Tag Archives: Health

Streetlife

The following is an extract from Coming Home for Good – my autobiographical book on homelessness, spirituality, identity and belonging – describing some of my experiences of an itinerant lifestyle choice as a young man in America:

 

In ’87, money became scarce. I saw myself as “road-wise” rather than street-wise, and lived for the open road. City life’s never been my thing. But when times were tough, I stayed in the cities to donate plasma for $5-$10 a time (depending on the city), which they’d let you do up to twice a week. The clinic would take a pint of blood, centrifuge it to separate the plasma from the red cells, and infuse the red cells back into the donor’s bloodstream.

I have no idea what the screening procedures were like back then, but all the street people used to do it for a quick buck, and I became one of them.

At one clinic, while I was there, they treated and dressed a really nasty, infected ulcer that had developed on my elbow from a simple graze I’d sustained while messing around with a football in a field with Joel and Mikey in Portland. I found that every little scratch I got – and you tend to get a lot when you’re sleeping rough – became infected. The elbow wound was so bad, I still bear the scar quite visibly 3 decades later.

The same thing happened to two symmetric wounds on my back that originated as simple scratches from the split rings on my metal frame rucksack when I walked or hitched with my shirt off in the southern heat. Two decades later, in a physical assessment class as part of my nurse prescribing course, a medical lecturer demonstrating an examination of my back was trying to guess the cause of my scars and surmised I’d had some kind of thoracic surgery. I took great delight in revealing the real, obscure cause was my distant history of hitch-hiking.

My nutrition – and therefore immunity – was no doubt pretty poor, not to mention hygiene. I was never a proud, image-conscious young man – well, except in my younger punkier days, with my all-black clothes and hair. Showers weren’t necessarily a priority when travelling, although I would find rivers to wash in, and one time discovered I could sneak into a high-class golf club through the back door to use their showers. That was luxury!

Homeless people are generally prone to infections, even if their hygiene is good. Like the rest of the population, many are keen to keep themselves clean and tidy, while others tend to let themselves go if their lives and energy are consumed by chasing the next beer or bag of heroin, or their minds distracted by psychotic illness or depression.

Many have health conditions like hepatitis that affect their immunity, which in turn may also be compromised by poor nutrition.

When I was travelling, my weight dropped to about a stone lighter than for most of my young adult life – giving me a BMI of 18 (in other words, quite underweight) – and about 2.5 stone lighter than my current (healthy) weight.

For all these reasons, homeless people have high rates of respiratory, skin and wound infections.

Incredible to think, looking back on the elbow episode, that I’m now running homeless clinics myself, treating wounds, infections and other health problems; that I’m prescribing antibiotics, dressings and nutritional supplements. Who’d have thought it when I attended that plasma clinic in ’87? Certainly not me.

Homeless people tend to have great difficulty accessing healthcare – even in the UK, where they don’t have to have an address to be registered with a GP – although not all surgery staff realise this, unfortunately. Systems are difficult to navigate; making doctors’ appointments is difficult even for people with the most organised lives; and healthcare often isn’t top of the agenda for people in chaotic, vulnerable circumstances.

Despite the eternal, infernal funding challenges in the voluntary sector, I find it incredibly satisfying, working for a charity outside the NHS, to be able to offer informal, friendly, drop-in clinics, making healthcare accessible at venues where homeless people congregate; not being restricted to 10-minute consultations.

Talking of nutrition, I learned to raid the skips just after McDonald’s had closed at night, for free, freshly discarded burgers while they were still warm! That was such a treat.

“Dumpster diving” as it’s known in the US, or “skipping” in the UK, has hit the media in recent years as high-profile cases have heightened public pressure to reduce food waste by supermarkets and to legalise the practice of taking discarded food from skips – to criminalise supermarkets, not the poor and homeless, for this mad situation. It’s been encouraging to see more scope being given for charities to at least accept food that’s going out-of-date.

The other draw to the cities on my travels was the free meals in soup kitchens and hostels, which tended to be pretty grim, to be honest.

In one hostel, lying on a mattress on the floor of a grimy, bare room shared with a male stranger who had wanted to have sex with me, I clung on to my rucksack in my half-sleep, not trusting anyone.

