After years of silence, doctors finally speak up about the difficult working conditions at St. Paul’s Hospital

A view of St. Paul's Hospital

I have frequently heard that St. Paul’s Hospital has a high commitment to patient care from all of the staff despite the challenges of a decrepit and crumbling building. With the urgent need for a comprehensive renewal since 2002, it is curious that very little has been publicly heard from the hospital staff on the subject. Especially given that staff at other hospitals often send open letters to the Premier and stage media events (remember to Tim Horton’s emergency room story at Royal Columbian Hospital:CBC story . For some reason St. Paul’s Hospital staff have been persistently silent on the widely known poor conditions where they work.

Now, thanks to the diligent work of MLA for Vancouver-West End, Spencer Chandra Herbert, who filed a Freedom of Information request to Providence Health Care, the public has a very shocking picture of the inner workings of St. Paul’s Hospital through two letters from physicians at St. Paul’s Hospital to the CEO Dianne Doyle.

In these two letters written by Carole Richford, BSN, MD, FRCPC and Stephen R. Wiseman, MD, FRCP, a barrage of serious issues with the conditions at St. Paul’s Hospital are chronicled from mice, pigeons, cockroaches, broken elevators, high absentee rates, patient care in hallways, risk of infection, risk of cataclysmic failure of building in an earthquake to both vulnerable patients and staff. Quite a litany of concerns were poignantly stated.

Here are some excerpts from the Letters

Dr. Richford

“…I now find myself completely demoralized with my physical work environment.”

“….building was ‘deplorable’ at 70 years old. I believe the mice and pigeons are also geriatric!”

“…sick time were higher than last year”

“…being publicly blamed by VPD for a psychopath stabbing an elderly man.”

“…this hospital has come to the point where NOTHING more can be improved until we have a new building. “

Dr. Wiseman

“You cannot provide good care regarding infection control, for example, with mice and cockroaches running all over patient care areas like I have seen for years now”

“…we cannot come close to properly addressing the scourge delirium in this hospital”

“Placing multiple patients to a room, to be kept up by the acutely ill, or snoring, or agitated by others’ family visits, is not appropriate care for those at risk of becoming delirious”

“I won’t even get started about the patients placed in stretchers in hallways of hospital inpatient units.”

“…if there is the slightest little burp of an earthquake, the building I spend most of my week in will fall to the ground in seconds….

“The West End/downtown of Vancouver is the most densely populated area of Canada…and it is situated on what is essentially a peninsula….Yet, we have had the incredible foresight to construct the only Emergency Department in this entire region on the first floor of the Burrard Building-so when there is an earthquake, it will be completely flattened and all the doctors and ruses working there killed. The brides will be out, and the downtown area of the city will be an utter disaster zone. “

After years of silence the dirt on St. Paul’s hospital is out. Check out the full letters: Doctor’s Letters

In an article in the Vancouver Province, by Elaine O’Connor, entitled, “Condition Critical: aging hospital at high risk in earthquake”, CEO Dianne Doyle of St. Paul’s Hospital is quote as saying, “We are on life support” comparing the hospital to a terminal ill patient in the intensive care unit.

The article goes further on the situation:

Surprisingly, Doyle, a senior executive in health care for 25 years, said her hardest job is not funding a major upgrade, but simply keeping St. Paul’s staff doing their best in a clearly sub-par environment.

“What I don’t want to see is that this progresses to a point where our staff become so distracted by that and so frustrated by needing to work in an environment that is so challenging and doesn’t enable their excellence that they begin to lose hope and begin to lose their focus on excellence … or leave,” she said.

Here is a link the full article well worth a read: Province story

This is the legacy of the BC Liberal government, after being in power for more than a decade, doctors and senior members of the hospital management team are frustrated and increasingly disengaged to order to cope with the inaction on the hospital renewal and piecemeal efforts when actually a comprehensive response is critically required.

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