June 21, 2024

Cathy Crowe

Cathy Crowe

June 21, 2024

Cathy Crowe is a Canadian Street Nurse, educator, social justice activist, and filmmaker specialising in advocating for people who are homeless in Canada. She is the author of Dying for a Home: Homeless Activists Speak Out (https://www.cathycrowe.ca/dying-for-a-home.html) and is a frequent commentator on issues related to health, homelessness, and affordable housing. Her articles have been published in The Globe and Mail, Toronto Star, and NOW Magazine, as well as on rabble.ca.

​Cathy was an executive producer in the Home Safe documentary-film series and is the subject of the film Street Nurse, directed by Shelley Saywell (https://www.cathycrowe.ca/street-nurse.html#:~:text=This%20documentary%20by%20Emmy%20winning,streets%20and%20yet%20never%20see.). Cathy is a co-founder of numerous advocacy groups, including the Toronto Disaster Relief Committee (https://www.tdrc.net/). She previously received the Economic Justice Award Fellowship from the Atkinson Charitable Foundation (https://atkinsonfoundation.ca/) and the International Human Rights Award in Nursing from the International Centre for Nursing Ethics in Amsterdam. 

​Besides her diploma in nursing from the Toronto General Hospital School of Nursing in 1972, her Bachelor of Applied Arts in Nursing from Ryerson University in 1985, and her Master of Education (Sociology) from the Ontario Institute for Studies in Education in 1992, she has been awarded an honorary doctorate from the University of Victoria, McMaster University, University of Ottawa, York University, and the University of Windsor.

Cathy received the Order of Canada in 2018 (https://globalnews.ca/news/3985472/toronto-street-nurse-cathy-crowe-receives-order-canada/) and most recently was a Distinguished Visiting Practitioner in the Faculty of Arts at Ryerson University.

​Cathy continues to fight for the right to shelter and a fully funded national housing program.

The Journey to both Nurse and Advocate

Cathy Crowe imagined herself a nurse from the age of five, influenced by both her mother who provided a model of strength in nursing, and being a woman within the era where career path options typically meant nursing or teaching. After her start in a cardiac stepdown unit where innovation and groundbreaking clinical experiments were the norm, Cathy moved to working in a physician-led office on Bay Street, where the billing practices and exclusive corporate clientele led to a sense of disillusionment about the delivery of equitable care.

She acted on her curiosity about a community health job posting in a newspaper by walking the neighbourhood prior to her successful interview, and this role eventually led to working at four different health centres and a variety of advocacy positions and roles mainly focused on homelessness. Cathy later returned to school (then Ryerson which is now Toronto Metropolitan University https://www.torontomu.ca/) to complete her Bachelor of Applied Arts in Nursing. Cathy then worked as a Nurse Practitioner, first returning to community health centres, public health and then in a newly funded capacity as a Street Nurse for Street Health. 

Cathy describes her subsequent 35 years as focused on street nursing, though she notes that despite having been twice-awarded the Atkinson Economic Justice Fellowship (https://atkinsonfoundation.ca/atkinson-fellows/), she became blacklisted for a period of four years as a response to her unrelenting fight for social and economic issues. 

Seeking Social Determinants of Health

Cathy describes her journey to street nursing as being informed by two main streams of influence. Firstly, she recalls that despite being a Nurse Practitioner in the considerably progressive setting of community health centres, she remained professionally limited by both the lead physicians, and Boards of Directors. Cathy sees this issue as persevering to this day (with some exceptions), impacting the ability of nurses to work at full scope of practice without being considered medical substitutes, therefore bypassing the “full expression of the nursing role”.

Co-founding the advocacy group Nurses For Social Responsibility in the 1980’s additionally influenced Cathy’s journey to street nursing, where the organization took on issues now considered to be part of the social determinants of health, and extending to challenging and forming policies, motions and resolutions leading to such determinations as nurses not participating in torture. 

