Video Case Study - Homelessness

Nurse Margot works as a community health nurse in the health department and is assisting a local homeless shelter to address concerns among its residents. Nurse Margot goes through the steps of the Clinical Judgment Measurement Model to make decisions by recognizing and analyzing cues, prioritizing hypotheses, generating solutions, taking action, and evaluating outcomes.

First, Nurse Margot recognizes cues. She distributes an anonymous questionnaire to residents at the shelter to gather demographic data, employment status, presence of medical conditions, and any other concerns they have. Nurse Margot then interviews willing residents to gather additional information on factors contributing to their need for the shelter and discusses with staff any concerns they have about residents.

She also obtains data from the shelter on the number of residents it houses and services that’re offered.

Next, Nurse Margot analyzes these cues. She reviews data from the questionnaire and her notes from the interviews to identify common themes. She notes many residents are unemployed and have indicated they’re unable to maintain employment due to mental health conditions. They cite lack of transportation and financial concerns as a barrier to accessing mental health care; and staff also report many residents have been struggling mentally due to lack of access to needed care. Nurse Margot reviews services provided by the shelter which include support groups, Wi-Fi, and assistance with housing applications.

Nurse Margot knows homelessness is a complex socioeconomic issue that consists of a range of living situations. She knows there are many types of homelessness including rooflessness, sometimes called absolute homelessness, where individuals lack any shelter; houselessness, also called sheltered homelessness, such as those who don’t have a permanent residence but stay in temporary housing like shelters; insecure housing, where individuals face threat of eviction or instability with their living arrangements; and inadequate housing, in which conditions are substandard, have structural hazards like leaking roofs or lacking basic utilities such as clean water.

Additionally, hidden homelessness is when individuals live temporarily in their vehicles or with friends or family and may not be included in the official homelessness statistics.

Margot understands there are a variety of factors that contribute to homelessness, including unemployment or working for low wages; mental illness; domestic violence; and inaccessible health care. She also knows that homelessness contributes to poor health outcomes, which can interfere with the ability to maintain employment, become financially independent, and obtain long-term housing stability.