I won't argue with educating guests about Narcan. The question remains as to why there is no attempt by the Pine Street Inn women's shelter to bring recovery into the shelter and to make it a part of everyday life there.
Several months ago, over a third of the 120 Emergency guests at the women's shelter signed a petition asking that there be 12-Step meetings at the shelter every day. The petition was ignored.
_________________________________________________________________________________
June 20, 2019
Community Meeting
Pine Street Inn Women’s Shelter
8:30 a.m.
In Attendance:
Director
Supervisor 7-3 shift
Guest services worker
Associate Director
Housing Specialist
Director: Good
morning, everyone. Those of you who
don’t know me, my name is (gives name), I’m the director of the Women’s
Inn….(Asks some guests to be quiet). So,
this is our monthly community meeting.
We have a couple of basic ground rules around the meeting. The purpose of the meeting is for me to share
information with you all that I think you might find helpful or
interesting. We also sometimes have
visitors; today our visitor will be here at 9:30 a.m. so that we don’t feel
rushed. (Gives rules, talking one at a
time, we don’t have to agree.) At 9:30
a.m., someone from the Victory Programs will be here. It’s about harm reduction. Narcan, what is it, how to administer it,
people who want to have Narcan on them for if their friends overdose, the
Victory Programs will be giving it out.
Guest 1 asks about being able to use back garden to
smoke. Is told she can.
DIRECTOR: (Discusses
mindfulness group, says it will be a closed group after a certain day in July).
Has anyone been participating who wants to talk about it?
Guest 2: It’s
really good. You feel really relaxed and
centered.
DIRECTOR: Thank
you. Anyone else who has participated
(who wants to talk about it?)
DIRECTOR: The
Resource Center, we have a self-help resource center back here in the far
corner. Does (name of Housing Resource
Specialist) want to talk about it?
HOUSING RESOURCE SPECIALIST: There’s a new development, they’re having a
lottery. (hard to hear from other side of room)
DIRECTOR: Did people hear? (Answer no).
Two housing opportunities, Hyde Park and Attleboro.
(DIRECTOR: I’ve
been finding pink pieces of paper all over the building. I throw them out.)
Guest 3: Can we
use a printer to print things that we find on the Internet?
HOUSING RESOURCE SPECIALIST: Yes, a printer and a fax machine.
Guest 3: What
about color?
HOUSING RESOURCE SPECIALIST: No.
DIRECTOR: It’s for
housing and employment.
DIRECTOR: Other
questions?
Guest 4: More
hours and a phone?
DIRECTOR: Yes, we
need a phone in there. In July, we’ll
have it open more hours. It won’t always
be (Housing Resource Specialist) who’s there.
Has it been open on the weekends?
(Someone answers:
it was for a while.)
DIRECTOR: When we
have the staffing.
DIRECTOR: There’s
going to be a group called Transgender Access.
It’s 2 people who are going to come out and do voluntary trainings on
gender identity, what does that mean, what does transgender mean, so you can
ask questions, questions you were embarrassed to ask. I went to one, it was really good. If you’re not sure what it is or you’re
struggling with those issues yourself, it’s a good place to go.
DIRECTOR: There’s
been a library representative coming here.
Her name is (gives name). They
have a bunch of technology-based classes, and she will also be here at that
table on Wednesday. I know that a lot of
people have renewed their library cards.
They also have WiFi boxes that you can take out for 3 weeks.
DIRECTOR: You know
we’ve been talking for months about the line outside coming into the
shelter. In May we started having people
come in earlier. You all like that, so
we’ll keep it. It has made the line shorter. We are still as an agency concerned about the
safety. People walking in the
street. We’re going to start a pilot in
July. If people are here before 1, we’ll
have people wait in the garden. We’re
not encouraging you to sit in the garden all day, we want you out there doing
what you need to do for your lives. If
people are waiting on Paul Sullivan, we’ll ask them to come into the
garden. We have that space available,
and we’ll ask them to come in.
Guest 3: I didn’t
hear that.
DIRECTOR: We’re going
to have people waiting in the garden instead of Paul Sullivan. People are sitting on milk crates out there,
it’s not good.
Guest 4: (Asks
about smoking)
DIRECTOR: The
general rule is to be 25 feet from the door for smoking. You can smoke in the garden. If people want to smoke on Paul Sullivan, you
can. We will also have staff monitoring
in the garden, and we’ll (have people smoke at one end).
Guest 5 asks a question.
DIRECTOR: (answers)
DIRECTOR: Also, if
someone needs to use the bathroom before 1:00, come to the door and buzz the
buzzer.
DIRECTOR: I hope
it works. It’s an experiment. If it’s a disaster, then it’s a
disaster.
