Duke nursing students discuss health care with homeless veterans

Jul. 27, 2013 @ 05:58 PM

Imagine a veteran diagnosed with cancer receiving frequent chemotherapy treatments.

Then imagine that veteran dealing with the side effects in a car or under a bridge.

Duke University School of Nursing faculty and students have recently partnered with CAARE, a Durham nonprofit that promotes a holistic and community approach to health, to help homeless veterans with their housing and health care needs.

The nursing students are spending part of their 16-month accelerated bachelor of science in nursing program outside of the hospital and away from the bedside.

The students are all adult learners, with the youngest being 23. Many also have family ties to the military.

Antoinette Atchor, 32, is an Army wife. As she works on this project in her Duke community health nursing classes, her husband is serving at Fort Leonard Wood, Mo. She, along with the other nursing students, sat down with homeless veterans at CAARE recently, enjoyed a home-cooked meal and learned about their struggles receiving or searching for medical care.

“A lot of people don’t have issues when they’re in the Army or don’t want to talk about it while they’re in the Army,” Atchor said. “It’s an opportunity to learn what I’ve been hearing but not been seeing. I never knew that it’s this bad. It can happen to anyone.”

The students will finish their projects next spring, when half group will present a plan for a CAARE medical respite, which will serve homeless veterans who are not sick enough to be in a hospital but are too ill to recover from an illness or injury on the streets.

The other half will develop and implement a chronic disease self-management course which will help homeless veterans manage their chronic health conditions.

Sharon Elliott-Bynum, CAARE executive director and co-founder, said the organization has helped homeless veterans since 1999. CAARE just received a certificate of occupancy for its new 15-bed dormitory for homeless veterans, and the staff is moving in furniture, she said.

“When people are discharged from the hospital and they’re homeless, that exacerbates the situation,” Elliott-Bynum said. “…This medical respite will be an opportunity for us to have a safe, clean environment with supportive services for them to recuperate.”

CAARE currently serves 9 veterans in their housing program and offers three community housing locations in addition to the new dormitory.

During the conversation between students and homeless vets, access to substance abuse and mental health programs as well as figuring out how to sign up for benefits were big issues, according to Elliott-Bynum and the students.

Dana Robinson, the 23-year-old Duke nursing student, said her father was a Marine and her aunts served in the Air Force. Her family tree is filled with military service.

She said she has worked with younger patients as a health educator at the University of Maryland, where she received her undergraduate education, and also has been part of programs that work with pregnant women.

But this project let’s her meet an entirely new group of people, she said.

“Sometimes when you’re in an academic setting, it’s hard to see what’s outside or just around the corner,” Robinson said.

“We see them on our streets all the time,” Atchor added, “but we don’t understand why they’re on the streets.”

For Elliott-Bynum, the path from nursing student to community health professional is a personal one. She entered the licensed practical nursing program at Durham Tech when she was only 17, after her mom was diagnosed with breast cancer. She then received her RN education at Watts School of Nursing and her BSN at N.C. Central University.

“These students are definitely the future of health care, and they’re going to be the ones that are going to make the decisions about the provision of care,” she said.

“Exposing them to a group of individuals that have challenges like our homeless veterans will give them an opportunity to do everything from the assessment to the implementation to the evaluation.”