Where can I get a warm meal? Where can I take a bath? Where can I get telephone call backs for a job? Where can I sleep tonight? Although these are questions we do not think about as we go about our daily activities, for the homeless they are major concerns. And although there are resources to deal with these concerns, before the project to be discussed was completed the homeless had difficulty getting answers to their questions. Staff in shelters or social and health agencies knew some resources for this group but often there was a waiting list to gain access to these staff members. At other times, homeless individuals saw staff who did not have answers to their questions. Thus, the services which were available for the homeless did not always reach them.
Each summer registered nurses studying for their baccalaureate degree in nursing have a community health nursing theory and clinical experience as part of thenfinal nursing course. The clinical experience is divided into two parts. The first experience involves visiting families and participating in other aspects of the community health nursing role at the local health department. The second part of the clinical is a community experience. In the community experience, students use the nursing process to assess, plan for, and implement care with a community group such as runaway teens, the homeless in community shelters, the aged in an adult living center or a group of pregnant teens in a special school. From past assessments students have identified the need for and carried out such interventions as a class on AIDS for staff in a homeless shelter who were fearful of AIDS, prepared and presented a manual of resources for staff use in sheltere for the homeless, a class on safety for a group of mothers, a class on nutrition for a group of elderly in an adult home, and participated in fandraising for homeless shelters.
From working with the homeless in several community settings it was obvious to this nurse educator that the homeless needed more assistance in locating appropriate resources in a timely manner. This assessment was discussed with students during the first day of clinical for the community experience. After brainstorming, the group decided to develop a flyer of resources for the homeless and low income individuals and families in Virginia Beach and another for homeless individuals in Norfolk, Virginia. When completed, these flyers would be placed throughout the community in strategic places where the homeless and those with low incomes would have access to them.
Because there were 23 students in the community clinical, numerous tasks to carry out, and only five additional days to complete the tasks, it was necessary to develop an organizational structure for the project. The group of 23 students was divided into four smaller groups according to the interest of the students. Each group selected a leader who met with the nurse educator regularly. Leaders were given beginning materials on resources and the names of contact people so that each group had a starting point. One group was to review, validate and add to resources for the homeless in Virginia Beach whereas another group was to do the same in Norfolk. A third group was to review, validate and add to resources for low income families in Virginia Beach. They were advised by the nurse educator to keep data simple such as where a homeless person could get a warm bed, a warm meal, or a place to wash clothes or take a shower. The fourth group was to find sponsors and collect money to reproduce the flyers and pay other associated expenses. This group was given the name of a businessman who worked with the homeless and the Kiwanis Club. One student offered to ask her sister, who was an artist, to develop a logo. Several students offered to type the master copy of the brochure after materials were submitted. In addition, after the nurse educator suggested media coverage to make people aware of the flyers, two students who knew individuals who worked in television and with the local newspaper offered to contact them. The nurse educator also contacted and provided information to the public information office at the university.
During the next two days of clinical (over two weeks) students contacted appropriate resources and validated, corrected and added to data. The logo for the flyer which showed two clasped hands over a house was developed and enthusiastically approved by the students. The group collecting money reported a committed pot of $700 and located a printer who would reproduce the first 2,000 copies of the brochure at a reduced rate. Students also decided to use 11" by 14" colored paper which would be folded to produce eight sides of information.
Problems encountered at this point were discussed. There were two major ones. First, after calling several church pantries which students hoped to include as resources for low income families they were consistently told that the churches did not want to be included. The reason given was that any publicity would increase their caseload which they could not handle. Some agencies said they gave food only on referral from social services. The nurse teacher and students decided to include a statement that area churches may have pantries and referral may be made by social services. The second problem encountered involved to whom checks should be made from donors so that bills could be paid when needed. After discussing this with the Chair of the School of Nursing it was decided to have payees make checks to the School of Nursing and to put the money in a special account. Since some potential contributors wanted to make the check payable to a homeless organization this arrangement meant the loss of some revenue. However, those who had committed the $700 were satisfied with the arrangement and were allowed to add "homeless project" after School of Nursing on their checks.
During the next two weeks some students continued to validate data and others began typing the information, reducing the size of the printed material and arranging it on the eight sides of the fourfold 11" by 14" master copy of the flyer. The first page consisted of the logo and the following identifying information: "Resources for homeless and low income individuals and families in Virginia Beach, Virginia." The next 3Vi pages listed resources for the homeless. Data followed the format of identifying the resource by name, listing their address, identifying what services they offered, when these services were available, who the contact person was, a telephone number, and any requirements for the service. The next 4 pages identified resources for low income individuals and families and followed the same format described above. On the bottom half of the back page the registered nurses as a group in community health nursing at Old Dominion University during the summer of 1992 were recognized. In addition, the organizations who financed the project and the printer were recognized. The name and telephone number of the nurse educator was also Usted so that individuals and organizations would have a contact for additional copies of the flyer.
With the money available, studente decided to have additional copies of the two flyers made. They also decided to purchase holders for each organization to use to display the flyers. Some money was also set aside for postage to mail brochures when requested by individuals and organizations not on a master list of locations for delivery. Using input from students, the nurse educator, financers, and shelter staff, it was decided to place the flyers in a variety of locations which would be frequented by the homeless. These included such places as shelters, soup kitchens, other locations working solely with the homeless, social service departments, health departments, free clinics, police departments, public libraries, and supermarkets.
Students were excited about the project and readily completed the tasks in the short period of time available. They felt it was a worthwhile project and they were "doing something for the community" and "not just writing a paper which didn't contribute anything to anyone." Some students also said they wanted to take the idea to other locations when they returned to their previous or new positions and try to do similar projects there.
During the last week of the experience the health expert from the local television station presented two segments on the project from the students' point of view on the evening news. Students were interviewed, discussed the project, and showed copies of the final product. In addition, the nurse educator's office telephone number was given so people could call for copies of the flyer. Within two days over 60 telephone calls were received asking for the flyer and most of these were from homeless people who didn't know where to turn for help. Over the next couple of weeks over 180 flyers were requested and sent in addition to the hundreds which were taken to the various agreed upon locations. Thus, we were beginning to reach the group we wished to reach.
During the last week of the project there was also a formal presentation of the flyers to community leaders who work with homeless and low income individuals and families. The mayors of the two cities were invited and some city council members. In addition, directors of the shelters, soup kitchens, medical clinics, health departments, social services, housing and other appropriate organizations were invited. The Chair of Nursing and the Dean of the College of Health Sciences also attended. Students selected two peers to present flyers to each community leader as they were introduced by the nurse educator. Reactions were again very positive to the flyers which represented a first for this type of assistance for the homeless in our communities. An article in the faculty newspaper at the University also covered the project and was presented and responded to in a positive way.
A month after the project was completed the nurse educator took additional copies of the flyer to all locations. In most, the supply of flyers had been exhausted. Comments from staff included "these help us a lot," "we ran out and have been xeroxing them to meet the demand," "people like them and have taken all we had," "excellent resource." One service provider told the author "you listed showers available at my facility from 9 AM to 3 PM whereas it should have been 9 AM to 12 noon." She continued on to say one man came for a shower at 2 PM and when told they finished at noon he produced the flyer and said "It says here showers till 3 PM," They allowed the man to take his shower and were pleased that the flyers were being used.
The Future of the Brochure
Some individuale representing resources listed in the brochure have called to give updated information and others from unlisted resources have called and asked to be included in the next revision of the flyer. It is anticipated that a future group of studente will use these flyers as a guide and update them when the current supply is exhausted or becomes obsolete.