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Roy McCallum and Suze Doucette with the Mobile Outreach van
Providing Transportation to Saskatoon’s Vulnerable Citizens
As I walk to The Lighthouse on a sunny spring morning, I try to mentally prepare for my ride along with the Mobile Outreach program. Then I realize that I’ve worked at the shelter for three months and only have a vague idea of what the support team actually does.
The front desk is a hub of activity as the morning shift change takes place, and day staff are updated on the events of the previous night.
I meet up with Suze Doucette and Roy McCallum, who will be taking me along with them for the day. We hop in the grey Dodge Caravan as McCallum throws a cooler packed with juice and sandwiches in the back.
Our first order of business is to take two clients to the Rexall on 20th Street to get their morning dose of methadone. They’re both shaking from withdrawal. “I’m so happy we have outreach!” exclaims one of the clients.
The Lighthouse only recently secured funding from the Saskatoon Health Region to operate the program 16 hours a day, from 8 am to midnight. The extended day hours means we can transport clients to their appointments all over the city. Before the program she would have to walk, bus or take a cab on cold days.
While our clients wait in line for methadone, we cruise the streets of Pleasant Hill. Doucette sits in the passenger seat and chats about finishing her practicum in Addictions Counseling at the Saskatoon Housing Coalition, “You sure see how mental health, addictions and housing go together, how it’s such a problem in Saskatoon.”
McCallum is quieter throughout the day, focused on driving. But it’s easy to notice both of them light up when we see clients on the street. They keep the windows rolled down, honking and yelling greetings to everyone by name.
We drive past a man on a bike and Doucette says, “He’s still sober, that’s great!” We pull over to chat with him and McCallum gives him an orange slip of paper– a free pass to the YMCA to use the gym, pool and shower. “You see? I told you I’d take care of you!” McCallum says.
Doucette shows me the journal she’s writing in. The outreach team has to keep a detailed record of every person they connect with throughout their eight hour shift. They use the stats to apply for funding. When I ask what the program needs to help them do their jobs better, Doucette immediately says, “A computer! Anything to make this paperwork easier.”
We spend the rest of the day zipping around the city, taking people to doctor’s appointments, driving clients to drop off housing forms and handing out juice and snacks.
The phone rings every few minutes and Doucette answers. It’s usually the front desk with another person who needs transportation. McCallum tries his best to get clients to their appointments on time.
We head to Riversdale to pick up the man we saw biking earlier. He has a doctor’s appointment in fifteen minutes on the other side of the city. While en route he explains that his doctor recently moved to Stonebridge and it’s too far for him to bike there.
After we drop him off, Doucette says, “If you could have seen him four months ago, you wouldn’t believe he was the same person.” She explains that when she met him for the first time last winter, he was intoxicated and suicidal- on his way to jump off the bridge. “My training immediately kicked in and I knew I had to talk him down,” says Doucette.
She spent an hour with him and eventually got him to sleep at The Lighthouse that night. Since then he has been committed to staying sober and getting his life back on track. “That rarely happens,” admits Doucette.
As we wait for someone at the bank, Doucette notices another client across the street, intoxicated and panhandling. She calls him over and gets him into the van, “It’s time to get some sleep,” she tells him. He comes with us willingly and we take him to the Stabilization Unit at The Lighthouse to sleep it off. He was seven months sober.
The day and night shifts are completely different for outreach. Since there aren’t appointments at night, the support team has more time to connect with clients and talk about their addictions, encouraging them to take advantage of services at The Lighthouse or other clinics around the city. “Humor is key in outreach,” says Doucette, “you got to know how to make them laugh.”
On top of a keen sense of humor, support workers also need a lot of training. First Aid, Applied Suicide Intervention Skills Training (ASIST) and Part and Wave, which teaches how to de-escalate violent situations, are required to work in outreach.
“You need a personality that jives with the clients,” says Doucette. Some people come to the program and clients can tell they’re uncomfortable, which makes it harder to foster relationships. “If you can’t deal with conflict, don’t work in outreach.”
Conflict can cover many things. “We’ve taken weapons away from people,” says McCallum. “I’ve been swung at and I had a sandwich thrown at me,” Doucette laughs, “but it’s more verbal abuse than anything.”
