Nurse Unit Manager of the Homeless Health Service at St Vincent’s Hospital Erin Longbottom, and her team, have led the pandemic homelessness response in Sydney.
I’m the Nurse Unit Manager of the Homeless Health Service at St Vincent’s Hospital. We are a multidisciplinary outreach team of clinical and non-clinical staff including nurses, Allied Health, doctors, peer workers, Aboriginal Health workers, educators and counsellors.
Our role is to work with people in all forms of homelessness, or those who are at risk of homelessness, sleeping rough, in unlicensed premises or at risk of losing their tenancy. Our clients often have a lot of health and support needs and find it tricky to navigate the health system, so our role is to connect them with the support they need. We go out to the services that people visit, such as drop in centres, or we also speak with them on the street where they sleep. We also see inpatients at St Vincent’s Hospital.
The response to the pandemic by the hospital and the Homeless Health Service has been incredible, as has the other services we work with. At the start of the pandemic there was a sense of fear and unknown, things were unfolding day-by-day which was confronting.
We were managing our own feelings around the unknown and how to work in this new environment with physical distancing which was tricky when we work so closely with people. Our aim was to make sure we were providing support for very vulnerable people who are socially isolated, and supporting our NGO partners and government partners who didn’t have all the health expertise that we had.
Our team was integral in leading the pandemic homelessness response in Sydney. We knew we had to get people who were sleeping rough into accommodation to self-isolate as they were a vulnerable cohort who were more at risk and could get very sick with COVID-19. Our cohort often have a lot of untreated or chronic health conditions and go to shared areas, which also increases the risk.
Within the Homelessness Sector we treated our response as an emergency. Our first priority was to get people who were sleeping rough off the street quickly. So we arranged to get them into hotels in the city. We then set up pop up hubs in some of the hotels and worked with our partner agencies to provide people with health support and pathways to longer term accommodation and psychosocial support.
For our clients it’s not necessarily a quick fix just to get a roof over their head. Many of them have a long history of really traumatic events and for some people being in a hotel room alone made them very scared. Some feel safer on the street as they have a community around them of others who are sleeping rough. They have people watching over them. Homelessness is a really complex issue – I don’t think anyone wants to be homeless, but it’s the things that lead up to that that make people feel that’s their only option. So for us, building trust with people is really important. Unfortunately many really vulnerable people end up back on the street again.
Nothing like this before.
I remember one example of a call we received about a man in his thirties who was living in a small park in an isolated part of Sydney. He’d been homeless for a really long time and had no identification, he had long-term mental and other health issues. He hadn’t engaged with any services, he’d fallen through the cracks. One of our team’s nurses and doctors went to see him at the park, but initially he wouldn’t talk to them. On the third visit he accepted to go into temporary accommodation at a hotel in the city.
While there, he said to one of the housing workers that he’d really like to see his mum. We didn’t know how to contact her until one of the other teams found her on Facebook and contacted her. She responded with the most incredible sense of joy, she really wanted to see him. We didn’t know the family dynamic, so needed to be cautious. We went to the hotel and one of the staff from our partner services contacted his mum. His whole family drove from regional NSW overnight to the city to see him.
Peer support workers went to the hotel and brought him down from his room to meet his family who were so overjoyed that they had found him. It was the most emotional reunion. Now he’s back with his family and is linked in with support services.
This is an example of how an opportunity which provided him with a safe place, led to him being reunited with his family.
We’re going to review out response to pandemic. If we had to do this again, we would make sure we had a more stringent capture of a person’s health needs before they’re put into accommodation to ensure we have the appropriate support and response there.
This experience has shown us what we’re capable of as a health service and a homelessness service, and we now know we can work even more collaboratively, with our NGO partners. During COVID-19 the collaboration was next level. The relationships and processes we’ve established with our partner agencies during COVID-19 has meant we now respond quickly as a team if we’re worried about a particular person.
This experience has also taught me a lot about my team. They’re really brave. They are real front line workers. They ramped up their client contact when COVID-19 broke and were seeing people when and where no one else was seeing them. They didn’t show any fear. In an environment where everything was changing, they didn’t flinch. They didn’t always know how to respond, but they kept going out and making sure our clients were ok. I’m very proud of them.
I have always been a big promoter of health – physical distancing and the need to be careful so as to prevent a second wave. I have vulnerable people in my family in terms of their health, so I encourage them to be mindful of how they conduct themselves when they’re out and about. And of course it’s really important to regularly wash your hands.
Well done. The response to the pandemic has been incredible. We’ve all felt fear and anxiety, but the support that we have all showed each other, the education the up-skilling, the hospital response, has been amazing. Good on you. Well done, all front line health workers are real heroes.
My family is my saving grace. For the first few months of the pandemic work life balance was hard, but my family help me forget about it. I do really have to separate my mind from it – I practise mindfulness, watch Netflix, listen to podcasts, walk our dog and read.
Do you have a story to share about how you are involved with the COVID-19 response? We’d love to hear from you. Email us at info@health.nsw.gov.au.
