Amanda Buccina, R.N., is the “Street Nurse” of Sacramento, Calif. She spends every workday caring for the city’s homeless residents.
The Street Nurse program began in March 2016 as a collaboration between Sacramento-based Sutter Health and WellSpace Health, a community health center.
Some 5,000 city residents are estimated to be homeless. The Street Nurse seeks out those who are unsheltered – the indigent population living under bridges, along railroad tracks or downtown streets or in tents or shanties along riverbanks. She has helped more than 200 people get on-site care, medical advice, disease management education and wound care.
“You have to be willing to meet people where they are,” says Buccina, who was hired by WellSpace Health to be the program’s sole Street Nurse. “A lot of times people just want to talk and they need someone to listen to them.”
Buccina also advocates for clients at a doctor’s appointment, helps get them into an alcohol or drug rehab program and connects them to other social services. “I translate the medical jargon or just help them navigate the health care system,” she says. “Being that liaison helps both the patient and provider.”
She works to build trust and rapport with her clients “so even if they don’t need me in that exact moment, we have a relationship and familiarity with one another.” Maintaining a trusting relationship is critical when clients do want support, she says. In some cases, it can take months or even a year.
“People want to know that there is somebody who is consistent and who they can trust,” Buccina says. “Being that consistent presence in a pretty unstable environment is extremely important.”
The program is a vital piece in the continuum of care, says Kelly Brenk, Sutter Health’s community benefit coordinator. Sutter Health funds Street Nurse.
“It is like being in your doctor’s office except the doctor’s office is a park and the patient is homeless,” Brenk says.
She says Street Nurse is part of the health system’s commitment to addressing the urgent health needs of the homeless, while also working for comprehensive solutions to homelessness in the Sacramento area.
Sutter Health is spearheading a strategic initiative, “Getting to Zero,” to align public, private and philanthropic resources in support of a “Housing First” response to homelessness – a strategic initiative that calls for low or no-barrier access to permanent housing. Sutter Health has committed to match up to $5 million in contributions to local governments and raise up to $15 million with the business community to meet that goal.
“The traditional ‘silos’ of medical, behavioral health and social services can’t address the needs of this vulnerable population alone,” Brenk says. “We are trying to align everybody around one strategy and work from the same playbook.”
Street Nurse Buccinna sees her role as “providing an access point into a traditionally very guarded population, so we can start to link the homeless to services they desperately need.”
Buccina perfectly fits the role, says Christie Gonzales, WellSpace Health’s director of behavioral health operations.
“Finding that right person who really gets it and wants to be out there in the heat and in the cold and in the rain to work with these folks and live with them day to day is our biggest success,” Gonzales says.
For Buccina, the rewards far outweigh even the harshest days on the street. “If they let me into their world and trust me enough to help them, then that is a big deal,” she says. “To be accepted by such a vulnerable population is very meaningful.”