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Lessons from the Homeless: Civil and Uncivil Interactions with Nurses, Self-Care Behaviors, and Barriers to Care.

Nursing Forum 2017 July
BACKGROUND: Civility, rooted in social justice, is a fundamental value of nursing. Homeless people are particularly at risk for experiencing uncivil behavior from nurses.

PURPOSE: The purpose of this study was to explore homeless people's perceptions of their interactions with nurses.

METHOD: In this descriptive, qualitative study, we interviewed 15 homeless adults who described their experiences with nurses. The interview guide, developed by the researchers, consisted of open-ended questions and probes. Transcriptions and field notes were analyzed through thematic analysis.

RESULTS: Three major themes emerged: nurses should be civil, self-care behaviors, and barriers to good care. Subthemes included listening, compassion, attentiveness, and judgment as components of civility; where they go for care and who cares for them as self-care behaviors; and lack of money and homeless status as barriers to care.

CONCLUSIONS AND IMPLICATIONS: Our findings indicate people who are homeless often perceive nurses to be uncivil and uncaring toward them; furthermore, our participants provide a unique description of healthcare interactions from the perspective of the homeless. These findings can be used as a basis for the development of education interventions for students and practicing nurses to assist them in learning to provide civil and compassionate care for the homeless.

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