Nursing class to partner with Open Door shelter
McGill partnership with Open Door focuses on helping city’s most vulnerable
When David Chapman picked up the phone last summer, he heard a familiar voice crying for help.
A homeless woman he worked with had just been beaten so badly her friends called an ambulance. But when the paramedics finally arrived at the scene, they didn’t seem to take her injuries seriously.
What’s worse, she told him that on the ride to the hospital they joked about how the victim was a “drunk Inuit.” It was like she wasn’t even there.
In the end, the paramedics took her to an emergency room and left her sitting there — bleeding, bruised, unattended.
“It was truly a horrible experience for her,” says Chapman, who runs the Open Door homeless shelter. “In the end, I picked her up and drove her to another hospital.”
Chapman says that, far too frequently, this is typical of the way homeless and Indigenous people experience Montreal’s health-care system. But thanks to an innovative course at McGill University, a new generation of nurses is beginning to soften the system’s approach.
Starting next fall, McGill student nurses will partner with the Open Door to learn about the lives and needs of Montreal’s most vulnerable population.
“This course changes the way students understand what it means to be a nurse,” says professor Françoise Filion, head of the Community Health Nursing Project that started five years ago.
“It’s incredible to watch them make the transformation. They’ll take the things they learn in the field and bring it to emergency rooms and clinics across the city.”
Street workers say there is no shortage of problems for homeless people who walk into an emergency room. Some have lost their medicare card or had it taken from them during a robbery.
When that happens, they have to pay for their care out of pocket.
There are those going through withdrawal or in the throes of a mental health crisis. And for some Indigenous patients — who are survivors of Canada’s residential school system — the experience of dealing with a government agency can be traumatic.
“Imagine you’re someone who has been through years of sexual and physical abuse at the hands of the government,” Chapman says. “You may not be so trusting of a nurse or a doctor. And it takes patience on their part to deal with that.”
The four-credit course pairs students with a community organization to learn how it works, and about the people it serves, and to assess its needs. Within three months, they create a project to address the community group’s pressing concerns.
Students have partnered with women’s shelters, community clinics and groups like CACTUS Montreal, which helps distribute safe-injection kits.
By pairing with the Open Door, they’ll be working alongside a shelter whose clients struggle with addiction to alcohol, crack and heroin. Some are involved in the sex trade and about half of the 150 people who visit the shelter daily are Inuit.
“Having these nurses work with us is an investment in the future of our health-care system,” Chapman says.
In one recent project, the student nurses worked with the Native Friendship Centre to help make health care more accessible to Status Indians. Because Indigenous health care falls under federal, rather than provincial, jurisdiction, a visit to the hospital comes with a number of complications.
“If the right forms aren’t filled out, it can wind up costing them money when it shouldn’t,” Filion says. “So we worked to make those forms more readily available, to have them filled for free.”
During a hospital visit with her son, Nakuset — who is Cree — says the doctor joked about calling child services to report a diaper rash.
In her work as the executive director of Montreal’s Native Women’s Shelter, Nakuset says many of her clients fear each trip to the hospital.
“There’s incredible insensitivity and ignorance in the system,” says Nakuset. “Sometimes the (healthcare worker) will say, ‘Why don’t you just go to Kahnawake?’
“There tends to be a hostility toward the women and it makes them afraid to ask questions and stand up for themselves.
“A useful exercise for these student nurses would be to accompany the women to the hospital and see what it’s like to be an Indigenous woman in the system.”
Perhaps the most effective part of the McGill course is that it gives future nurses a chance to enter the workforce after having walked a mile in someone else’s shoes.
“Hospitals have a built-in hierarchy,” says Filion. “It’s often a doctor or a nurse telling a patient how things are going to be. But in this project, the students approach people — vulnerable people — as equals.
“It makes them better nurses, it makes them better people, and when I see how much they care and how therapeutic these relationships are, I’m so proud of them.”
This course changes the way students understand what it means to be a nurse. It’s incredible to watch them make the transformation.
FRANÇOISE FILION, head of the Community Health Nursing Project