Seeking Creative Upstream Solutions

Cathy's daily street nursing routine could vary significantly based on the needs of the community, but typically she would visit 1-2 off site clinics independently or with up to three other nurses. Here, individuals could sign up in person for care, including helping clients gain documentation or identification. She recalls her negotiation with clients in need of hospital care who instead were focused on staying in place until they could receive their next meal. Following her documentation, she would often be engaging with community stakeholders or members in various rallies, meetings or social movement activities.

“Street nursing across the country is a huge specialty, unfortunately.”

Cathy shares that because of the uncharted territories of street nursing at the time, she and other frontline nurses became experts on TB, HIV and other diseases as both outcomes and reflections of the health challenges related to homelessness. Cathy recounts her own nursing development and professional role transition was supported by first working in the area in which she completed her final student placement. The Cardiac unit she began with was additionally led by a supportive and strong Head Nurse, and Cathy was one of a cohort of graduates she already had relationships with from their nursing program together. 

Later, Cathy was mentored by a large number of influential advocates and healthcare providers, including physicians from the Medical Reform Group (https://pubmed.ncbi.nlm.nih.gov/2342533/), which Cathy later became the only nurse member of. Her activities as a nurse were enmeshed with community walks, lead pollution advocacy and other upstream and downstream strategies. 

Cathy credits some of her trust-building abilities to a determination to “never, ever” refer anyone to a place she herself had not been to before. Instead, she would initiate relationships with communities and stakeholders, leaving her card and finding out local key resources and needs. She additionally feels that people who are unhoused are generally trusting of street nurses, who are typically in the field because of their desire to be there. She surmises that despite society having failed the unhoused, she doesn’t think that nurses have, and suggests that most homeless people would agree. She shares stories of the incredible holistic efforts of nurses who have literally gone the extra mile for their community. Encouragingly, Cathy shares that despite being a challenging professional field, street nurses these days are notably skilled practitioners, now participating in such programs as palliation, mobile clinics, and infirmaries for the unhoused. 

“You can win, there are wins there for the taking”

Cathy notes that for those seeking a career in a similar field, she sees the ongoing fight for increased housing and social supports as winnable and worth striving for. She discovered the necessity of allies in often unexpected places, like other professions, areas and activist groups. Her strategy remains that there is “always a step forward”, and that skills of documentation, speaking and being interviewed, writing and organizing panel discussions have enhanced her ability to move issues forward. She recommends that others learn how to tell their stories and what they are seeing as nurses. In addition to this, Cathy suggests that to become known in your community of work and hold a position of trust, nurses should spend time engaged in community activities outside of their clinical nursing work. She shares that, particularly within the homeless community, your presence at rallies or events benefiting community members will be noted and quickly shared amongst those you serve. For example, her presence at the waterfront Tent City didn’t focus on clinical nursing work but as she was organizing sanitation and safe water supply and connecting within the community, she kept her ‘knapsack full of dreams’ supplied with food and basic medical items. 

Seeking a student placement in a community health or street nursing setting can be easier in some programs than others. Cathy’s advice to nurses interested in healthcare of persons who are homeless is to shadow nurses in the position you are interested in, sample the roles surrounding your interests, engage in the community's activities such as attending Board of Health meetings or walking tours.

Additionally, Cathy considers provincial associations and unions a place of resource and support for nurses engaged in large-scale issues, the foremost of which she still considers to be the need for a national housing program. Quoting a longtime friend, “housing is healthcare” and this concept has only been strengthened through the growing needs of support for the middle class, response to cost of living increases and the backsliding of supports that were not renewed post-pandemic. 

I Hope You Land Well

In parting, Cathy reflects on her best wishes for newly graduated nurses entering the field:

I hope you land well, find a….good place to be”.

Our deepest gratitude to Cathy for her dedication to serving others, and for her strength of conviction to continuously seek betterment of social needs for the most vulnerable.

You can read more about Cathy Crowe and her experiences by ordering her book, “A Knapsack Full of Dreams: Memoirs of a Street Nurse” (https://www.cathycrowe.ca/a-knapsack-full-of-dreams.html

Nursing The Future™ acknowledges that nurses across this country live, work and play on the lands of our Indigenous Ancestors and we join our members in expressing respectful gratitude for this privilege.
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