Welcome to Harbouring Hope, a podcast brought to you by the Nanaimo District Hospital Foundation.
I'm Barney Ellis Perry, CEO of the Foundation and your host for this series.
We're on an exciting journey with our dedicated donors who you will hear from throughout this series as they share why it is in our nature to give and their collective vision for
improving health across Central and North Vancouver Island.
In each episode, we'll take you behind the scenes at the Nanaimo Regional General Hospital, Oceanside Health Centre and other facilities supported by our Foundation.
to explore the many departments, innovations, and dedicated professionals who keep our healthcare system running.
from doctors and nurses to administrative leaders and patients with lived experience.
We'll hear powerful stories that reveal both the challenges and the triumphs within our hospital walls.
Most importantly, we'll shine a light on the critical role our community plays because behind every success story is a network of generous supporters helping to make it all
possible.
To kick off our series, in this episode called If These Walls Could Talk, we're taking you behind the scenes at Nanaimo Regional General Hospital to share our story and shine a
light on the staff who make it
all happen.
We'll explore their day-to-day work, their passion and their unwavering commitment to excellence in healthcare.
At the heart of it is compassionate care that embodies a spirit of harbouring hope in your community.
Hospitals can sometimes feel like massive, complicated machines, but at the heart of it all are people, nurses, doctors, techs, cleaners, maintenance workers, administrators and
more.
It takes an entire community to keep a place like this operating day in and day out.
From the fast-paced emergency room to the quiet behind-the-scenes work of those who keep the lights on and the halls clean.
We're here to understand how this hospital functions, not just on paper, but in practice.
What does a day in the life really look like for the people who show up here every day?
What keeps them going and what challenges do they face?
To kick things off, I'm joined by Damian Lang, the site lead for NRGH.
He's responsible for overseeing operations across the entire facility and he has a unique perspective on what it takes to keep this place running smoothly.
I think we're going to cover a lot of ground today.
How does that feel, Damian?
Looking forward to it.
I think we're going to hear some of the passion that our physicians, clinicians, team members bring to their work every day and what we know about Nanaimo.
hospital is that it's a bit of a puzzle piece.
New, old to your point, everything in between and no matter where patients land, including here as we stand on our ambulatory wing, we strive to provide the best care possible.
And so let's get out there and see what we can find.
I love it.
Do think they're going to talk to us?
100%.
Okay, let's do this.
Friday's a little bit of a quieter day in the hospital, but that's all relative when we're talking about NRGH.
Damian, tell me what a quiet Friday looks like.
A quiet Friday?
We have lunch together.
Friday, some services are a little bit quieter, but this is our biggest discharge day.
Biggest discharge day of the week, so we'll see about 60 to 70 patients leave NRGH.
Lots of surgery still happening and prepping for the weekend.
And what's our bed count today?
410.
410 and we're funded for 350 beds.
354.
354, I'm corrected.
So it's a busy day.
It's a busy day, okay.
We're going to wander down to the emergency department.
ah Yesterday I was having lunch.
On our way to the emergency department, we see an example of what it's like to be over capacity.
And as we walk through, we're walking past the nursing station, we're walking past a screen and behind that screen is a patient.
And this is a main hallway.
We're literally walking out to the main hall of the hospital.
And as a patient behind a screen, there's no...
a bathroom facility, there's no wash basin.
It's just crazy, absolutely crazy.
So when Damian talks about being over 400 patients when we're funded for 355, that's what happens.
People are sitting there behind screens.
It's not just inpatient care that's overwhelmed.
Let's get to the emergency department.
As I've spoken so many times to you and others, busiest emergency department on the island, seeing about a little less than 200 patients per day on average.
um But let's see what it looks like on a Friday here.
And the hallway we're walking down is a very long hallway.
There's light coming in, but it's disturbing because on the side, on the windows, they have hall number six, hall number five, hall number four, and that represents basically
where we put patients in beds when we're in an extreme overflow situation.