But in every soup kitchen and hostel, the soup and sandwiches were a welcome relief to an empty stomach. Most were run by Christian missions and I’m forever grateful to all of them.

Some of these mission halls insisted on visitors listening through a gospel talk before being given food. Not too sure of the ethics of that now. And I’m not sure how receptive those raucous crowds with ravenous stomachs could have been to the messages being preached.

However, little bits of what I heard made me think, and I ended up debating and arguing one-to-one with some of the preachers. By this time, I had an interest in Buddhism and didn’t much like these Christians’ dualistic ideas of heaven and hell, God and Satan, good and evil, but something was beginning to chip away at me.

But I had no doubt that, if there were a God, then I was a sinner and needed saving. My understanding of sin, if there were such a thing, was simplistic. My stealing, lying and deceitfulness, my general sense of being a bad person, constituted my sinfulness – if God was real. It was self-evident that my lifestyle constituted one of sin before the Christian god.

If I could be convinced of the existence of God, I’d need no convincing of my sin. But if I continued in my atheism, I could continue in the dubious freedom of my amorality….

 

Coming Home for Good is available here, in print and on Kindle.

Comments and reviews always welcome!

Thanks for reading,

Roger Nuttall

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Hope for the Homeless

Maybe you’ve read about my journey to faith in My Life’s Soundtrack. If you haven’t, I’d love it if you decided to have a peek. From being physically – but primarily spiritually – homeless some years ago, I found a home in Jesus and my insecurities began to be healed from the inside out.

Of course, that was just the start of the journey. It can be tempting to think, when we have that kind of turn-around, that that’s it. We’ve found what we were looking for. We’ve been born again, found peace, were lost but now we’re found, or whatever. But it’s just the start. And the best is yet to come.

Like the romance of honeymoon, those who genuinely love and are truly loved know that real love is not the passion of newlyweds but that which has overcome trials, which has stood the test of time and tragedy and challenges, which has matured and developed into something deeper, more courageous, more giving.

My relationship with God is not what it was when I was a zealous young fanatical charismatic Christian. It’s not better. It’s not worse. It’s different. Actually, it is better!

For one thing I’m more reflective, and more secure in my faith, and therefore more free to be honest about my beliefs rather than feel I have to agree with any party lines of the Christian establishment – while at the same time valuing unity more highly than ever!

My outer life tends to consist of mornings, evenings and nights spent managing the joys and challenges of my family – a toddler, a teenager and one in between – wrapped around daytimes spent busily coordinating a homeless health service. It’s all good, of course. That is, I have everything to be thankful for, even if I’d like to complain about being too busy and tired and not having enough time to go running or to write stuff like this! But here I am.

(OK, I am busy and tired and that’s why I can’t sleep and why I’m writing this in the middle of the night, but I still have no reason to complain…)

But even these things are not what my life really consists of. My real life is internal and is made up of my waxing and waning love for Jesus, my attachments, joys, temptations, hopes and doubts, and the attitudes of my heart towards my family, clients, colleagues, friends, neighbours and strangers.

I express my love for God differently these days. The scriptures I treasure (i.e. the Bible) tell me that the kind of worship that God is pleased with is not so much exuberant songs or sacrificial giving or church commitment, but treating people in need – especially those most marginalised by society or religion – with dignity, respect, value and compassion – with ‘agape’ love.

Homeless and vulnerably housed people, amongst others, are a gift from God to us. They offer us the opportunity to express our love for him in a tangible way on this earth.

Doing the job I do is a mind-blowingly incredible gift, privilege and responsibility that I’ve been entrusted with. One I don’t want to take lightly. In my busy-ness, an attitude of love, so easily forgotten, is everything.

Bulletin-316-coverIt has been a wonderful privilege and opportunity also to have an article on the Hastings Homeless Service featured in this month’s Royal College of Nursing Bulletin.

Please click on the picture opposite (that’s me!) and then go to pages 8-9 to have a read about what I do…

…externally, at least.

And if you’re a praying person, please pray for us, that this service would reveal divine, healing love to its clients and colleagues.

