UCSF School of Nursing: Helping the Homeless at Glide Health Clinic

Glide Memorial Church

Some of the toughest illnesses require more than medications and procedures to manage. Diabetics, for example, can ward off some of the effects of their disease, such as blindness and heart attacks, by keeping their blood sugar levels in a safe zone. So it's good news that Glide Health Services reported recently that its 80 diabetes clients averaged less than 8 percent on a blood sugar test in the last quarter of 2005. This rate has been dropping among most clients for several years, so they now average close to the nationally recommended target level of 7 percent. That's remarkable, considering that many - often most - of those clients are homeless members of the community served by Glide Memorial Church in San Francisco's Tenderloin. "It is not easy for anyone to manage diabetes - to exercise and eat right, maintain proper hygiene and take medications on a schedule. Imagine how hard it is when you don't have a home," says nurse practitioner Patricia Dennehy, practice director of the Glide Health Services clinic. Founded in 1997, the clinic now takes care of 3,000 underserved patients a year in more than 10,000 visits to Glide. A federally funded Health Care for the Homeless clinic, it is managed by the UCSF School of Nursing Adult Nurse Practitioner program in cooperation with Glide Memorial United Methodist Church, Catholic Healthcare West and other community partners. Most patients come in three times or more for treatments ranging from wound healing to blood pressure checkups to care for a mental health problem.
Founded in 1997, the clinic now takes care of 3,000 underserved patients a year in more than 10,000 visits to Glide.
The holistic and nonjudgmental philosophy of a church like Glide helps the clinic gain the trust of a community that often is difficult to reach by mainstream programs, Dennehy says. It's the sort of place where a patient may get a "pew call" as a doctor or nurse practitioner checks blood pressure while they sit together in church. JoAnne Saxe, clinical professor in the UCSF School of Nursing and director of the Adult Nurse Practitioner program, says, "The Glide clinic is an excellent example of the value of a nursing model to care for people with chronic illness. It draws on a range of resources to help people cope - if possible, to help them live well with their condition." Dennehy and Saxe direct a multiyear federal education and training grant that helps to support Glide efforts to overcome health disparities - including the diabetes management program, a program to help people coping with depression, health screenings and immunization drives. The grant also supports opportunities to expose nursing students and advanced nursing degree students to this method of community care. The grant process allows its leaders to evaluate accomplishments, seek improvements and report to others, who may learn from the Glide model. Dennehy directs the Glide clinic with nurse practitioner Karen Hill as clinic manager and physician Dianne Budd, a board-certified endocrinologist, as medical director. They work to care for the injured and sick from the Tenderloin and other poor, high-risk neighborhoods, drawing on the skills of nurse practitioners, physicians, nurses, psychiatrists, psychologists, social workers and trained medical staff, as well as a complementary care team that offers massage, acupuncture and energy work. "Thanks to these professionals - most of them volunteers - we can offer integrated service, so that patients can come in for primary care, urgent care, mental health services and non-Western healing," Dennehy says. Clinic staff members also do case management in the community, and they partner with Glide's recovery program, the HIV/AIDS unit and Glide's larger social programs. "We can wrap the client in a net of services," she says. Glide Health Services welcomes volunteers. Physicians, nurse practitioners and other health professionals should contact clinic manager Karen Hill. Links: UCSF School of Nursing