And some days you can't even walk down this hall because there's so many patients in it.
Isn't that correct?
That is correct.
Thankfully today there's none, but ah yeah, probably half the time we use those spaces there.
All right, we're here to see Karen.
And there's Karen.
All right.
uh Good, Karen.
Karen Munkaster is the lead for the emergency department.
How's your day going, Karen?
It's been a busy day, but not too bad.
What does a busy day look like for you?
Let me see.
We see about 200 patients a day.
So we have a total of maybe 90 to 100 patients in the department at one time.
That would be busy.
And both our trauma rooms are busy.
that would be a busy day.
Just trying to get patient flow going through because we hold a lot of admitted patients too.
So right now we have 32 admitted patients in the department that we're trying to sort through.
So there's just a lot of flow and movement going through here right now.
A lot of people moving through.
It's incredible.
Right as we stand here.
Now you always seem really happy when I see you.
How do you keep your spirits up when you're dealing with this intense situation all the time?
I don't know.
Some days are harder than others, but we have a great team here.
Lots of people that work really well together.
And I think it's just the people.
The people are here to help serve the public.
They do great care.
Their hearts are in it.
And I think that's what keeps everybody going and keeps everybody coming back day after day.
Yeah, I think that's why NRJ punches way above its weight despite being over 60 years old and very much in need of a new patient tower.
But the emergency room is
10 years old or 15?
2018ish.
2012.
Oh, 2012.
Yeah.
2012.
Yeah.
It's a busy place though.
So you can see it's been showing its years just from the use that we get through here and the movement that we get through here too.
But yeah, definitely one of the newer places in the building.
Which is great.
All right.
Thanks, Karen.
After we finished talking to Karen, we ran into Cassie, who is known like Karen for her upbeat attitude.
You always seem, I see you a lot like Karen, you always seem in up mode, you know, you're dealing in this rather chaotic situation all the time.
How do you stay so calm and up?
Not sure exactly.
I think it's a little bit my personality type that maybe why I've arrived into this position that I have, but yeah, I think people are arriving here on their absolute worst
days and whatever we can do to bring them a little bit of calm and compassion and...
help them feel reassured that the care that we're going to provide to them is good and uh right and for the right reason is really beneficial and I think a little bit of humor goes
a long way and a smile and some kindness and yeah.
That's awesome because nobody chooses to come here they don't get up in the morning go oh I think I'm gonna go see the emergency department today do they?
Not at all no.
We always say we see people here on their worst day and everyone's emergencies are different.
uh Yeah so every interaction we start with our patients we try to
Start with a fresh mind and a fresh set of eyes.
Whether you're coming here with a stubbed toe or a heart attack, you should get the same level of kick from us.
All right, so we're walking back down that very long hallway.
We're going to see some of the folks at the new critical care building, which is just, we've just opened the ICU portion of that last summer.
And we're about to open the new HAU portion, which is a high acuity unit.
That's pretty exciting project.
And Damian, maybe you could talk about how sort of the interfaces, is there much interface between the emergency department where we just were and the critical care building and the
units in there?
There's a significant interface and as we know the Emerge department uh captures any and all patients but particularly the sickest that need care and the intensive care unit and
the high acuity unit to your point.
uh They, if you're needing an overnight stay you land in those two units so um there's plenty of back and forth of uh
you know, the patients and where and how they receive care at our site.
But these teams here uh prepare patients for transport if they have to go out to other sites on the mainland for intensive care that we cannot provide.
But for the most part, and similar to how we mentioned earlier on, this intensive care unit here, which is 12 beds and soon to be completed 12 bed high acuity unit, uh service
all of central North Island.
So again, a lot of inflow from
not only in Nanaimo, but the center north as a collective.
So very high demand and beautiful.
And we have now gone from what was up till three years ago, I guess we had an eight bed ICU officially.
A lot of research was done and it was deemed to be the worst in Canada.
So that has now been replaced by a pretty stunning state of the art 12 bed ICU.
