When Michael O’Shaughnessy started working at St. Paul’s hospital in 1992, the situation for people with HIV-AIDS was very different than it is today. The virus, which would ravage people’s bodies, was swift in causing death, killing about one person in B.C. every day. Those with the illness had to pay for medications. Some local health facilities wouldn’t even accept patients who were HIV-positive, O’Shaughnessy—the founding director of the B.C. Centre for Excellence in HIV/AIDS—alleges.
“Vancouver Hospital didn’t want people with AIDS in their hospital, so they sent them to St. Paul’s,” the recently retired virologist tells the Georgia Straight in a phone interview. “They practised taxicab medicine”¦.St. Paul’s made sure we admitted them”¦and was supportive of getting people with HIV into good care.”
It’s somewhat ironic that St. Paul’s has gone on to be a leader in HIV-AIDS treatment and research, given that it was founded more than 100 years ago by a handful of nuns, members of the Catholic Daughters of Charity, Servants of the Poor (better known as the Sisters of Providence). But as Vancouver celebrates its 125th birthday this year, there’s no denying the vital role the hospital plays in the city, and not just because of its internationally recognized HIV-AIDS centre.
When those sisters were looking for a site for a new hospital in 1894, the land just west of what is now Burrard Street was merely a former forest that had been damaged by the 1886 fire. The women paid $9,000 for seven lots. The 25-bed, four-storey building served the growing port as well as nearby mining and fishing camps. The founders had a vision of being responsive and relevant to the community, in particular the poor and disenfranchised.
That vision hasn’t changed, says David Brown, a former emergency-room nurse who’s now the department’s operations leader.
“It started out for people who couldn’t look after themselves, the poor and marginalized, and in some respects that’s very much the same. Our role is to treat everyone with respect,” Brown says in an interview at the hospital along with Dianne Kierstead, access services’ operations leader.
“That’s really part of our culture, our mission and values, from the very top level right down to the frontline staff,” says Kierstead, who’s also a former ER nurse. “It’s about caring for people regardless of why they’re here.”
Providence Health Care—which operates 15 other health facilities in the region, including Mount Saint Joseph Hospital—is a Catholic health-care community “inspired by the healing ministry of Jesus Christ”, according to the 2007 book St. Paul’s Hospital: A Proud Tradition of Compassionate Care.
Although crucifixes are common fixtures on the hospital’s walls, it’s the organization’s values—and not its religious affiliation—that matters most, Brown explains.
“You don’t have to be religious to work here, but you have to believe in the values, the way you live your life, with honesty and integrity.”
The ER, which sees everything from trauma and mental illness to substance misuse and colds, treats about 67,000 people a year. The department was recently renovated, making the triage process more efficient for patients and staff alike, with real-time electronic patient-tracking screens, electronic patient records, a rapid-assessment zone, and a 24-hour diagnostic-treatment unit among the new systems in place.
There’s also the Angel’s Cradle: an empty bassinet is accessible from outside the emergency-department entrance, allowing a woman to safely and discreetly leave an unwanted baby in good hands. The cradle has been used once, when a two-day-old baby was left there last fall.
Although upgrades to ER were desperately needed, the hospital as a whole is in dire need of such work. Consider last month’s brief power outage, which meant employees had to manually work patients’ respirators until generators kicked in.
“Elevators, electrical, seismic, ventilation, reconfiguration of space: these are all things that need improvement,” says Providence Health Care president and CEO Dianne Doyle in a phone interview. “We need to have larger ORs [operating rooms]—not necessarily more, but bigger—because we’re using bigger pieces of equipment and the rooms are too small.”
Doyle, who began working at St. Paul’s as an intensive-care-unit nurse in 1976, says that one of the goals for future planning is to make services more integrated, since so many conditions are interrelated. “We want it to be more patient-friendly-focused”¦and allow multiple needs to be met in one visit,” says Doyle, who notes that a “concept paper” for a redevelopment plan has been drafted. The next step is for a project board to be created, then approved by the Ministry of Health.
“There are compelling reasons why we’ve got to have the infrastructure,” Doyle says, noting that not only does the hospital serve the local community but it’s also a provincial resource with many specialty services and a teaching hospital.
Some of the initiatives that make St. Paul’s unique include the aforementioned HIV-AIDS centre (which is now headed by Dr. Julio Montaner), plus its heart centre, pain centre, and eating-disorders program, as well as programs for kidney and lung care, among others.
Bruce McManus, director of the James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research and of the Providence Heart + Lung Institute, says the organization has ambitious goals when it comes to research, treatment, and innovation but that it largely achieves them because of the type of people who are drawn to work there in the first place.
“What makes it special is that people care about the end goal, whether they’re working on a molecular project or there in ER: they do their best for patients,” he says. “Atmospherically, we don’t have a great facility, and we struggle to get the kind of physical renewal that we need. But people relentlessly believe in the vision.”