DESC started practicing integrated healthcare long before most social service organizations. We sited our first full-time RN in the main emergency shelter more than 25 years ago in partnership with Harborview Medical Center. Mary Pilgrim worked in the shelter for 20 years providing care to people who weren’t able to access care in other settings.

DESC continues to integrate nurses in our programs. DESC now employs 37 RNs and ARNPs, and Harborview or Neighborcare Health employ nine more who are sited at DESC. Of these, eight work in outpatient behavioral health, survival shelters or permanent supportive housing programs. Twenty-five provide 24/7 inpatient services at the Crisis Solutions Center. We also collaborate with the UW School of Nursing to provide practice placements for RN, ARNP and doctoral nursing students.

Nurses are the backbone of success in meeting multiple needs in a single setting, especially for DESC clients who live with a host of medical, psychiatric, behavioral and physical disabilities. Research has shown that people who have experienced chronic homelessness live in bodies that age more rapidly than their housed peers. Roughly one-third of all DESC clients have a chronic or major medical condition, most commonly diabetes and cardiac or pulmonary diseases. These conditions are too-often made more severe due to challenges in following medication regimens, completing medical tests or forgetting to go to follow-up medical appointments. In addition, DESC clients tend to be more susceptible to systemic infections and injuries such as broken bones because of years of malnutrition.

Healthcare integration is a hot topic in medical and social services these days. Much of the time, it means bringing behavioral providers into emergency rooms and medical clinics. DESC, on the other hand, strives to bring medical services to people where they are – on the streets, in survival shelters and in permanent supportive housing programs – and nurses working in these environments offer education, support and services with compassion and expertise.

Nurses provide valuable service to our clients, from crisis intervention to preventive assessments to primary care to opiate education and overdose response to medication management to assessment for emergency services and much more. As the Covid-19 pandemic emerged in 2020, our nurses took up the challenge of protecting our clients from infection and ensuring the safe treatment of those who experienced illness.

Clinical and primary care RNs and ARNPs at DESC care for our clients’ minds and bodies every day, and they have also brought their perspectives and experience to the table and have greatly influenced the organization’s strategic thinking and its constantly-evolving plans for proactive integrated care into the future. They have been integral to DESC’s ability to rapidly pivot to develop new protocols, assess clinical needs and provide medical services. DESC deeply values and appreciates the hard work that our nurses do every day!