Courtney R. Petruik

Courtney R. Petruik (she/her)
Ph.D. Candidate
Department of Sociology
University of Calgary

Current Research Project:

Examining end-of-life care for persons experiencing homelessness using an institutional ethnographic approach

Courtney’s current project focuses on the social organization of the work of a local grassroots initiative that provides palliative and end of life care for persons experiencing homelessness and/or vulnerable housing situations in Calgary, Alberta, Canada. This team, the Calgary Allied Mobile Palliative Program (CAMPP) was built to address a major gap in our current mainstream palliative health system. The team addresses social factors that exacerbate the challenges associated with living with life-limiting illnesses. In 2019, she followed the CAMPP team for approximately 100 hours to learn about their work and how their work fits into the larger social organization of the health care system delivery. It is Courtney’s hope that her research will help to inform future policy and practice around the delivery of end-of-life care for persons experiencing homelessness and the importance of employing a social lens to this delivery using CAMPP as an example.

The research looks to answer the following inter-related research questions:

What daily work does CAMPP have to do to care for people with life-limiting illness and experiencing homelessness? How do people in the community come to be known as clients of CAMPP?  What systems are in place to allow clients to become visible to CAMPP? How does care provided by CAMPP hook into other agencies, services, and organizations while delivering their services?  What accountability frameworks are in place that CAMPP must report to?

Courtney hopes to see her project serve to inform those who make decisions about how our health system is set up for people on the margins to fail. She hopes to push the cursor further toward healthy equity in our mainstream health system.

What are your most surprising findings?

I have been fascinated to learn that the CAMPP team, while incredibly clinically savvy, does much in the way of social-type work which lends itself to improving clinical outcomes. What I mean by that is, because of the team’s clinical training (health navigator, nurse coordinator, and palliative care physician), they are able to liaise with other health professionals well while using their knowledge of the health system and medical conditions. However, their social and clinical approach to caring directly for clients helps them bridge the gap between their clients and the health system. One issue that comes up for clients is inconsistently attending medical appointments or inconsistently taking their medications properly. CAMPP is able to help reconcile these challenges because they acknowledge what the client’s contextual situations are that may lead them to miss appointments or mis-take medications, helping to solve the medical issue at hand and trying to improve the context that puts them in that situation. The most challenging aspect of the work has been gaining a better understanding of the structural and systemic barriers in place working against our society’s most vulnerable, people experiencing homelessness who are nearing the end of life.

How did you get involved in this research?

I came to know about CAMPP through a colleague in my department who knew I was interested in grief, end of life care, and marginalization. In learning more about the work that the CAMPP team does on a day to day basis and the barriers they experience working with limited resources, I knew I wanted to be involved. A few months prior to learning about the program, in February 2017, our family lost my mother and grandmother who both died in the acute care setting in the hospital. Neither family member had access to palliative care because of the swift state of their illness which in my opinion contributed to undue suffering at the ends of their lives as well as for our family who knew little about how to care for dying persons. Additionally, my mother experienced many of the same things that the CAMPP team’s clients experience which made CAMPP’s work all that more intriguing to me. The system is not set up to serve people who experience these challenges especially at the end of life and I want to help contribute to change that improves care for all people especially those who may not fit mold of being the “mainstream ideal-type” patient.

Innovative Research Methods:

Using an institutional ethnographic lens, I used observations, interview, and document review methods to gain an understanding of the social organization of CAMPP’s work. I take up Dorothy Smith’s Institutional Ethnographic Mode of Inquiry which places the research squarely within the project without trying to “neutralize” the observer. I really appreciate this part of the IE approach because it acknowledges that being interested, passionate, and attached to one’s work does not preclude them from carrying out solid and scientific research.

Courtney’s advice to other graduate students:

If you are pursuing a topic, make sure it is something you care about. There will always be bad days, but if you are doing something that lights a fire inside of you, those days will pass.

Publications:

Johnston, K. (21 January 2021). Student learns How end-of-life Compassion helps those living on Calgary streets. Retrieved from https://cumming.ucalgary.ca/news/student-learns-how-end-life-compassion-helps-those-living-calgary-streets

Petruik, C. R. (2018). Social work practices in palliative and end-of-life care for persons experiencing homelessness: a scoping review. Journal of Contemporary Social Services, 99, 4, 317-328.

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