Despite a few incidents, Doucette says most people are grateful for the program and she feels perfectly safe working in outreach. “This is my comfort zone,” she gestures to the van. “They’re still human beings and they still deserve to be treated with respect and dignity.”
There’s a new addictions counsellor at the Lighthouse, and she goes by the name of Leanne Murdaugh.
“She’s very respectful and kind,” says David, a client of Leanne’s, who visits the Lighthouse almost every day to connect with Leanne.
David recently moved out of the Lighthouse and into a home in the community after staying temporarily in the shelter’s stabilization unit, which provides a safe place to stay for people who are under the influence of drugs or alcohol. Prior to the Region’s Better Every Day14 Day Challenge, the unit was open only at night, but as of March 2, it is now open 24 hours a day, seven days a week as part of a pilot project aimed at reducing emergency room visits by those seeking services that the unit can provide.
“The stabilization unit is a safe, non-judgmental place for people to go,” says Leanne, who provides addictions services in the unit alongside a case manager. “Having the unit open 24 hours a day keeps our clients safe. They know they can come here and lay down if they need to, rather than having to go to the hospital.”
A familiar face to the Lighthouse, Leanne worked in the stabilization unit, as well as the men’s and women’s shelters, for a year as a case manager prior to accepting her current role as addictions counsellor.
“One thing that’s really important for people who have addiction issues is a familiar face and a connection with someone they trust,” says Leanne. “Our clients already know who I am. They know our stabilization unit staff, and our nurse and nurse practitioner, so they’re comfortable and are able to come to us with some of the things they’re dealing with. As a team we can refer them to the appropriate care.”
Having an addictions counsellor onsite means that Leanne does not have to refer as many clients offsite for treatment in the community, where wait lists can exceed four to six weeks. Since the expansion of the stabilization unit, her recovery group numbers have increased, more than doubling on some days from six to 13.
“I’ve got a lot more people coming to recovery group now, and I think it’s because they’re already in the building,” Leanne noted. “Instead of having to get up at 7 a.m. and leave the unit because it’s closing for the day, they’re sticking around to sleep and eat breakfast, where I can chat with them. It’s easier to connect with clients and to refer them to treatment because I’m not running around looking for them.”
Leanne is not the only one who has noticed a positive impact on the clients who are accessing expanded services at the Lighthouse.
“I see a difference in the clients,” says Dave Thiessen, Lighthouse general manager. “They’re happy and excited, and seem proud to live here and have access to all of these services.”
Over the next few weeks, The Region Reporter will share with you a series of stories about improving care and health through partnership and teamwork at the Lighthouse. These initiatives are underway thanks to the hard work of the Community Services Team (Team 1), which is part of our Ready Every Day: 90 Days of Innovation project.
Within the past two months, the Lighthouse team has grown by nearly a dozen people and now includes an addictions counselor, nurse practitioner, special care aid, and paramedics. The Lighthouse is a community-based organization that provides emergency shelter, supported living and affordable housing to those in need.
Staff were hired as part of a six-month pilot, resulting from the Region’s 14 Day Challenge, to expand services. The goal of the pilot is to reduce the number of monthly admissions to hospital from this location.
“There were bits and pieces of this starting before the 14 Day Challenge,” says Donna McKnight, registered psychiatric nurse. “However, the resources weren’t available to expand. The 14 Day Challenge really augmented our services and took them to the next level. For example, with increased staff, we’re able to come together as an interdisciplinary team every single day to identify the clients we should be working with and to come up with care plans that can be followed in a consistent way.”
McKnight, a health region employee, started working part-time at the Lighthouse a year and a half ago.
“When I first came to the Lighthouse,” says McKnight, “I met someone who had diabetes. It was very difficult to get resources for this person, and he ended up getting a partial amputation. There was significant cost to the healthcare system, but more importantly, there was a significant cost to that person because it was difficult to get his needs met in a way that resulted in a good outcome.”
The Lighthouse is one of Saskatoon Health Region’s many partners.