All the equipment in there has been funded by our donors as over 5.5 million.
and we are looking at the construction site of the second floor, which is a high acuity unit, which will be another 12 beds.
We hope to open that this summer, I believe late summer.
And again, that's been funded by donors, all the equipment in there, which is another $5 million.
Enough from us.
Let's talk to someone on the front lines of this unit.
We ran into Jane, the clinical nurse leader for the high acuity unit.
I asked her to explain the difference between a nurse on a regular floor versus one in the ICU.
Part of my role is also um as a clinical nurse leader in the high QT unit is supporting the nurses within that unit.
Understanding that all of our nurses are critical care trained, so they all have that higher level of training, which entails a degree of education that's far beyond their
regular degree.
um So they invest time and we invest in training, giving them that expertise to take care of critically ill patients.
And they are on a spectrum of critical care patients.
They range from needing just a higher level of monitoring and care, kind of like a high QD style type of patient.
So almost like a bridge between a med-surg unit or a surgical unit to being upward where they need more one-on-one care or one-to-two care.
Critical care in the ICU is more about patients who are on life support, so a ventilator, maybe renal support.
so continuous renewal replacement therapy.
So just more intensive, needing more of that one-on-one care.
The beauty of the HiQT unit that's opening, it really allows us to have that bridge between patients who are maybe just a little bit too sick for the standard nursing care on
the floor, be it surgical, be it medical, and they come to the HiQT unit and we're able to support their care needs.
then the other thing we can do is kind of those patients that need treatments that are what we call treat and return.
So they need an intervention that requires a higher level of monitoring and care that can't be done safely on a medical unit.
And so we're able to facilitate that by allowing them to come.
We have the nurses who are trained to do that and then the patients can return to the floor and in all eventuality maybe go home and sooner.
So that supports them.
So those are some of the key differences.
I love it.
That's really cool.
Thank you.
The nurses in this unit see patients on some of the worst days of their lives.
Their jobs are intimate and require the absolute best care they can give.
They're truly an amazing team.
As we leave the ICU, we ran into a hospitalist.
If you don't know what a hospitalist is, don't worry.
We got Fiona to explain her role.
So a hospitalist is basically a family doc equivalent in hospital.
Maybe doing a little bit more internal medicine.
per se, just because of the nature of the work.
We see all in-patients that aren't attached to a specialist or sometimes even along with a specialist.
And we carry the load of, guess, caring for the majority of the patients in hospital.
That's a huge load.
And what is it like 180 patients you'll have?
that it?
210.
Roughly, yeah.
210 patients on a given day.
That's incredible.
Yeah, at one point it was up to 240, but we're scaling it back as we can.
Yeah.
That's crazy.
Amazing.
And what's like, what's a good day for you?
What's Gosh, well, a good day is, guess, when we're advancing patients care, um doing sort of team based care with all the allied health and, our nurses and community team as well.
um I guess getting patients out of hospital and well, or we're having hard discussions about goals of care, but involving families in that and
Yeah, I don't know.
think every day is a pretty good day.
I'll get you brutally honest.
What's a nasty day?
I guess when you have unexpected things arise.
Like people with podcast mics in your face?
Yes, that.
And sudden emergencies or people acutely becoming unwell or having really hard conversations that are challenging for families and for us as well.
We're all human and we feel that pain.
As I said before, our staff see people on their worst days.
best thing our staff can do for the patients is to try and keep an upbeat attitude.
Damian and I wanted to hear more about how our staff do this, so we walked up to the sixth floor to meet Terry, a healthcare aide who I consider the happiest guy at NRGH.
Hello sir.
How are you?
I'm good.
How are you?
I'm a little winded from coming up the stairs.
You are a brave man.
Damian insisted we do that.
So we're here on the sixth floor.
We're with Terry who's a healthcare aide.
We had a donor who was up here and I was so
Just blown away by your attitude, but everyone on the floor's attitude.
I just was amazed by how chaotic it is.
The halls are really narrow.
