Inclusion Health Nurse Career Stories
Find out from Inclusion Health Nurses how their careers began, where they are now and why they chose this path.
Case Study – Kirit Sehmbi, Nurse Practitioner
I started working in Inclusion Health volunteering as a Support Worker for Doctors of the World at their drop-in clinic. Doing this alongside my full-time work as a Staff Nurse in a hospital showed me the stark reality of health disparities and barriers. This experience led me to working as a New Entrants nurse in a deprived area of London screening newly arrived individuals for TB. From a specific area as TB, I then went on to working with a wider group of people including those who are homeless, dealing with addictions, those seeking asylum and those who are undocumented migrants.
Now as a Nurse Practitioner, I work in a nurse-led team, but autonomously to offer health care to clients seen in day centres, hostels, a specialist GP service and on street outreach. Taking each case individually, the work varies and includes registering individuals with GPs, carrying out full health assessments and screening, treating minor injuries and illnesses, managing chronic conditions, offering long-acting contraceptives and making safeguarding referrals where needed.
To do this, we work closely with external agencies and partners such as Social Services, housing departments, homeless charities, GPs, mental health services, advocating on behalf of our clients to ensure they receive the care and services they are entitled to. No two days in this area of work are the same, and although it has its challenges, that’s what makes it interesting and fulfilling. In this area of work, you will never be bored.
Case Study – Sandra Oritsesan, Specialist Health Visitor, Initial Accommodation
I am a Registered Nurse, Midwife and a Specialist Health Visitor, and I have worked as a Health Visitor for 18yrs. Prior to joining the Health Inclusion Team as a Specialist Health Visitor, I worked with Lewisham Hospital NHS Trust as a Liaison Health Visitor based within the Hospital Accident and Emergency Department, and working closely with the Neonatal Nurses, Paediatric Nurses and team of Doctors.
Since 2012 I have worked as a Specialist Health Visitor based at an Initial Accommodation Facility. Initial Accommodations house and support destitute Asylum seekers and Refugees, who need immediate housing when they arrive in the UK. Most clients arrive via aeroplane, in the back of lorries, or via boats over the channel. My role includes offering support, guidance and referrals for residents who are victims of human trafficking, torture, domestic violence, sexual or other abuse. Many have resultant mental health problems, and most of them don’t understand spoken or written English. Most of my work takes place via interpreter.
I work closely with a Specialist Midwife, and am involved in the health assessment of children from New Birth to age 18yrs of age, ensuring that the Standard Operating Procedure for Health Visiting are offered to all Children under 5. I give outstanding immunisations to all children age 2months to 18yrs living in the Hostel, and ensure the holistic health assessment of all children.
I work closely with the Southwark and Home Office Safeguarding Teams, Freedom from Torture, the Helen Bamber Foundation, Hestia and Red Cross Charities. This can be a difficult job, but it is also a very essential and rewarding one. I know I make a difference.
Case Study – Amanda Chakraborty, Lead Nurse for the Homeless and Health Inclusion Team
I trained as a Registered Nurse over thirty years ago. I later trained as a Midwife and District Nurse, working within inner city practices where the patient demographic related to high vulnerability, both socially and medically.
However, for the last three years I have been nurse delivering the Homeless Admissions Leeds Pathway (HALP) – part of the wider Homeless and Health Inclusion Team for which I have recently become the lead. Our patients can be street homeless, living in tents, staying in temporary accommodation / sofa surfing, struggling with a tenancy, or at risk of losing their tenancy sometimes due to another individual or groups of individuals. This includes victims of domestic violence, women who are sex working, vulnerable migrants, and people from the Gypsy and Traveller communities.
Our community in-reach service helps to facilitate a discharge plan that will help prevent the revolving door of patients going into hospital vulnerable and being discharged with the same level of vulnerability. I work alongside two care navigators, who support patients with benefits, issues around probation, attending multiple appointments/medicals and applying for housing/tenancies. Our service has access to three step-down beds at St George’s Crypt for ongoing care.
More intensive support continues once they occupy a ‘HALP’ bed. From these beds we facilitate patients into more sustainable accommodation, and with appropriate follow up around health and wellbeing. To do this we work with multiple community partners. Some of my proudest moments have been around organising and helping to deliver appropriate and compassionate end of life care for homeless clients. This is perhaps the best example of working together to improve the quality of care for our marginalised patients. My work was also recently featured in a QNI film on community nursing.
Case Study – Yasmin Appleby, TB Nurse Specialist, Find & Treat TB Project
I have been working in homeless health for the past 15 years. As a clinical nurse specialist in the Find and Treat TB Team, my role is to support some of the most vulnerable people through diagnosis and treatment. I cycle around all of London helping individuals take up screening for TB, Hepatitis C, Hepatitis B and HIV on the mobile Health Van.
It’s the job of the Find & Treat team to go to places where homeless and vulnerable people might be found, such as day centres, soup kitchens and churches, educate them about their risks for TB and other infections and invite them onto the van for a chest X-ray and screening. When people come onto the van for a health check and X-ray, it can also open a whole can of worms though and we try to assist.
From the results of screening, the team can tell instantly whether a person has TB and other infections, and begin a programme of tailored treatment and/or support. The Find & Treat team provides immunisations against influenza, pneumococcal pneumonia and Hepatitis B. During Covid-19 the team has also been involved in delivering Covid-19 testing. The team comprises two nurses, two radiographers, two outreach workers and a driver. It operates in every London borough, but also tours the UK on a circuit. It is regularly called upon to support the control of TB outbreaks nationally.
Nursing is crucial to what I do. This is a nurse-led service that was initiated by a nurse. Just saying I’m a nurse breaks down barriers. People have trust in me in a way they don’t feel able to with other health services. I love my job – it’s utterly relentless – but it allows me to help people who have lived their whole lives on the edge. There is something very special to be in a position to do that.
Case Study – Jonathan Dickson, Senior Homelessness Mental Health Practitioner
For nearly 3 years I have worked as a homelessness mental health practitioner integrated with Ipswich homelessness services. I work with people who are homeless, people who are at high risk of becoming homeless, and those within night shelters, hostels and supported accommodation. I work very closely with multiple services including the council, the homeless drop-in centre, health outreach service, as well as traditional mental health services. Most of the individuals have multiple and complex needs e.g. mental health issues, physical health issues, criminal behaviour, high vulnerability and substance use, so joint working is vital
in meeting all their needs and helping them get their lives on track and out of the homelessness cycle.
A normal day for me is going to see people where they are comfortable, not making them come and see me. I am very assertive with my approach, and don’t give up easily as often people who are homeless are chaotic and would lose contact with services if I didn’t do this. Many have been through traumatic events and suffered abuse, so working in a ‘trauma informed’ way is very important. Often, they may have had bad experiences with services in the past so spending time to build up a trusting relationship us vital.
I offer a wide variety of support options and interventions depending on the individual including basic talking and listening, explaining diagnoses, physical health screening, prescribing mental health medication, social prescribing, and referrals to other agencies including mental health services. I get a huge amount out of my job, and cannot imagine doing anything else. Having the opportunity to work with people who are so marginalised and help them on their recovery journey is a privilege.
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