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Creating safe space: lived experience guides dedicated nurse through harm reduction, street work

‘As nurses, I think we’ve always, as a collective, been very open to providing the care people need and deserve, no matter who they are,’ Ally Vegter says

By Laura Eggertson
June 24, 2024
Danielle Nicol
Ally Vegter founded Street Cats Night Reach, a grassroots organization in Calgary that helps people who use drugs and alcohol. “We go and walk around downtown, respond to drug poisonings or give out basic supplies, including food,” she says. “We hang out, develop relationships, provide connections to resources if they need them.”

This article is part of the Canadian Nurse series, Harm Reduction Saves Lives.

Every Wednesday night at 7:30 p.m., Alyssa Vegter assembles her team and carts full of food, socks, wound dressings and other health-care essentials, and a store of naloxone kits and harm reduction supplies.

Then Vegter, along with other nurses, paramedics, and volunteers with lived experience of substance use, heads off to provide what comfort and care she can to people living on the streets of downtown Calgary.

“We go and walk around downtown, respond to drug poisonings or give out basic supplies, including food,” says Vegter, whose friends call her Ally. “We hang out, develop relationships, provide connections to resources if they need them. Sometimes we will let people use phones to call their families or people so they can regain connection.”

These weekly trips are core to Vegter’s work with Street Cats Night Reach. The registered nurse founded the grassroots harm reduction organization to advance health equity, provide community education, and empower people who use drugs and alcohol.

She’s also a charge nurse at Calgary’s only supervised consumption site, and as a crisis responder and health-care provider at the city’s new mobile crisis response unit. Sometimes, the patient populations intersect.

Struggled with wellness

The work in substance use with marginalized and unhoused people comes from a deep place within Vegter. As a teenager and young woman in Claresholm, Alberta, she struggled to maintain mental wellness and used drugs, including psychedelics, cocaine, and crack.

She also narrowly survived a physically abusive relationship that began when she was 15 and lasted until she fled home to her parents, at 21. She credits them with providing her with the safety net she knows other people don’t have.

“They didn’t give up on me, and they didn’t shame me about what I was going through or how I was handling what I was going through,” she says.

Once she moved home, after gradually weaning herself off one substance, and then another,  Vegter went back to school and qualified as a licensed practical nurse. She spent 10 years working on a range of hospital units, from acute care to elective surgery, while going to school part-time to become a registered nurse so she could work to a broader scope of practice.

All the while, she continued to try to educate her colleagues about substance use and find ways to use her own experience and compassion to help those she knew needed a health-care provider who would not shy away from their circumstances.

“I can understand their experience because I’ve found myself in those places,” she says.

Vegter’s history is the reason she supports supervised consumption sites and embraces practices at the mobile crisis team she belongs to that will eventually, she hopes, allow team members to respond to crisis calls without a police accompaniment.

No safe space

When she was a teenager, she felt she had to lie about her substance use, she says. That deception also constrained her from disclosing the domestic violence she was experiencing.

“There was no safe space for me to talk about it,” Vegter says.

Fortunately, the people using substances taught, protected, and helped her, rather than exploiting her, she says. She had early tutorials in harm reduction.

Although her dealer sold her drugs, he refused to let her inject them. And instead of demanding that she pay for the drugs with sex, he had her clean his house and wash his dishes.

“I really wanted to go into street nursing and be able to support the people who kept me alive,” she says. “They taught me what I needed to know to keep myself safe.”

Today, Vegter tries to create that safe space for the patients and clients she works with, no matter where she encounters them or how they are doing. That’s particularly important during crisis response calls.

Earlier this year, she sat outside a health clinic with a young queer person for three hours, talking about “random things” while she built enough trust that they disclosed their suicide plan. After talking through alternatives, she was able to convince them to go to a hospital and seek support voluntarily. Later, she and another team member stayed with their patient.

“What’s unique in that case is we were able to sit in a hospital with them while they were waiting to be seen,” Vegter says. “We created that feeling of safety and warm transition by not just dropping them off at the hospital or bringing them in cuffs, making them feel like a spectacle.”

Relationships key

On a separate occasion, she and her team spent six hours supporting a woman who had been sexually trafficked. They listened to her, supported her, and advocated for her while she reported her situation to police. The woman succeeded in having the police take her seriously, after previous occasions of having her complaint dismissed.

Then, Vegter and her crisis team co-ordinated with a separate organization to find their client safe housing and resources.

For Vegter, the basis of her practice involves building relationships to create trust, even as she meets people where they are in their lives. Sitting and listening to someone talk as they have a cigarette, giving them warm socks or a cup of coffee, is as important as teaching them rescue breathing or dressing an ulcerated sore, she knows.

That’s why she set up Street Cats, which runs on volunteers — including people who are still using substances — donations, and the sales of the art she and her partner, Chris Mascorro, and other supporters make. In addition to their weekly round, Street Cats holds a brunch once a month in different parks, and hands out harm reduction supplies at punk and alternative concerts.

If any of their community members are in jail, they help arrange bail, or connect them to supports.

“I witnessed a lot of community care in an underground world in my youth, and I still see a lot of that now,” Vegter says. “As nurses, I think we’ve always, as a collective, been very open to providing the care people need and deserve, no matter who they are.”

Loss is a major part of Vegter’s work, including the loss of community members who die on the streets from drug poisonings. It’s a constant struggle for her to nourish herself enough to avoid burnout, as well as to support her team.

There is not much time to decompress or enjoy time away from the work.

“It’s been hard navigating as a team through that grief,” she says.

Still, Vegter finds solace in the Instagram posts she creates and art collages, as well as the time  she spends with Mascorro and her two cats, Emma and Lucy. Then she returns to the work.

“I find a lot of my own healing within Street Cats, and the ways in which we develop relationships out there in the night.”

Laura Eggertson is a freelance journalist based in Wolfville, N.S.