Street Outreach Services Celebrates the Return of a Dedicated Nurse

From left to right: SFCCC Director of Community Services, Beth Rittenhouse-Dhesi, SFCCC SOS Outreach Worker, Francisco Barrera, Jesse Merril, Jim Schwartz, SFCCC SOS Program Manager, Lara Cruz

In 1998, Jesse Merril was studying nursing when she was assigned a student rotation to provide street medicine to the unhoused with San Francisco Community Clinic’s Consortium’s Street Outreach Services (SOS) mobile medical program. “There are some things in life that totally change the course of it and that did”, she shared on a recent January afternoon, fresh off her first day back on the SOS van in 27 years. Jesse is a wish recipient of Wish of a Lifetime, a charitable affiliate of AARP that grants life-changing wishes to older adults and inspires people to redefine aging in America. Her wish? To spend a day back on the job that helped shape her.

Twenty-seven years earlier, while doing outreach with SOS, Jesse had become close to a family living in a converted bus in Bayview, their rapport becoming so strong that she went on to foster their eldest son, “it was very life changing seeing what was going on and being involved with the family…in a lot of ways, it completely altered my life”. In fact, it’s this experience that Jesse cites as inspiring her to become a parent herself, adopting her daughter from California’s foster system. Though in the intervening years, she’d retired from nursing and moved away from San Francisco, Jesse had long felt a pull to return to SOS.

When Jesse learned about Wish of a Lifetime from staff at her local community center, her dream of returning to visit SOS suddenly seemed possible. Just a few months later, the Wish of a Lifetime team arranged for Jesse and her longtime friend and fellow nurse, Jim Schwartz, to fly to San Francisco and spend a day doing outreach with SOS staff, following Jesse’s old route in the Bayview district.

The two joined SFCCC Director, Community Services, Beth Rittenhouse-Dhesi, SOS Program Manager, Lara Cruz, SOS Outreach Worker, Francisco Barrera, and longtime volunteer clinician, Dr. Dan Wlodarczyk on a rainy day in January. Jesse and Jim handed out health and hygiene supplies like socks, water bottles and wound care materials, knocked on the doors of RVs and tent encampments, and helped to make referrals to needed social services. Their nursing backgrounds allowed them to provide an added layer of health education, instructing clients on how to dress wounds and self-treat other minor maladies. Jesse was pleased to see that the unique bond SOS staff share with their clients was unchanged, “They were very receptive to seeing us coming,” Jim observed, “the staff is very intuitive to their clients’ needs”. What had changed was the van itself. “The clients are in the same plight they have been for the last 27 years, but the SOS van and its services are so much better”, Jesse observed. “Back in 1998 it was a cargo van...it probably feels a lot better to the patients to go inside something that is dignified.”

Jesse & Abby Lehrman, a former colleague from her original stint on the SOS van

Jesse and Jim made such an impression on SOS staff that they were invited back for a second shift the next day, an offer they enthusiastically accepted, joining the team at their weekly pop-up clinic at a local soup kitchen. As it turned out, Jesse was in for a serendipitous treat: working in the soup kitchen’s courtyard was Abby Lehrman, a former coworker of Jesse’s from her original stint on the SOS van, and the person responsible for introducing her to the family in Bayview she became close to. 

Jesse is not the only SOS staff member who cites their time on the van as a major influence on their life. Many outreach staff go on to pursue careers directly related to their work on the van, working in street medicine or social work. It’s also not unusual for staff members to return to SOS as they proceed in their education: a former SOS program manager is currently completing her Nurse Practitioner training on the van, others have returned as medical residents to complete their rotations. Even former Director of the Illinois Department of Public Health, Dr. Eric Whitaker, has shared his passion for mobile clinics, rooted in his experience on the SOS van when he was a UCSF resident.

What Jesse said of her experience with SOS, “It’s been such an incredible trip to come back and see it 27 years later…it was so awesome to see all that they are able to accomplish now,” also rings true for the ripple effects SOS has had on training providers to serve in the nation’s heath safety net.