The basic role of a nurse is to provide health care. The nurse has to address the unique problems that face the homeless population. Poverty and lack of affordable housing are some of the issues contributing to homelessness. When the limited resources have to cover food, child care, health care and education, often it is the housing that has to be dropped. Lack of employment opportunities and declining public assistance are factors contributing to poverty. It is the role of the nurse to provide and advice for alternative and affordable health care and gives counseling to avoid addiction disorders due to frustrations. Homeless persons face tremendous challenges to treatment services and recovery support due no access to health insurance and also lack of documentation.
Compared to other sectors of health care services, nursing address issues in regards to the well being as well as the quality of life for the homeless. The nurse does more than coordinating comprehensive services. The nurse will design the health care systems so that they can be objective and meaningful. The nurse will carry out a needed assessment and will ensure that the clients get medical care at the comfort of their residence. The nurse will bring it to them as a preventive measure rather than they seek it for curative purposes. The nurse will ensure that the extreme cases are identified, find a solution, plan on how to alleviate the future problems, implement solutions and evaluate whether the outcomes are desirable.
A meta-paradigm is the broadest perspective of a discipline. It is a method that describes the issues that regard to the profession or domain. The meta-paradigm for nursing describes those concepts that define the discipline of nursing. Since the early 70’s the four concepts are; nursing, health, patients and environment. For all these to be successful there must be aspects, such as:
• Determination by both parties i.e. client and nurse.
• Passion-this mainly will involve the nurse, when she is caring out her duties.
• Strength-this is on the client; part through the support of the family and community.
• Hope-for both parties.
• Co-operation-this is between the nurse, client and the community at large.
• Healing-it requires patience since it is gradual.
The 4 Meta-Paradigm
1. Patient – these is an individual who receives nursing care, it can be a family, individuals and communities. For a population that is homeless, the kind of life they lead and their capability to work are the most vital parameters for evaluation. To get a clear picture of the outcomes, specific guidelines have to be spelt out. They could include; the number of days one was not intoxicated 80% accuracy in doing a task. The patient should be a part and parcel of the process, and it can be done effectively through monitoring and evaluation.
2. Environment – this is the internal and also external issues of life, which influence an individual. Many renowned services involving health are mostly for medical purposes and are not designed for other factors, resulting from being homeless. Being treated for the problem at hand without going further to investigate the main cause of the ‘problem, will definitely cause a recurrence of it. One has to conduct a conclusive investigation as to the causes of the previous situation. Providing an enabling environment for the homeless would facilitate a gradual approval of the importance of their health and sanitation.
A person living in a positive environment will definitely get to see positive outcomes than one is living in negative ones. A positive environment is one with a clean sanitation and has acceptable standards for human decency.
3. Health – these is a level of wellness that a person experiences. Homeless people face tremendous challenges and obstacles in regards to receiving of treatment services as well as recovery support, due to lack of vital things, such as: medical cover inform of insurance, poor records, scheduling problems in terms of appointments’, lack of transportation to access the services, cheap and ineffective treatment modes, lack of supportive services, which would facilitate follow up’s, mistrust of registered and recognized medical facilities and insensitivity of the culture. I, therefore, believe with no doubt that facilitating health is to implement the theories of caring into the nursing practice, creating a positive, and nurturing environment, in which the patient/person/client feels encouraged and he/she is compelled towards wellness and becomes in a position to discern bad health traits.
Health is a concept that is defined by many, as an absence of illness. On the contrary, it is a state of overall well-being physically, spiritually, emotionally, and mentally and it supersedes any pending or disease state one may be in. One could be very healthy, although coping with a chronic disease.
4. Nursing – these are the interventions that the nurse renders to take care of the patient in terms of support in day to day activities that the client or patient engages in. Nursing outcomes should be purely about the patient. It should be collaboration between the nurse and the patient. The patient should be part and parcel of the process so that it can be meaningful and objective.
This is normally done by social workers who have embraced the art of giving voluntary services. This is because the homeless cannot afford the services. They involve many aspects as follow up and monitoring. The focus of nursing is selfless and one is always asking the question: ‘what is in the best interest of the client?’ A nurse must be in a position to synthesize different modes of dimensions in order to create a healthy atmosphere for the health of clients. Trained personnel are highly advocated for.