Novice Nurse Series: How to Prepare Novice Nurses to Care for Patients Experiencing Homelessness

Nurses join the profession because they care. Their empathy is their superpower, and they bring this to the front lines where they are caring for vulnerable populations like patients experiencing homelessness. So, how can you, as a nurse educator, empower your nursing students and new nurses to use that superpower to best care for patients experiencing homelessness?

In this Novice Nurse Series, UbiSim is shedding light on the ways nurse educators can teach new nurses how to work with specific populations. 

The growing necessity of nurse-led care for patients experiencing homelessness

With the ongoing impacts of  the pandemic, job loss, and what feels like endless rising costs of living, homelessness is increasingly rising. According to a 2024 State of Homelessness report, a record-high 653,104 people experienced homelessness on a single night in January 2023. This is more than a 12 percent increase over the previous year.

Patients experiencing homelessness often face barriers to healthcare access, including lack of transportation, limited resources, and stigma. Nurse-led initiatives play a pivotal role in bridging these gaps, with nurses often acting as the primary healthcare providers for unhoused patients.

Preparing novice nurses to work with this vulnerable population involves equipping them with specialized skills and an understanding of this population’s unique healthcare needs.

Ways to prepare novice nurses to care for unhoused patients

Encourage a holistic approach to care

Just as physical health itself is crucial, social determinants of health are just as important—employment, transportation, access to mental health treatment, etc. When a patient experiencing homelessness comes in with something as straightforward as a fever, encourage new nurses to take a holistic view. This might mean creating space for the patient to ask questions, understanding what other challenges they’re facing, and connecting them with resources or people who can provide the support they need.

Jillian J. Weber, PhD, RN, CNL, Homeless Patient Aligned Care Team (HPACT) National Program Manager, Homeless Programs Office, Veterans Health Administration (VHA), shared, “The nurse-managed health clinics that are utilizing holistic approaches to care were shown to improve patient satisfaction, reduce health-related costs, and increase access to care."

Help them build trust 

Share with nursing students or new nurses that trust takes time, patience, and a safe, non-judgmental approach. Encourage them to imagine a situation where they felt safe with a provider. Was that nurse or doctor listening, validating, and refraining from judgment? Putting themselves in the shoes of the patient can help them think about how they can build that sense of safety and trust. 

Researchers of a review found that this kind of trust is a key component of working with patients experiencing homelessness, particularly for patients who may have experienced stigmatization or trauma in healthcare settings. Nurse educators can encourage students to prioritize creating a safe, judgment-free environment where patients feel heard and validated.

Teach them to provide trauma-informed care

Encouragenurses to consider what has happened to the patient up to this point rather than focusing on what’s 'wrong with them’. Curiosity can lead to greater empathy and, in turn, trauma-informed care. Some aspects of trauma-informed care, according to Nurse Journal, are empowerment (acknowledging the patient’s strength and resilience) and cultural humility (addressing one’s own biases and judgments). 

Although it’s likely wholly unintentional, providers can inadvertently trigger past traumas for  patients experiencing homelessness. To help prevent this, Nurse Journal goes on to suggest that nurses assume every patient has experienced trauma, respect boundaries and privacy, and empower patients to take an active role in their care, ensuring they feel informed and in control.

Offer virtual reality as a tool for empathy and therapeutic communication

Many new nurses are thrown into their first experience with a patient experiencing homelessness with little to no preparation. They may not have had exposure to unhoused patients in clinicals, and their studies may not have prepared them for this specific instance. Virtual reality is an innovative tool to help nursing students and new nurses develop essential clinical skills and also practice therapeutic communication and empathy in a safe, immersive environment

By simulating encounters with this vulnerable population, students can gain the confidence and competence needed. UbiSim, an education and training platform for nurses, has a scenario where the patient, Pauline “Polly” Knight, comes to the ER with symptoms like shortness of breath, a cough, and a fever. Polly had been evicted from her apartment and was sleeping on a park bench. Nursing students and new nurses engaging in this scenario not only treat her physical symptoms but also practice empathetically communicating with Polly. Students have shared that this exposure increases confidence when they get into real clinical settings.

Be an example advocate for patients

One of the most powerful lessons nurse educators can impart is the importance of advocacy. Of course, nurses have a lot on their plates, but if they can, they should be encouraged to actively advocate for the needs and rights of patients experiencing homelessness. This might include connecting patients to community resources, supporting housing referrals, or collaborating with social workers and other community resources to create a support network.

Encourage students to stay informed about local resources and policies related to homelessness, such as shelter availability and access to mental health and social services. Guide them on how to navigate these resources effectively to support their patients. Advocacy builds confidence in nurses and empowers them to make a lasting impact on the lives of their patients.

Final thoughts

In addition to all these tips, take a moment to reflect on your own early experiences working with patients facing homelessness. What were the insights or approaches that helped you most—or, perhaps, the ones you wish you’d known sooner? Now, imagine the impact if today’s novice nurses could start their careers equipped with these same guiding principles.

You’re not only preparing them to provide compassionate, effective care but also empowering them to become advocates and allies for some of our most vulnerable populations. Through thoughtful education, you can shape a generation of nurses who lead with empathy, resilience, and a dedication to holistic patient-centered care.