Guest 6: (Asks a
question)
DIRECTOR: People
aren’t going to come into the building through the front door. There’s a gate; people will be able to come
and go. We’ll ask that people don’t
abandon their bags out there. The garden
will be for people waiting.
DIRECTOR: I hope
it will make things more comfortable.
DIRECTOR: That’s
all I had on my agenda. So now it’s time
for open forum. People can talk about
their suggestions, comments. Last month
it seemed to work well to start on one side of the room and work our way across
it. You are also free to pass if you
don’t want to say anything. (Speaks in
Spanish to a Spanish-speaking guest.)
Then translates: Guest says she
doesn’t have any questions, that she’s happy and comfortable and getting the
help that she needs.
Guest 7: The lady
who changes trash in the back lobby doesn’t change her gloves. When she’s finished touching the dirty
barrels, she doesn’t bother changing her gloves before she starts serving
food.
DIRECTOR: It’s a
food services staffperson? Maybe if you
guys know who it is, you can tell me after?
DIRECTOR: (Asks a
guest if she wants to ask questions.)
Guest 2: This
morning, a lot of people didn’t get their wake-up on the 3rd
floor. I needed to get up at 4:00
a.m. Thank you for the saved bed for
everyone, but it was discombobulated.
(There was a staff appreciation day yesterday, so guests
had a saved bed for June 18th and 19th.)
DIRECTOR: Yeah, we
don’t like to have to make changes like that because (it’s confusing). Things are back to normal now.
Guest 8: (speaks
softly)
Guest 10: I was
brought here by the Outreach van a few nights ago; what time do I need to be
here to get a bed?
DIRECTOR: 3:15
p.m.
Guest 9: Thank
you.
Guest 10: Things
are being made difficult for people with disabilities. Another thing is the vegetarian options that
were talked about a few months ago were helpful, but they’ve started to
disappear. There’s been salad with ham
in it, sometimes the ham is underneath so you can see it. There are people who are vegetarian who
aren’t eating.
DIRECTOR: You’re
saying that there were some vegetarian options and they’re going down.
Guest 10: The
vegetarian options are random and haphazard.
DIRECTOR: Ok.
Guest 11: Can
there be a locked storage?
DIRECTOR: We have
very limited options here. We only have 80
lockers in the lobby. We’ll be adding
(50?) lockers (when?)
Guest 11: Is there
a form for accommodations based on disabilities?
DIRECTOR: We don’t
have a form, but you can talk to me or (name of Associate Director) and we’ll
(see what we can do).
Guest 12: The
resource center bulletin board is too high.
I’m not that tall, and I can’t reach the notices at the top.
HOUSING RESOURCE SPECIALIST: I’ll stop putting it up there.
DIRECTOR: We’ll
talk about where else to put it.
Guest 13: I
noticed that there’s a trash can near the sleeping area of bed 26 on the second
floor. Right were the bed is. Near the area of where we’re sleeping. I have pushed it aside so that I could sleep
through the night, but I noticed when I got the bed again that it was there
again.
DIRECTOR: Ok. (I’ll do something about it.)
DIRECTOR: Questions
back here?
Me: When are there
going to be new lockers?
DIRECTOR: Next
year.
Me: There used to
be garbage cans under the water fountains.
Some people use them to cover the lights on the hallway. I like those lights, because I can read by
them and I’m a night person, but not everybody feels that way. I don’t know; maybe there’s a way to cover
the lights for people who don’t like them.
The trash cans seem to disappear and reappear.
DIRECTOR: There
are trash cans by the elevator and in the restrooms. I’m not sure what the solution is.
Guest 14: There
are people who have too many bags.
DIRECTOR: We have
a plan for each and every one of those people.
Guest 15:
(Discusses that she doesn’t like people not cleaning up after themselves
in the bathrooms and showers.) I like
staffpeople who don’t talk a lot in the morning. Maybe guests who need to get up can set their
own alarms on their phones in the morning.
There are some staff who can be bothersome when they’re telling you over
and over to get moving and you’re trying to get through what you have to
do.
Guest 16: I have
never seen such a disgusting bathroom, people leaving diapers in the restroom-
Me: I have seen
disgusting bathrooms before. I have
cleaned many public restrooms, and this is how it is when you have a lot of
people using a restroom, and in this situation, people are actually living
here. Some of the bathrooms don’t have
little trash cans, some of the trash cans are tilted. The bathrooms need to be renovated. An adult diaper won’t fit in one of those
little trash cans. Also, nobody who has
to wear a diaper is going to want to walk out of the stall with it and put it
in one of the larger trash cans under the sink, because people won’t like that,
either. Maybe the stalls should have trash
cans that are for the diapers.
Guest 17: (Talks
about not liking it when guests are angry.)
