More than 6,000 people are experiencing homelessness in South Australia each night. They do not have access to safe or secure housing, and many are sleeping rough on the streets. These Australians – among our nation's most vulnerable – have complex health needs requiring expert care outside the walls of the hospital system.
As we renew our focus on these issues during Homelessness Week (August 1-7), RDNS Silverchain nurse Jacqui Bonfield shares her insights on her role in supporting people experiencing homelessness to access health care.
Jacqui works at the RDNS Silverchain’s Homeless Nursing Clinic at Adelaide's Hutt St Centre. More than 30 years ago the service started in one small room, but in the last year supported more than 1,400 people experiencing or at risk of homelessness to access primary health care.
In partnership with a visiting GP, the clinic provides support for wound care, medication, financial assistance to fill prescriptions, diabetes, mental health and referrals to allied health specialists.
Since joining RDNS in 1990, Jacqui has spent more than half of her career as a Clinical Nurse in the RDNS Homeless Program. Jacqui says working with people facing homelessness, particularly rough sleepers, is challenging, but the small wins make it worthwhile.
"I work with people at their most vulnerable and whose experience of homelessness is complex and has many contributing factors. The work is very grounding, and you learn a lot,” Jacqui said.
“You build genuine relationships with the people you provide health care to, and together with Hutt St, we can help people regain their independence. It's the best gift you can give someone who is doing it pretty tough.”
Jacqui says her clients have specific needs which are best treated and managed in a familiar setting like Hutt St.
"Many homeless people don't have a GP. They're surviving from one day to the next, so it's hard to focus on health when you're cold, hungry, and anxious. Their experience of homelessness itself can have long lasting impacts, including on their mental health, and they are vulnerable to other types of harm and disadvantage."
Jacqui says a significant part of her work is about relationships and building trust.
"When I see a homeless person, too often, they've fallen through the cracks of other health services that aren't always equipped or resourced to deal with the complexities they face,” Jacqui said.
“A simple request for Panadol for a headache can reveal much more of their situation once you get to know someone. As you slowly peel back the layers, little wins become big wins. I value the trust we build together.
"We see people from all walks of life; there are many different challenges in our community that contribute to homelessness.
“Recently, the impact of COVID-19, the cost of living and unaffordable housing is driving more people into homelessness. Some may have a roof over their head but no money. Some have nowhere to go and are sleeping rough on the streets,” Jacqui said.
Jacqui says it's embedded in the DNA of RDNS Silverchain and Hutt St to support the most vulnerable and disadvantaged people in South Australia.
"The Hutt St team are an amazing, passionate group of people who work hard to support people to move beyond their experience of homelessness. Providing access to primary health care is so worthwhile because it creates hope," Jacqui said.