Supporting Well-Being for Nurses Who Care for the Homeless

Ambulatory | Portland, OR


Central City Concern (CCC) focuses in the complex intersection of patients experiencing a combination of the effects of homelessness, addiction and acute/chronic mental health issues. The nurses that work at CCC experience a high level of moral injury and primary or secondary trauma in the course of their work because the needs of patients often exceed the resources within a nurse’s scope of medical or psychiatric practice.

The nurses identified initiatives to help decrease stress and mitigate the impact of the secondary trauma and moral injury. This grant would support the implementation of a collaborative project implementing a common language, teamwide agreements of support, time/space for a break, mindfulness tools, and training in mindfulness and on debriefing critical incidents.

There are 60 Registered Nurses who work across 8 sites at CCC in Multnomah County, Oregon. Our locations of care span two Primary Care clinics, Assertive Community Treatment outreach teams, Hooper Detoxification Stabilization center, Hansen shelter clinic, Recuperative Care Programs, Letty Owings Center (LOC–residential treatment for women who are pregnant or parenting small children), population health and a team to outreach and provide support for medically fragile members. Including support staff in this important work would bring the number of supported individuals to 100.

An evidence-based workplace well-being snapshot survey, designed by What Works Centre for Wellbeing in collaboration with the UK Department of Work and Pension, will be deployed prior to the implementation of any grant funded interventions and will continue to be deployed quarterly through the course of the grant to measure the impact of the initiatives implemented.

Success Metrics
1. The wellness scores of participating nurses using the short form of the workplace wellbeing snapshot survey will demonstrate a 10% increase from baseline by February 2025.
2. 100% of nurses indicating interest in EFT tapping training as evidenced by an educational interest query survey will obtain training during the course of the two-year grant.
3. 100% of nurses who manage other nurses will be trained in critical incidence debriefing during the first 6 months of the grant to support their teams as these events occur.
4. Toolkits to support mindfulness practices will be purchased and deployed to all 8 nursing locations by April 2023.
5. 100% of nurses hired after 05/01/23 will be assigned a support peer for the first 6 months of onboarding to mentor them in understanding the tools that are available for their support.

The intended outcome is to see a measurable impact on the well-being of nurses and support staff at Central City Concern.