Guest 18: (Talks
about overnight staff sleeping.)
DIRECTOR: You’re
right, staff aren’t supposed to be sleeping.
If you see it, you should let the supervisor on duty know.
Guest 18: Every
night, overnight staff are sleeping.
DIRECTOR: You have
to tell the overnight supervisor. If
enough people are telling her, she can do something about it. If nobody tells her, there’s nothing she can
do.
Guest 18: If you
try to tell an overnight staffperson something, she doesn’t know what’s going
on. That’s no good.
DIRECTOR: Please
report it.
(Guest asks about the compliment box).
DIRECTOR: It means
a lot when guests write positive things about staff.
Guest 19: Is there
a way that we can thank the kitchen staff for changing the meals?
DIRECTOR: (answers)
Guest 20: I have a
suggestion for the comment box.
DIRECTOR: That box
is for the resource center?
HOUSING RESOURCE SPECIALIST: Yes.
Someone suggested that I get it, nobody has written anything.
Guest 10: (Make
the bulletin boards accessible.)
HOUSING RESOURCE SPECIALIST: Whatever is on the other bulletin board, I’ll
make a copy; we’ll have two boards.
Guest 10: Also,
from what (she) was saying, I don’t think it’s just about diapers. It’s also about hygiene, people who aren’t
flushing, feces around, using sinks as spittoons. It’s about self-respect.
Guest 11: Some
guests here don’t sleep at night. They
want to sit down and have conversations with staff; when staff see them, staff
will close their eyes. Staff have to
tell them to lower their voices. The
workers are not necessarily sleeping; there are guests who want to have
full-length conversations for too long.
Guest 12: It’s
rude for people to cut the line at Paul Sullivan; I had that situation. It was a short line. I had walked to the gas station and asked
someone to watch my things. When I got
back, the line had moved. Two people had
cut the line and they were very rude, cutting me down, cutting my animal
down. This shouldn’t be going on. Also, yesterday, someone was able to put two
bags in the back room and also upstairs in the locker.
DIRECTOR: You
don’t know what the situation was. There
are many more of you than there are of us.
If there’s one of us, and 20 guests, we need guests to help us by
following the rules.
Guest 12: (says
more about the bags)
DIRECTOR: That’s
something we want to hear about.
DIRECTOR: Everyone
should be going to the resource center to find a way to get out of here.
Guest 12: One more
thing, I’m sorry. I ran into another
problem the other night when I had to put my bags on the elevator and run
upstairs. Staff asking guests to help
push the bins. I happened to come up
when the elevator opened, and a guest pushed the bins right into my
things. Then she said “Staff asked me to
help push the bin.”
DIRECTOR: Typically,
we try not to have guests do things that staff are supposed to be doing. We also shouldn’t have guests put their bags
on the elevator without being on the elevator with them.
Guest 21: Is there
going to be a quiet space on the 2nd floor for people to be able to
do what they need to do without other people yelling and screaming around
them? Can there be a time when people
have quiet time to do paperwork and other things that they need to do? Also, I don’t understand, why there is this
concept of there are this many people in one place, and you only have cleaning
twice a day.
DIRECTOR: Unfortunately,
we don’t have a place which we can designate a quiet space, even though a lot
of people will appreciate it. We’re
going to set these two tables aside just for housing resource work when people
come in at 1:00 p.m. If you need more
space to do paperwork, I would suggest coming in at 1:00 p.m.
Guest 21: What
about people coming in at 12:00 p.m., so that there isn’t the combative noise
around? Whenever something is going on,
your excuse is “What are you doing about your housing,” as if we’re idiots and
can’t do 2 things at once.
DIRECTOR: Ok. What was your next question?
Guest 21: The same
issue is constantly brought up. You
don’t have enough janitorial staff for the amount of traffic that is going on
here. It’s apparent that there isn’t
enough. It should at least be once a
day. You wouldn’t do this at a school or
a stadium. The amount of people who are
in here warrants more cleaning.
DIRECTOR: Ok. Anything else?
DIRECTOR: Thank
you everyone, for your comments and suggestions. They are always very helpful.
DIRECTOR: (Introduces
Victory Programs visitor from Victory Programs.) He’ll be doing a Narcan
training.
VISITOR: Good
morning everyone.
VISITOR: I’m from the
Victory Programs Mobile Prevention team.
I’m going to say a little about what Narcan is and I also have about 15
of them if people want to take them. I’m
going to keep in relatively brief, maybe 15 or 20 minutes, and then I’ll answer
questions.
(At this point there were too many questions to keep
track of the guests who asked them.
Various people are identified from here to the end of the minutes as “Guest.”)
Guest asks a question; Visitor answers.