Fortunately, one of McKnight’s current diabetic clients, who does not have a home and is living temporarily in the shelter, is having a much different experience. As a result of the pilot, the client now has access to a new team of care providers as well as access to expanded hours in the stabilization unit, which provides emergency shelter to clients under the influence of drugs and alcohol.
“This person was sick the other day, and because the stabilization unit is now open 24 hours a day seven days a week, we sent this client over there to rest and be monitored,” says McKnight, who is seeing how the pilot is making a difference in the health of Lighthouse clients.
Another service that has been expanded is the Mobile Outreach van, which allows a team of two to provide transportation to homeless or struggling individuals to the Lighthouse and other support services. The van’s daily hours have been expanded from six to sixteen, and it now runs from 8 am to midnight.
“There are still challenges and gaps,” says Dave Thiessen, General Manager at the Lighthouse. “The pilot isn’t answering all of our problems, but it’s certainly starting. It feels like we’re moving toward solutions to provide better care.”
See the www.saskatoonhealthregion.ca/ReadyEveryDay website for more information about 90 Days of Innovation: Ready Every Day.
See the original story on The Region Reporter https://regionreporter.wordpress.com/2015/05/03/expansion-of-services-at-the-lighthouse/
Over the next few weeks, The Region Reporter will share with you a series of stories about improving care and health through partnership and teamwork at the Lighthouse. These initiatives are underway thanks to the hard work of the Community Services Team (Team 1), which is part of our Ready Every Day: 90 Days of Innovation project.
In the past two weeks, thanks to the services of an onsite paramedic, the Lighthouse has drastically reduced the number of people who require transportation to the hospital. The Lighthouse is a community-based organization that provides emergency shelter, supported living and affordable housing to those in need.
Mitchell Ehr is one of seven paramedics who is providing care at the Lighthouse as a part of a pilot project that resulted from the Region’s 14 Day Challenge.
Since April 20, an onsite paramedic has been available to provide care to clients 12 hours a day seven days a week from 11 a.m. to 11 p.m. The initiative is part of a six-month pilot to expand services and hire new staff at the Lighthouse, with the goal of reducing the number of monthly admissions to hospital from this location.
Mitchell Ehr is one of seven paramedics at M.D. Ambulance who has joined the Lighthouse staff for this initiative.
“It’s new to me,” says Ehr. “I’ve never worked in a scenario like this before. Usually I’m with a patient for half an hour at the most and never see them again, whereas here I could be with a patient for the whole 12 hours. It’s definitely a change, and I’m excited to see where it goes.”
Ehr says patients who experience minor emergencies have needs that can be better met onsite by a paramedic than in an emergency room, where wait-times can exceed five hours.
“Let’s say there’s a patient with a cut on their arm,” explains Ehr. “The Lighthouse staff calls 911 and an ambulance is dispatched. As the onsite paramedic and first responder, I then assess the patient to decide whether this person needs care in the hospital, as opposed to just sending them there because the resources aren’t in place to support them in the building.
“If it’s not urgent,” continues Ehr, “I’ll downgrade the response so the sirens aren’t on or I’ll cancel the call altogether. For example, if the patient with a cut arm isn’t bleeding much and just needs stitches, I’ll bandage the wound and have one of the Lighthouse staff take the patient to a walk-in clinic.”
Over the past year, ambulances have been dispatched to the Lighthouse approximately 40 times per month.
“It really speaks to the need of having a paramedic onsite who can triage appropriately and provide care as needed in a timely fashion,” says Dave Thiessen, General Manager at the Lighthouse.
Having a paramedic onsite also means clients have access to follow up care if required.
“Because we now have a paramedic onsite, we can provide consistency of care and make sure care plans are being followed,” says Thiessen. “Our clients deserve to get adequate health care and to have their needs met.
“With support from the Region,” continues Thiessen, “we are now able to put resources where they’re going to have the most positive impact, and that’s not an ambulance call for someone who needs minor stitches or an antibiotic.”
See the www.saskatoonhealthregion.ca/ReadyEveryDay website for more information about 90 Days of Innovation: Ready Every Day.
See the original story on The Region Reporter https://regionreporter.wordpress.com/2015/05/04/onsite-lighthouse-paramedic/
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