen from people seeing something in her and giving her a chance. Now Amy is able to give other people a chance.

We also heard from Dr Mike Taylor (lead GP at Bristol’s Homeless Health Service) on why developing an effective data pathway and sharing data between professionals is a fundamental part of providing effective care.

Professor Alison Fuller (Research and Development at UCL’s Institute of Education) spoke to us about employee-lead innovation taking a ‘bottom-up’ approach.

Martin Burrows (Director of Research and Campaigns at London based homeless charity ‘Groundswell’) informed us of a scheme at Groundswell where people who have experienced homelessness in the past become peer advocates and support people who are currently homeless to attend medical appointments and deliver health promotion sessions. This asset-based approach utilizes the experiences of people who have been homeless and turns it into a positive.

Rounding off, Susan Harrison and Jane Cook from the Health London Partnership spoke about changing commissioning standards so that we can design upstream solutions to homelessness. What an amazing day!

And it didn’t end there… There were networking opportunities, an interactive discussion session on homeless health and student nurse education. We were particularly interested in this and have since set about developing a potential project at Plymouth surrounding homeless health. We were also interviewed for The QNI’s new film on the event, so keep your eyes peeled!

The QNI and Oak Foundation are doing brilliant work by funding 10 projects led by nurses to improve homeless health, as they are a population group that has the most emergency admissions and spend the most time in hospital – but with a great deal of heath inequality. It’s therefore so important that, as nurses, we have an awareness of some of the most common struggles people experiencing homelessness face when they try to access healthcare services, such as not being able to register with a GP due to having no permanent address. This enables us to provide the person-centred care we endeavor to deliver. Consequently, it’s so important that meetings like the QNI Homeless Health events exist to widen the awareness for health professionals.

We are so grateful we were able to attend this free event and our presence was valued so highly. We would definitely urge other student nurses to keep an eye out for QNI events – you’ll learn so much and meet incredible people doing some amazing work for community nursing, which of course is the future.

More care than ever is being delivered outside of hospital and it’s a career we both are pursuing with Dawne interested in community nursing in a GP surgery and advanced practice and Rachael a clinical nurse specialist visiting patients in their homes.

Follow us on Twitter for more of our journey: @PUNC17DawneJ and @PUNCrachpalmer