Working with Sydney’s homeless and disaffected, nurses from the Haymarket Foundation provide an essential service to some of the city’s poorest people.
Groups of weathered looking men are gathered outside the Haymarket Foundation, sitting quietly on plastic chairs and in the gutter, or talking among themselves. ‘We’re not here to “save” them,’ says clinical nurse consultant Jill Leys. ‘We’re trying to improve the health situations they come across here and now.’
The men here are some of Sydney’s most marginal inhabitants: the homeless, alcoholics, drug users and mentally ill people. The Haymarket Foundation, wedged between Surry Hills and the Cross, is a free healthcare clinic for anyone who walks off the street and needs care.
The people who attend the clinic usually have more than one diagnosis, says Jill. ‘These are people that have been through a lot. They might have had years of addiction and mental illness or other things. There is a lot of violence in their lives, and very little family contact,’ she says. Here they can see a nurse or a doctor, pick up their medication (but not methadone) or have a wound dressed.
But perhaps more importantly, the clinic is an outpost where people can have a shower, get vitamins, call Centrelink or send and receive mail – somewhere to feel centred and respected. Like many services for the homeless, the Haymarket Foundation has a kind of gravity for its clients – with nowhere else to go, they tend to use the clinic as a kind of anchoring point.
Sometimes women come and sleep on the veranda in the morning. ‘Most girls are working girls, and are usually heroin addicts,’ says Jill. ‘Often they stay up all night working, and they might come and sleep on the veranda here after 7am because they know it’s safe.’
Having a place to go – any place – is an important psychological foundation for people. ‘One of the most important things for homeless people is the aspect of safety and a home base,’ says Jill. ‘People tend to do a lot better when they’ve got their own place, they feel safer.’
For many homeless people their own space could be a bed in a hostel like Matthew Talbot, but for others it’s simply a regular spot in a doorway. ‘There are also groups that sleep out,’ says Jill. ‘There’s a big group that sleeps out near the library, up in Macquarie Street, but they’re going to have to leave because they’re putting in some trendy café there,’ she says.
‘There are a few guys who live on the trains – they do the Lithgow to Newcastle run. They catch the all-night train and sleep on the train. From what I can judge, the train guard knows a lot of them, and if they behave themselves and they don’t act up or they’re not bizarre in any way or don’t smell too much, then they’re OK. Others live in caves along the Hawkesbury. They catch the train up there, usually they’re alcoholics. There used to be a group that slept on Brighton Beach but I’m not sure they’re still there.’
It’s essential that the three nurses at the clinic are able to build trust with their clients, especially those with mental illness.
‘There are the chronic psychiatric patients who fall through all the cracks: they have no one to look after them, they won’t attend the mental health crisis team, so they’re never case-managed. They’re sort of lost souls apparently. We manage them the best we can from down here,’ says Jill. ‘If they know you’re truthful and that you’re interested, if you do what you say will do and tell them the options, then after you’ve done that a few times, they realise we’re trying to help them.’
Jill has qualifications in women’s health and a degree in counselling from UNE, and is hoping to complete her Masters. The nurses at the clinic have to be all-rounders who can deal with anything that comes through the door, and be able to manage a wide and unpredictable range of patients.
‘You have to have extremely good boundaries,’ says Jill. ‘None of us is frightened to say no. You have to know where your space begins and ends. The clients know that they can’t get benzos or Panadeine Forte here. But they can have antibiotics or anti-psychotics if that’s their medication.’
It can be demanding work but Jill loves her job and is a passionate advocate for her patients.
‘It’s tough out there. There are a lot of heavies around,’ she says. ‘But they’re a really worthwhile group of people. They’ve seen a lot of life.’
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