VNA Shelter Nursing History

Since 1987, VNA has provided public health nursing services to women and children living in Omaha area homeless shelters. The need for services is due to the difficulty shelter residents have in accessing health care. The services are preventive in nature with an emphasis on:

• Early and regular prenatal care
• Normal child growth and development
• Adult and well-child care and immunizations
• Positive parenting and child care

In 1996, public health services expanded to serve men residing in homeless shelters. The services for men focus on:

• Assessment of health needs
• First aid and injury care
• Monitor chronic health conditions
• Referral to healthcare providers and community agencies

In 1999, VNA developed a public health nursing program to serve individuals and families living in transitional housing facilities in the Omaha area. VNA nurses are able to follow families from homeless shelters into transitional housing situations, and provide the same supportive health and human services needed to sustain them in their new environment.

In 2003, VNA expanded its public health program to provide care to the fastest growing population in the shelters – children. VNA visits six Omaha shelters that specifically care for homeless children. These children (birth to 18 years of age) are in the shelter for such reasons as:

• Abuse and neglect
• “Throwaways” – abandoned by their parents
• Runaways
• Experiencing a family crisis

In 2008, the VNA provided care to 764 children, 1,221 women and 1,704 men for a total of 3,689 individuals.

The shelters in which VNA provides public health nursing include: Siena Francis House, Open Door Mission/Lydia House, Cass Street, The Shelter for Abused Women, Youth Emergency Service, Family Service Shelters, and Stephen Center. In 2007, VNA also expanded services to homeless families at MOHMS Place, Micah House and Phoenix House in Council Bluffs. In 2008, we expanded services in Council Bluffs even more to meet the growing need.

Local Homeless Challenges and Facts

According to the Metro Area Continuum of Care for the Homeless count, on any given night in Omaha and Council Bluffs there are more than 1,197 homeless people living in shelters, in abandoned buildings or on the streets. Of the people surveyed, the average age of homeless adults was 44 for men and 39 for women. This count is only an average of a typical night in the shelters. This does not include those individuals staying with friends.

Homeless children, we know statistically have:

• Three times the number of stomach problems
• Four times as likely to have asthma
• Four times as likely to have developmental delays
• Twice as many ear infections
• Five times the number of diarrhea infections
• One and one-half times as many chronic health disorders
• Two times the number of hospitalizations as non-homeless children
• Homeless infants are more than two times as likely to have low birth rate

The homeless population is at great risk for illness due to lack of regular preventative care and check-ups. Many of the homeless health issues can be treated by the VNA’s shelter nursing program, which leads to less serious complications from these problems being untreated until it is too late, which then leads to fewer visits to the emergency room. The community as a whole can benefit from this as ER visits are the most costly form of care and cause a great strain on the healthcare system as a whole.

A Growing Need – Children Living in Community Homeless Shelters

Women, children, and adolescents continue to be the fastest growing number of homeless people. Recent research data suggests homeless female heads of household reported more physical health issues, major depressive illness and post traumatic stress disorder than those surveyed in 1993.

Other research shows that homelessness is a predictor of poor health status and high-service use among children. The present findings highlight the importance of “preventive intervention” to increase access to primary care among children and adolescents.

This requires VNA shelter nurses to refine services to be more responsive to changing needs. In addition, it supports VNA’s need to sustain funding for women and children’s shelters and assure primary care for homeless youth on the streets through VNA Nurse Practitioners.

For more information, please contact Michael Elias (402) 930-4018, melias@thevnacares.org.