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The Spirit of Healthcare

I shouldn’t have been surprised when my manager’s manager flew into a furious rage a couple of years ago over a small section of a report I’d written on a service evaluation survey. In response to a client’s comment expressing a need for ‘more religious support’, I’d attempted to show how our homeless service could do more to take into consideration clients’ spiritual needs.

As a Christian working for a secular organisation, I have no wish to use or abuse my position by ‘proselytising’ or Bible-bashing at work (nor to do the latter anywhere else!), and my comment in the report was simply a reflection on one client’s wishes (whatever he meant by that) in the context of holistic care.

Our Western society is dogged by cynicism, scepticism and negativism – and no more so than when it comes to matters of faith, religion and spirituality. The dominant secularist (and often prejudiced) agenda often ignores the vast contribution made by faith communities (i.e. mainly churches) to society, week in, week out, and to blame religion for many of the world’s ills. The narrow-minded atheist also pits an unnecessary battle between theism and science…

…whereas the thinking person, atheist or Christian, acknowledges that it’s people and institutions with power, not religion, that cause wars, and sees no conflict between science and belief in God. But that’s another blog post…

Secularists, under the ‘new atheism’ banner, would rid the world of religion, claiming its harmfulness – sometimes out of fear of religion and faith, simply because they don’t understand it, in the same way that ignorance breeds racism and homophobia.

Healthcare and spirituality are inextricably and historically intertwined. But the manager in question had no clinical background. His reaction was founded in ignorance, probably of faith and spirituality, certainly of healthcare.

At this point we could discuss the faith-based history of hospitals and hospices and indeed the organisation I work for. We could also look at research that shows how people who belong to a church tend to have lower rates of ill health – how belonging to a (faith) community bestows proven psychological benefits and promotes altruism.

But rather than tread the well-worn path, however useful that may be, for the sake of freshness I prefer to speak from my own experience, so here are some examples…

First of all, my U-turn from a hedonistic life on the road, to a career as a nurse (see My Life’s Soundtrack) was the direct result of a fairly dramatic conversion to Christianity. An inner change effected a passion to promote the physical, social and spiritual health of others.

Then, early on in my nurse training, I was taught that spirituality was an important yet often neglected part of patient assessment and nursing care.

That spirituality was not just about whether the patient ticked ‘C of E’ on their hospital admission form, but about what gives meaning and purpose and values and joy and hope to that person’s life.

How they feel about death and dying.

How they deal with their own suffering and illness.

What their longings and aspirations are.

And also whether they have a faith or religion in the conventional or unconventional sense, and how they express that faith.

These are spiritual (and psychological) considerations which every healthcare professional needs to be aware of when dealing with patients and clients. And yet, many professionals shy away from such questions for fear of the unknown, being unsure – as many are – of their own spirituality and beliefs, let alone those of others.

Adrift in their agnosticism.

This neglect is further magnified in the world of homeless services, in which clients are hardly ever asked about faith and spirituality, let alone encouraged to engage with their religion and attend places of worship, if they have faith, or to explore their spirituality1.

An uber-secularist world which sometimes goes so far as to actively discourage such discussion, to the detriment of its service users. So much for person-centred care.

On one occasion, as a student nurse on Coronary Care Unit (a small open plan unit where everyone could hear everyone else’s conversation), a patient asked me question after keen, searching question about my faith, and I found myself speaking in some detail about the good news of Jesus and what that meant to me. I felt quite trepidatious (OK, I know it’s not a real word, but it should be) about being overheard by other staff and patients, and wondered if I’d be disciplined for ‘proselytising’.

To my relief and amazement, in my final assessment on the placement, the staff nurse who was my mentor praised me for delivering spiritual care, and again emphasised how often spiritual needs are neglected. The patient made a full recovery, but being hospitalised with a cardiac condition, had perhaps faced questions and fears in his own mind about death, dying and suffering. And perhaps I was the right person at the right place and time for him.

Another time during my training, in the anaesthetic room, I was alone with a patient about to undergo surgery. She seemed especially anxious and yet somehow I ‘sensed’ that she was a Christian and might appreciate prayer. She confirmed this was the case, we prayed, and her anxieties were significantly allayed. Later on, she found out my name and wrote me an effusive letter of appreciation for the difference this encounter had made to her in facing her op. Her spirituality was integral to her healthcare, recovery and wellbeing.

