OHSU Expanding Street Nursing Teams in Southern Oregon

Sept. 7, 2022
By the end of 2026, the team hopes to conduct more than 1,000 visits with Jackson and Klamath county residents who are unhoused, and to have nearly 300 nursing students participate

After a successful pilot project in Jackson County, the Oregon Health & Science University School of Nursing’s Street Nursing Team is expanding its services in Southern Oregon.

OHSU faculty members are expanding the Street Nursing Team’s outreach efforts. By the end of 2026, the team hopes to conduct more than 1,000 visits with Jackson and Klamath county residents who are unhoused, and to have nearly 300 nursing students participate.

“The rising cost of living, the COVID-19 pandemic and the 2020 wildfires have sadly all contributed to increasing homelessness in Southern Oregon,” said the project director, Heather C. Voss, Ph.D., RN., who is also an associate professor of clinical nursing in the OHSU School of Nursing Ashland Campus, in a story on the OHSU website. “Not having a place to call your own home can lead to new health concerns and worsen pre-existing ones,” she continued. “At the same time, people who are unsheltered don’t often feel comfortable seeking help from traditional health institutions. The OHSU Street Nursing Team seeks to build trust over time by meeting people wherever they are, week after week. If someone wants help, we offer basic health services and can connect them with other providers for more advanced care.”

The team’s efforts began as an offshoot of a class on population health. To apply her class’s lessons to the real world, Rachel Richmond, M.S.N., RN, an assistant professor of clinical nursing in the OHSU School of Nursing Ashland Campus, in 2015 began organizing foot-soak clinics, which offer a safe, judgment-free space where clients can engage with students or faculty while also addressing foot ailments, which are common among people experiencing homelessness. OHSU nursing faculty originally organized foot soaks weekly in Ashland, but they’ve recently increased their frequency to up to three times a week, and they now happen in both Ashland and Medford.

Early this year, the foot soak clinics transitioned into a street nursing pilot project, with small groups of OHSU nursing faculty and students visiting people experiencing homelessness near Ashland and Medford. Between January and June of this year, 179 visits occurred at encampments and other sites.

During each visit, team members offer local residents a variety of services, such as foot soaks, hygiene supplies, clean socks and overdose prevention education that includes how to give the overdose-reversing drug naloxone. Team members also coordinate client care by facilitating virtual telehealth appointments with other healthcare providers and accompanying patients as advocates during in-person medical appointments.

In addition to the goal of expanding the Street Nursing Teams, student team members will be enrolled in the OHSU School of Nursing’s undergraduate and graduate programs, with the latter working to become psychiatric mental health nurse practitioners.

To further enhance nursing education, various classes at the OHSU School of Nursing’s campuses in Ashland and Klamath Falls will teach about people without housing and related topics. Expected lessons include the traumatic experiences that are common among unhoused people; how some healthcare approaches can inadvertently be harmful; best practices for providing care outside of a traditional clinical setting; and, how mobile health options can better meet certain patients’ needs. By encouraging students to understand the nuanced complexities of people without housing early on, OHSU hopes its future graduates will become nurses who provide care from a more patient-centered mindset.

In addition, the Ashland and Klamath Falls campuses will offer a total of $660,000 in scholarships to as many as 26 undergraduate and 12 graduate nursing students interested in serving patients without housing. Scholarships will be offered to students who have experienced housing insecurity or otherwise come from disadvantaged backgrounds. As part of the scholarship program, recipients will have additional hands-on educational opportunities with local providers. Supporting underrepresented students is part of OHSU’s larger efforts to grow and diversify Oregon’s health care workforce.

To support the current health care workforce, the OHSU Street Nursing Team also plans to offer evidence-based training opportunities for healthcare workers and community service agencies that work with the unhoused population.

Local organizations that have partnered with the OHSU Street Nursing Team include: Jackson County Library Services, La Clinica, Jackson County Syringe Exchange Program, Options for Helping Residents of Ashland and Jackson Care Connect. The team continues to build connections with other organizations and hopes to add more partnerships as the project moves forward.

The project is currently supported by a four-year, $3.9 million grant from the U.S. Department of Health & Human Services’ Health Resources & Services Administration, and previously received a $20,000 grant from Jackson Care Connect.

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