Jean-Luc St-Amour is a nurse clinician who worked as a street nurse with people who live on the streets. He was interviewed by Karine Marineau on March 16, 2021.
Providing care on the Streets
Before the first two waves of the pandemic, Jean-Luc St-Amour had been working for a few months as a street nurse through the CIUSSS Centre-Ouest out of CLSC Métro (beside Guy-Concordia metro). He was on vacation when the first wave hit and felt guilty for not being on the ground. As soon as he could, he returned to his small, tight-knit team (two addiction experts, two social workers and two nurses) to share his vital infection prevention expertise and understanding of infectious diseases.
“Our world had changed overnight, but our clients’ needs were the same,” he explained. “We didn’t know what precautions to take. It took a long time for us to receive masks, personal protective equipment and visors…I had to look for information and share it with my team.”
Very soon, all community organizations, clinics and rehab centres closed their doors and hospitals stopped taking appointments. Public bathrooms also closed. “Our personnel had to push authorities to make some public bathrooms accessible in our territory,” Jean-Luc recalled.
There was no longer a place to provide safe care, except in certain community centres that had premises allowing it or by making links with nearby organizations such as churches. “They were the nearest places where I had access to a room.” St-Amour met with community partners, trying to figure out ways to keep working together. Before the pandemic, he spent a lot of time there dispensing physical care, doing screenings and taking people to their appointments but now there were even more pressing problems.
“That’s when I had the idea of walking around with a backpack (he still does this to this day) full of Band-Aids, blood sampling kits, gloves, gowns, disinfectant wipes, etc.” For a month and a half, St-Amour and his team distributed sandwiches, crack kits and injection kits as there were no other follow-up services that were operating in their sector.
He also collaborated with other diverse community organizations to provide services and care in parks where tents were put up. He quickly connected with other resources as well.
CIUSSS du Centre-Sud set up a red isolation zone for homeless people. “I was really impressed with how they implemented this initiative, and we learned a lot. I volunteered in this unit for three weeks before returning to my team,” St-Amour recounted.
Thanks to the suspension of several internal projects and media coverage, his team built closer ties with the nursing directorate. “It allowed us to receive the services we had been lacking for so long.”
The tents were eventually taken down and then the second wave hit hard. Unlike the general population, COVID cases among homeless people spiked later, in December. Major outbreaks began in the recently reopened day and emergency centres. But St-Amour felt he “already felt more in control of the situation. March to July was really when we adapted.”
Providing care in these difficult circumstances did not leave his own team unscathed, however, and a third of the staff had to go on burnout leave after the second wave. “It’s definitely emotionally hard when you can’t really provide the kind of care you want,” St-Amour explained.
“Despite the closures and tough conditions, we never stopped giving homeless people the care they needed, and of that I’m proud,” concluded St-Amour.