Colorado University ‘Street Medicine’ Brings Nursing Students to Front Lines of Homeless Care

Homelessness is a complex and worsening issue around the country. The Denver metro area is no exception to the national trends.

Fortunately, nursing and other health professional students from the University of Colorado (CU) are here to help.

According to Denver Rescue Mission, 1 out of 3 people are experiencing homelessness for the first time. There are currently 7,334 homeless people in Denver living in cars, under bridges, or in abandoned buildings.

While housing is a significant issue, a 2022 study found that even after moving unsheltered people into permanent housing, they continued to die at the same rate as those who lived outside.

In response to this need, CU’s College of Nursing developed the street medicine program to help bring healthcare to these populations. Recognizing that a one-size-fits-all model does not meet the needs of people experiencing homelessness, their innovative program utilizes nursing students and licensed healthcare professionals.

Kiera Connelly, RN, and co-founder of the CU Street Medicine team, talked about the importance of the program to the nursing profession in a press release from the university.

“They are still human. But when healthcare professionals get burned out, the first thing to go is their compassion. It’s tough to see. I think this program will help us provide better care because it teaches students not to make assumptions and to see the whole person,” she said.

The program was started in early 2021 by a student group whose mission is to connect healthcare students with volunteer opportunities. Connelly, then a nursing student, and Rebecca Henkind, a medical student, met while at the Colorado Coalition for the Homeless before attending the University of Colorado.

Once at the university, they realized the importance of ensuring healthcare students had the chance to work with a population that’s often ignored. Both Henkind and Connelly were EMTs before attending CU and understood the barriers to accessing healthcare that people experiencing homelessness face.

Even after seeing healthcare professionals, individuals without housing often experience negativity and difficulty navigating the system. The street medicine program utilizes students and faculty from CU’s Anschutz Medical Campus and community partners like Connelly and Scott Harpin, Ph.D., RN, MPH, an associate professor at CU’s College of Nursing and co-chair of the CU Street Medicine program.

Together with other community collaborators, the group goes out twice a week to talk to homeless individuals about their healthcare issues. Community collaborators can include the police department, city council, and community well-being manager.

The program offers healthcare to individuals where they sleep, which Harpin describes as a “win-win-win:” CU can offer a unique program to healthcare students, people experiencing homelessness in the community receive care, and students learn firsthand about social justice and inequities.

Currently, the program is offered as volunteer work for students, which opens the door for students to find a passion for their work and deliver compassionate care to the people they serve.

As an integral part of the CU Street Medicine program, Harpin was asked about the rising number of people without housing in Denver and how that impacts healthcare and the nursing profession.

“We are really seeing the need to treat people where they are and with what they are experiencing. We changed our medical school curriculum last year,” Harpin said in the statement. “Every medical student now is required to do a service-learning project in the community in their first year and a half of medical school. Our CU Nursing program has taken this to heart as well, and we’re being far more thoughtful about the lives of people we’re seeing both in hospitals and other health settings.”

Healthcare for underserved populations is a notoriously difficult problem. People experiencing homelessness face unique circumstances, including difficulty with transportation, housing, and navigating the healthcare system, including the payment system.

The program is entering its second year of nursing students meeting people where they live, delivering prescriptions and education, and offering barrier-free healthcare.

Henkind was asked how the CU Street Medicine program could meet the needs of the homeless population in Denver. She noted that street medicine isn’t a replacement for primary care, but some individuals without housing may never have the opportunity to receive primary care.

Many experiencing homelessness have a history of institutional trauma. Trust is a vital part of an individual’s compliance with healthcare recommendations. Sometimes this can take months or years to establish.

“We will never be able to provide as much comprehensive care as a clinic because of the environment we practice in. We currently offer our services to as many as we can, but do not currently have the capacity to reach everyone in our community; we hope to expand our reach this coming year, and donations and grants are a vital part of that plan,” Henkind said.