Real Life Scenario

As you learn about homelessness and the complex ways in which it is experienced, we encourage you to begin with this real life composite scenario. Take a moment here to pause and consider this person‚Äôs experience. 


Pia is a‚ÄĮ50-year-old‚ÄĮfemale. She has a history of substance misuse, who has been drug free for 2 years. She is currently living in a local shelter as her partner died suddenly from a massive stroke, without an updated will. All of his assets went to his wife, whom he had been estranged from for 15 years, forcing her return to her hometown.‚ÄĮPia presents to the emergency department of the local community hospital with severe abdominal pain. She has a history of GI issues including Irritated Bowel Syndrome (IBS). She has been managing her IBS successfully with diet and the support of her Nurse Practitioner. Since moving home, she has yet to find a primary health care provider. On admission to the emergency department her old records are accessed. The most recent visit was 5 years previous. After reviewing the old records, the first notation made at the top of the new chart is ‚Äúknown drug user.‚ÄĚ She is seen by the ER nurse and physician who both ask about drug use. She explains her history to them, including her success with sobriety. She denies any recent drug misuse. She waits in the ER for 16 hours, very uncomfortable. No tests are done. No pain medications are offered. No referral‚ÄĮis sent‚ÄĮfor a surgical consult. She is discharged at 4:00 am still with significant pain. The final entry on the ER record is ‚Äúdischarged home, pain of unknown origin.‚ÄĚ‚ÄĮ‚ÄĮPia was admitted 3 days later for a ruptured appendix, requiring surgical intervention. 


Reflection Questions

With this scenario fresh in your mind, consider these reflection questions. You may wish to record your answers before moving on to the next section. We will return to the scenario again at the end of the chapter. 

Reflection Questions

  1. Do you feel that stigma played‚ÄĮa part‚ÄĮin Pia‚Äôs care?
  2. Did the care provided meet your idea of expected care and/or of best practice?
  3. How do you think the ‚Äúculture‚ÄĚ of a hospital impacts care for patients?



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Understanding Homelessness in Canada Copyright © 2022 by Kristy Buccieri, James Davy, Cyndi Gilmer, and Nicole Whitmore is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, except where otherwise noted.

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