Reference no: EM133236149

Donnell Gamble

Donnell Gamble never knew his birth parents, but for most of his young years he knew stability. Then one day it was gone.

Donnell grew up in the foster system until he was 8, when he was adopted. For the next decade, he lived in West Baltimore with his adoptive mother. He graduated on time from a small public middle/high school that emphasized college preparation and personalized instruction. But the importance his school placed on college did not translate into a plan for Donnell for life after school.

"FEAR AND SHAME WERE THE WORST PARTS"

Donnell had no employment prospects or adult mentor to offer direction, his mother had no money for college and in short order he was "mildly misbehaving" and smoking marijuana. In an act of tough love one day following an argument, his mother threw him out of the house. Suddenly and unexpectedly at 19, Donnell had no place to live.

Donnell made his way to a shelter that night, but did not arrive until 11 p.m., long after closing. A security guard, moved at seeing someone so young with nowhere to go, found him a bed. But that initial act of kindness could not make up for how terrified Donnell felt in those early days of homelessness. He had never imagined this happening to him and didn't know what to do or where to turn. Worse, people stole his belongings and intimidated him, and he was embarrassed to stand in line for meals, at the shelter and Our Daily Bread.

"Fear and shame," Donnell says, "were the worst parts."

JUST 12 SHELTER BEDS

Health Care for the Homeless was an early stop on Donnell's attempted return to stability. Here, he met Judy and Debbie, our pediatric nurse and social worker, who helped him get his footing in his new world. He wanted to quit smoking pot and they connected him with Connie, an addictions counselor. After a couple of months, he graduated from treatment.

No longer getting high, Donnell's focus shifted to finding a job and getting housed. He landed a spot in a job readiness program at a local hospital, working in a program that steers young people away from violence. And after seven months in the shelter, he moved in with an aunt. Then Donnell found out he was going to be a father, and once again, his sense of stability was rocked.

At the hospital soon after Donnell Jr. was born, the maternity ward nurses assigned Donnell as sole caregiver of his infant son. Around that same time he was forced to leave his aunt's home and, as a single father, securing housing became that much harder. There are just 12 shelter beds in Baltimore City for a single father and child experiencing homelessness, and they are always full. So for the last year, he and Donnell Jr. "doubled up" with acquaintances in a neighborhood in northwest Baltimore where more than one-third of children live in poverty, nearly half of residents lack access to a car and crime is unrelenting.

"BEING HOMELESS...MADE ME THINK ABOUT LIFE DIFFERENTLY"

One morning in April 2015, there was a shooting near the house where Donnell and Donnell Jr. were staying. That same morning, Donnell Jr. had his six-month checkup at Health Care for the Homeless. But the neighborhood was in chaos, public transportation was rerouted away from the area and Donnell didn't feel safe coming downtown with his son. The Health Care for the Homeless team called to check on him, and ended up arranging for a cab to bring Donnell and Donnell Jr. to the clinic, so Donnell Jr. could get his six-month shots.

Today, Donnell Jr. is a sturdy toddler who is meeting all his developmental milestones. And his dad has a positive outlook on his experience of recent years. His time on the street, Donnell says, has taught him to respect everyone as equals, work hard and seize every opportunity to repay kindnesses he's received from others.

"Being homeless made me the person I am," Donnell says. "Before, I wasn't ready to take responsibility. It slowed me down, made me think about life differently. And I realized all our parents want is for us to do well in school."

Donnell's experience also reminds us just how hard it is to be a young parent without a home, and how fleeting stability-and stable housing in particular-can be.

1. Answer the following questions:

A. What are social determinants of health?

B. Identify the social determinants of health that impact Donnell's quality of life?

C. What are his risk factors?

2. Visit the Maryland Healthcare for the Homeless website:

A. Identify the healthcare services offered by Healthcare for the Homeless.

B. What role does nursing play in combating these disparities? Give an example.