In our clinic we always try to serve the children first because they are not allowed to stay overnight in the church shelter (according county regulations). The shelter staff planned to give this family a motel voucher. The plan would be to allow them to eat dinner at Glenkirk Church and then be transported by shelter staff to La Puente (10 miles away) over to the motel that participated in the ESGVCH motel voucher program. The motel would provide a room for this mother and her children. At least that was the original plan.

So, two of my nurse practitioner students took over and interviewed Carmen and then examined baby Andrew, too. They came to me and reported that the baby had a fever of 105 degrees! They learned that he had received immunizations earlier this day at a county clinic, but Carmen had no Tylenol to give him. I also checked the baby and confirmed his high fever, but he was alert, though quite irritable, but otherwise had a normal physical exam. I watched this young concerned mother, with her straight brown hair pulled back into a bun, there rocking and cradling her sick baby. I saw anxiety on her face, as all mothers feel when their infants are ill. Fortunately, Ramon, her older child, appeared robust and healthy.

We formulated our treatment plan with the open possibility that we might have to send them over to the Emergency Department of nearby Foothill Presbyterian Hospital, if we could not get the baby’s fever to break. We decided to work on the fever and then re-examine Andrew. We knew that we would be at the shelter for the next 4-5 hours to conduct our outreach clinic, and so we would have ample of time to continue to observe and treat this infant during the evening. The only dilemma was that the driver of the shelter van, an ESGVCH employee, who planned to take this family (and several others) to the motel would be off duty within an hour, just following dinner. At that point, I decided I would use my clinic funds to pay for a motel room nearby in Glendora, where this family would be close by so we could monitor the baby here and provide the transport to a close by motel. We planned to observe until our clinic was finished (or alternate plan to drive them to the Emergency Dept. if the baby was not improved). The decision depended on the baby’s response to the fever management. So, I called a local motel and made a reservation for the family, and as I did so, my NP students treated the baby with infant Tylenol and tepid compresses made out of disposable wash cloths which were applied to his head and trunk. After 25 minutes or so, we rechecked the temperature and it was already down to 102. Though still not normal, it was a big relief to all of us to know that his temperature was going down at least.

After this treatment we gave Carmen a half liter of Pedialyte for Andrew’s bottle and she began feeding it to him.

We went on with our clinic, seeing lots of other shelter clients with their various ailments, coughs, colds, skin problems, traumatic injuries, the usual fare. We also continued to monitor Andrew. Eventually after a couple of hours his temperature was down to normal, and he drank the pedialyte well without spitting up or vomiting. After a time he began to smile and be playful. We did not have to send him to the emergency room, after all. We decided on a plan to teach this young mother how to monitor her baby over night, by showing her how to check the baby’s temperature, how to do cooling measures (compresses) and how to administer the Tylenol. We advised her that if the baby’s fever returned, she should call me, and I would come to the motel and to take them to the Emergency Dept. if necessary. So, about 10:30 p.m. when our clinic finished I drove this little family a local motel about a mile and a half from Glenkirk Church. I paid for them to have 2 nights in the motel, just to be sure they would be housed long enough for monitoring of the baby through this episode and to give them all some badly needed rest in a quiet environment. As we were waiting to check into the motel I asked Carmen where her husband was. She confided that he was in jail (she did not say what for and I did not ask), but she said things had been really rough since he was gone. She said she and her children had been staying here and there with friends, but things always seem to “get bad” and she would be forced to leave those situations. Her only family was her grandmother who had raised her, but she had died last year. I helped her get settled in her motel room. Baby Andrew was now looking very happy and content as Carmen tended to him, changing his diaper, giving more pedialyte, and preparing him for sleep. Ramon turned on the TV and wanted to see the Simpson’s (like many kids), as he settled onto the queen sized bed that the three of them would occupy this night. I asked Carmen how long she had been homeless. She said for several weeks. She had been at another shelter in downtown L.A., but didn’t stay as she felt the people there were too rough and the shelter staff were not kind to her. She confided that she had nearly given up hope finding anywhere to stay, and someone told her about the church shelter program of the E. San Gabriel Valley Coalition for the Homeless (ESGVCH). She said she now felt more hopeful and that people had been kind to her at this shelter. She had an appointment to follow up with the shelter’s housing case manager to assist her in finding housing. She also planned to go the next day to the El Monte DPSS Office to get her county support started again, as it was stopped when she did not have a permanent address. The office of the ESGVCH had given her to use the office address so that once again she could start receiving some aid.

I asked her if she wanted prayer before I left. She said “Oh, yes!” She told me her grandmother used to take her to church and that she remembered about God and Jesus and believed that this would be a place she could turn for spiritual help. She also said she resolved to really try hard to depend on herself to get out of this situation. We prayed, asking for strength, perseverance, continued healing for Andrew, help for her husband in prison, and that resources to sustain her family would be forthcoming. Carmen did not call me that night. I stopped by the motel at about 9:00 the next morning and the owner told me she saw her go to the bus stop early in the morning along with her children. My conclusion was that the baby must have been fine overnight. I left Carmen a note to let her know I had been there. I also stopped by in the late afternoon after work, but they had not returned yet. Later I learned from the shelter staff that Carmen walked from the motel over to Glenkirk Church with her children in the early evening to eat, and that the baby continued to look well. I also learned that on the third night (after the 2 motel nights were used up) the shelter staff had to send them to another shelter in Pasadena, one that could keep the families there over night. I did not see Carmen again that season, but continued to pray that things improve