Many of nurse Michael O’Connor’s patients suffer from pains both psychological and physical.
“They’re homeless, many dealing with addiction, estranged from their families,” says O’Connor, a nurse who specializes in HIV with Boston Health Care for the Homeless Program (BHCHP). “They have all sorts of physical problems, mental illness and they’ve been diagnosed with HIV. I have to listen, be present and share their grief. My job is to find the positive, to offer hope and act as an agent of change.”
O’Connor, who lives in Jamaica Plain with his wife Kristen and year-and-a-half- old son Harry, has never been one to choose the road well traveled. He knew working with Boston’s homeless men and women would become his career two decades ago, after taking a job as a counselor at a city shelter handing out food and blankets. The work was very satisfying, but he soon realized that it was the shelter’s nurses who were having the greatest impact on the residents.
“In the nurses’ clinic there was some real therapeutic work being done,” says O’Connor. “They interacted with patients on a much more intimate level. Yes, they treated their immediate problem, an infection or a rash, but they also talked to them about what was going on in their lives.”
That slow building of trust—through conversation and small gestures—is at the heart of BHCHP’s treatment philosophy. The 20-year-old nonprofit organization, which O’Connor joined after going to nursing school at age 30, delivers care to 9,000 homeless men, women and children a year. BHCHP staffers run medical clinics in homeless shelters, hospitals and detoxification centers. They also deliver care on the streets and in countless other places where homeless people gather.
O’Connor’s work with BHCHP can take him to a half-dozen different sites a week, including BHCHP clinics based at Boston Medical Center, a downtown homeless shelter and a residential treatment facility for HIV-positive addicts on one of the Boston Harbor islands. He runs support groups, sees patients, hooks people up with physicians and educates newly diagnosed patients about medication adherence and the basics of their disease.
“There’s a lot of education to be done on HIV for newly diagnosed patients,” says O’Connor. “For example, if a person is told to take all of this medicine and not to miss a dose, it’s important that they are taught why. That requires educating patients about viruses, the immune system, resistance and white and red blood cells. This kind of education doesn’t happen during the doctor’s visit. This is the territory of nursing.”
O’Connor says that, despite the fact that HIV is now often a chronic disease, it remains a death sentence for too many homeless patients. That’s because among the homeless, the disease often goes undiagnosed or untreated longer, leaving patients vulnerable to potentially deadly opportunistic infections, according to O’Connor.
“And treatment requires dedication and religious regularity,” he says. “A lot of times our homeless patients are distracted by addiction, mental illness and different priorities. They’re looking for a place to stay, something to eat. They’re not able to take medicine every day and that’s almost worse than not taking it because of the resistance that develops.”
A passion for music
O’Connor loves his job, but finds it necessary to counterbalance its intensity with his other passion: music. He plays saxophone with the Pressure Cookers, a reggae band with regular gigs at the Milky Way Lounge. He also plays bass with the Cha Cha Cha All Stars, a band with a preponderance of horn players from Jamaica Plain.
O’Connor is especially proud of a compact disc of children’s music he produced a few years ago, “Songs for Sibusiso,” with the help of local and South African musicians. The proceeds go to a South African orphanage whose residents have lost their parents to AIDs.
For O’Connor, music and nursing are complementary pursuits. “There’s a spiritual aspect to both,” he says. “When you visit a place like South Africa, the doctors and nurses are praying all the time and singing too. Here, you can find spirituality in healthcare, but it’s more hidden. I believe that nursing is very holistic, and in the future, it will include spirituality more and more.”
The writer is media coordinator for the Boston Health Care for the Homeless Program.