For nurses serving homeless, hospitality comes first

Talking with participant
Augsburg College professor and nurse Kathleen Clark talks with Lee Anthony Cosby at Health Commons at Central Lutheran Church in Minneapolis, Feb. 2, 2015.
Jeffrey Thompson | MPR News

As Darryl Brown, a first-time visitor to the Augsburg College Central Health Commons, slid into a big easy chair recently, nursing instructor Kathleen Clark offered to check his blood pressure.

Clark told him the numbers were high.

After learning Brown smokes, Clark decided against a lecture on the health risks of tobacco use.

"People get that all the time," she said with a laugh. "So we're really trying to suspend the judgment in that situation."

Instead she used the easy-going conversation to learn more about the man. With more visits and conversation, she hoped he might decide to quit smoking on his own.

Conversation is a central aim of the work of nurses at the Health Commons, a drop-in center run by Augsburg College faculty and volunteers at Central Lutheran Church in downtown Minneapolis.

Talking with student
Kathleen Clark instructs an Augsburg student at Health Commons.
Jeffrey Thompson | MPR News

Augsburg uses Health Commons to help train students in the college's nursing program. Clark, the health center's coordinator, sounds a familiar lament about health care in this country: Everyone is in too big a rush, with not enough time to talk to those they serve.

"[There are] more tasks, more procedures, more documentation, more technology," she said. "And we're not oftentimes allowed the time to sit down and really listen to people."

Clark and her colleagues have a different philosophy. For them, effective nursing is about hospitality. Toward that end, they treat people who arrive for help as visitors rather than patients.

The center does not have exam rooms or do medical tests. People with serious health problems get help finding a doctor, making an appointment and arranging transportation.

Augsburg College started the center 22 years ago. It is open a couple of hours each morning on Monday and Thursday and is funded by Augsburg, Central Lutheran Church and private donations.

The Health Commons is part of a cluster of services called the Restoration Center. Augsburg College, the church and other non-profits help people obtain housing, jobs and health care. There's also a free clothing store.

On Mondays, Central Lutheran Church serves a free midday meal to as many as 350 people. There are also places to rest, use computers and watch TV.

Waiting in line
Augsburg assistant professor and nurse Katherine Baumgartner talks with Enrique Barsanas Lopez as he, Virginia Prog, right, and others wait in line at Health Commons.
Jeffrey Thompson | MPR News

All of the services are free and there's no limit on how many times people can visit. Many of those who do are homeless.

Clark said the center does not keep records of visitors. But one number remains constant: Staff and volunteers hand out dozens of pairs of socks — one pair per visitor — each day.

Between them, Clark and Baumgartner have years of front line nursing experience — eight for Clark in oncology and more than 30 for Baumgartner in nursing care, nurse management and home health care. Both have traveled extensively overseas to study health care in other countries and cultures.

The hospitality model emerged from such studies, said Katherine Baumgartner, a nursing program professor at Augsburg College who teaches at the Health Commons.

"There are places in the world where people understand that health is created in community," she said. "How do we live with one another, how do we help each other, how do we pay attention to one another, how do we respect each other, how does that foster health and well-being?"

Handing out health items
Augsburg College student Jane Timmins, left, and Augsburg staff member Jay Peterson volunteer to hand out free health care items.
Jeffrey Thompson | MPR News

The power of the relationships built from the hospitality nursing model practiced at the Health Commons became clear to nurse June Sand, 66, a longtime Health Commons volunteer.

When Sand, had a health problem a few years ago and was recuperating at home, a regular Health Commons visitor pulled into her yard.

"She rode her bike from her apartment to my home in Arden Hills and did my gardening every day for a whole summer," Sand recalled. "Just as a gift. I was just shocked."

Many of the visitors to the Health Commons, including Lee Cosby, are homeless and have foot problems.

"The majority of us beat the street," said Cosby, 56. "That means we walk a lot, so that's why we come and get our feet taken care of."

Health Commons nurses recently helped Cosby get treatment for a foot infection. He returned for treatment, soaking his bruised feet soaking in a blue plastic tub.

But he also enjoys the friendship.

"They make it so pleasant where you know we wish we can stay," Cosby said. "But we know we can't."

Correction (Feb. 23, 2015): An earlier version of this story incorrectly identified Katherine Baumgartner in a photograph. The current version is correct.

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