VISITOR: Narcan is
only going to work on opioids. It
doesn’t work on anything else, but it is also harmless to use if you’re not on
anything. What are opioids?
Guest: Downer
drugs.
VISITOR: The drugs
are sitting on the receptor sites of your brain which keep you awake and
alive. When you overdose, the drugs sit
on too many of those receptor sites and you can die.
(A guest): It
stops your breathing.
VISITOR: Yes, and your heart. Opioid overdoses are becoming more
common. Does anyone know what Fentanyl
is? About 5 years ago, Fentanyl
completely replaced what we were seeing on the streets in terms of heroin. It’s much more dangerous than heroin. It was designed for people going through
end-of-life pain like cancer. Now it’s
being intercepted or created on its own.
It’s very dangerous stuff; within seconds after injecting or snorting
it, it can result in an overdose. It’s a
very quick response because of how powerful it is.
Guest: Can you put
it into a cigarette?
VISITOR: It’s not
possible to burn it in that form. It’s
being mixed into a lot of other drugs, such as cocaine and crack. People who think they’re not at risk for
overdose actually are because even a small amount in those drugs can cause an
overdose.
Guest: Can they
put it in marijuana?
VISITOR: No.
Guest asks question.
VISITOR: Even a
tiny bit of cross contamination between the drugs can cause an overdose. Drug dealers know how addictive it is, so
they’re putting it in drugs to keep customers coming back, but it’s killing
people.
Guest: Can you put
it in K2?
Guest: No.
Guest: Can you use
Narcan for K2?
VISITOR: No,
Narcan only works for opioids.
Guest: Which drugs
are those?
VISITOR: Heroin
and fentanyl mostly. Oxycodone,
oxycontin.
VISITOR: I bring
those up because sometimes people think it’s safer to take pills, but it’s
happening more and more now that dealers are pressing their own pills and
putting fentanyl in them.
Guest: You can buy
everything that you need to make a pill.
VISITOR: If
someone else is making the pill, then it’s not pure.
Guest: So Narcan
only works on reviving people who have heroin in their system?
VISITOR: Yes,
people who have heroin, fentanyl or some other opioid.
VISITOR: Most
frequently people use Narcan to revive someone from a fentanyl overdose.
VISITOR: What are
the signs that someone is overdosing?
Guest: Nodding.
VISITOR: It may be.
Guest: Not
always. Sometimes you hear a gurgle
sound.
VISITOR: That’s
called a death rattle.
Guest: Then they
start turning blue.
VISITOR: You just
hit all the signs.
VISITOR: Nodding
may mean that they’re just very high.
The death rattle is your lungs trying to suck in oxygen; the person is
gasping for air. The next thing that you
look for is the coloring of the nailbeds and lips. If someone has a lighter complexion, their
skin will start to turn blue. A darker
complexioned person will be ashen.
Guest: Can someone
put (an opioid) in an alcohol drink?
VISITOR: No, that
doesn’t usually happen.
Guest: They won’t
waste a drug like that.
(Some laughter)
VISITOR: So if
someone is passed out, lying on the floor, what do you do?
Guest: Sternum
rub.
VISITOR: Sometimes
I start by tapping on their shoulder and yelling. Sometimes people come right back to life. If you Narcan them, you’ll ruin their high
and they don’t want that. If they don’t
respond when you yell and tap them, that’s when you start the sternum rub. You’re going for a pain response. Someone who is overdosing isn’t feeling the
pain response. If you can’t access their
chest, where do you think you’ll go?
Press hard above their lip. You
can’t do serious harm with those places, which is why we recommend them. What if there’s no response?
Guest: 911.
VISITOR: That’s
right. Fentanyl is really strong now,
and you may not have enough doses to bring someone back. We’re hearing that it can take 4 or 5 doses
to bring someone back.
Guest: (Talks
about Good Samaritan law; you can’t be searched if you call 911)
VISITOR: If you’re
nervous about calling 911, you can walk away after you hear the siren; then
you’re a bystander. You don’t have to
answer questions to the EMT or the police, you can just walk away. If there is a situation, if you have a
warrant, they’ve gotten good about following rules not to ask you. Obviously, it’s not a perfect world. As a responder, you are protected by the Good
Samaritan laws.
VISITOR: (Goes
through how to use Narcan and basics of CPR).
VISITOR: You also
need to call 911, because no matter what, the person is going to need medical
care.
Guest describes a situation in which ice cold water was
wrung over someone’s face and it woke the person up.
VISITOR: The
problem is that old tricks of the trade for heroin overdoses don’t work for fentanyl
overdoses. There has to be a chemical
interaction to stop a fentanyl overdose.
VISITOR: I’m going
to set up at a table to give out Narcan and answer individual questions.
Copyright Homeless Humans, June 20, 2019