I love being a Christian – for all kinds of reasons. One thing I like about Jesus is that he was (is) such a renegade. Always breaking the rules. Not for the sake of it, but to show us a better way. I relate to that.

Not keeping the Sabbath. Because there are people who need healing, affirmation and love every day of the week. A better way.

Not condemning a woman who’d been unfaithful. So that both she and her accusers could learn mercy and a new way of life.

Hanging out with sex workers, outcasts and underdogs, while lambasting religious leaders. Setting the record straight.

The messiah being tortured and executed. That’s not meant to happen, is it? Breaking the rules for our freedom and healing.

The way of Jesus, unlike religion, has no rules. Except perhaps the ‘rule’ of love. Love God, and your neighbour as yourself.

Loving yourself is definitely not a rule, but an inevitable response to being loved. When we’ve received the affirmation and acceptance that Jesus offers, we start to forgive and love ourselves. That kind of self-love, self-worth, changes our attitudes to our bodies and minds, as well as to other people.

There are no rules against smoking, booze or drugs for Christians. No rules against chocolate, all-you-can-eat-breakfasts, espressos or over-working.

Smoking and getting drunk AREN’T ‘against my religion’. Couldn’t resist putting that in BOLD type.

And yet…

I stopped smoking about the time I came to faith in Jesus. Tobacco, that is. Cannabis and all other illicit drugs came to an end for me a bit later. I haven’t wanted to get drunk (or been drunk) since before I first experienced the Holy Spirit about 25 years ago. It would be no big deal if I had been drunk – the point is that Jesus gave me a better way.

I do have my vices (let’s not discuss my coffee habit or chocoholism), but my life is pretty healthy. I have self-worth. I care about my life, because I know my worth to my Father. My spirituality is inseparable from my physical and mental health.

When my homeless and vulnerably housed clients find self-giving love, whether from God or others, they find a reason to care for themselves. They’re less likely to be suicidal or to self-harm. A higher power or higher purpose gives them a reason to live and change. Spirituality cannot be divorced from health, especially mental and emotional health.

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Moving from my own experience to an excellent and much-needed recent study…

Clients – not support workers or managers – initiated a spirituality group at a homeless service in London, which they felt lacked the opportunity to explore issues of spirituality and faith.

This client-inspired group then led to research conducted by (self-confessed atheist) Carwyn Gravell on behalf of secular thinktank Lemos & Crane.

This much-needed, much-welcomed study, Lost and Found, reports on the results of 75 in-depth interviews with homeless service users on the subject of faith and spirituality.

Clients “described faith and spirituality as being a significant aspect of their personal lives and identity, contributing to their wellbeing, helping them to recover from mental health or drug and alcohol problems or to pursue a future free from offending”.

Spirituality inseparable from health.

Over 70% described themselves as religious or as having been religious at some stage in their lives. Many saw themselves as spiritual in a broader sense.

Most service users appreciated the opportunity to express their inner selves and their own unique responses to their profound experiences of loss. One interviewee felt the research indicated that the organisation was taking him seriously as a whole person with an individual identity, and not just a mechanical service user.

This thorough, objective report confirms what I and others already knew and has given that knowledge substance and evidence. For those of us who long to move on from the narrow-minded, secularistic-worldview-dominated service delivery model, to give truly holistic care, this report is welcome news.

My manager’s manager – the one who had the tantrum – has left the organisation I work for. That obstacle to holistic care of my homeless clients has gone.

And I’m looking forward to discussing Lost and Found with my line manager and colleagues, exploring how we can implement its findings.

Whatever form that takes, it certainly won’t involve conducting religious services or anything specifically ‘Christian’, but will entail working with clients where they’re at and towards where they want to be.

And I’m so glad that God is able to meet with people where they are. And will be found by those who are honestly searching.

I was thinking about how to finish this post and I don’t actually have a witty or flippant comment as I usually do. Maybe that’s because this is a subject so close to my heart.

If you have any views on the subject of spiritual care in the world of healthcare or social support, I’d be very grateful if you could share this post and/or comment below, as appropriate.

Thank you, and blessings for reading this!

1. Lost and Found: faith and spirituality in the lives of homeless people (Lemos & Crane 2013)

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