You've got the nurses at their nursing stations.
It's really hard to get a bed through.
This is crazy.
This is a 1963 state-of-the-art patient tower.
We've talked about the patient tower before, but I should probably explain what that means.
A patient tower is essentially a multi-story building designed specifically for patient care.
and ours was built in 1963.
So it's a little out of date.
We really need a new one.
During the 2024 provincial election, this was a campaign promise from David Eby.
However, it wasn't included in the budget and it won't be until the business case is fully developed and approved.
We're hopeful, but we also know it happen overnight.
Now let's get back to Terry.
But what I've always been amazed with Terry is when I see you, you always have this really positive attitude and you told me about that one day.
Right.
Well, why?
Can you tell me about that?
Well, just imagining coming in as a patient and just feeling miserable or in pain.
And then the people that are supposed to be caring for you are miserable and they don't want to put a smile on their face.
So that's just my goal is to just come to work.
Whatever has happened in my personal life is at the door and I just come here and my energy is high and we're just here to get them home and healthy.
That's awesome.
That's it.
And the Batman uh shirt scrubs his upper.
You got it.
You got to.
You're a superhero here.
Everyone on six is a superhero.
Everybody in this hospital that works here is a superhero, period.
I couldn't agree more.
It's pretty amazing, actually.
After we talked to Terry, we made our way back downstairs to talk to Donna, who works in the kitchen.
So we've been in ER, we've been in ICU, we've tied in the doctor's lounge, we've been on six, we're sort of bouncing around.
But one of the really important parts of the hospital, of course, is the kitchen and his food.
Can you tell us a little bit about, you know, how many meals you guys prepare a day?
Because I watched your line one day.
And I don't think people would ever realize that every patient gets a customized meal.
And that's incredible.
yes.
We provide 1,800 meals a day, and that's between NRGH and Duffer Place Long-Term Care.
We're very fortunate at NRGH to be the only production kitchen on Vancouver Island.
So we make 14 soups a day, 14 soups a month, sorry, on our menu that are built fresh here.
We feel we're very strong here with our cooks, and we try to keep them
um cooking good food, we're really, really proud of the products that we deliver.
It's challenging when folks are ill and not feeling at their best.
So we do understand some of the comments and stuff like that, but we always like to make sure that they know that the food is cooked here.
We get lots of positive comments on the food.
And we see that.
Like, Damian, you get the letters from people and often they'll say the food is surprisingly good for hospital, which is great.
I eat lunch there almost every day.
Your salad person is amazing.
Let them know, yeah.
At this point, we've been walking around the hospital, chatting with our amazing staff for close to two hours.
But before we sign off, we want to visit two more departments.
Let's start with Rehab Services.
We're walking into the Rehab Services gym.
It's big, light, spacious gym.
It's really quite phenomenal, actually.
It looks out into a nice lawn.
It's got basketball.
It's like a basketball court, this gym, isn't it?
It's huge.
It's very big.
It is a full-size basketball court and...
similar to the other units that we've seen already.
This is our high intensity rehab unit and this gym services uh central North Island again.
So there's a definite theme as our viewers probably already know but need to know.
And so lots of inflow of patients and families from across the region and get them through some of these intensive rehab programs and then back to their daily lives as quickly as we
can.
Back to the last, over 9,000 people come through the rehab services each year here at NRGH.
And the nice thing is they like to say 85 % go home.
So a lot of people come here have had a stroke, they've had an amputation, but they may have had a workplace accident, they may have had a car accident.
So we have all the equipment here, a lot of it's very aged and we are fundraising to replace a bunch of it.
But it's all here to help people get back to their normal lives.
There's even a full kitchen that helps people.
test and see if they can, you know, take care of themselves.
And there's a bedroom, et cetera, sort of as a mock-up that is used by the staff here to make sure people are able to go home and give them their proper assessments and stuff.
But as I say, over 9,000 people come through here in the course of the year.
It's pretty cool.
Pretty cool spot.
There's, you mentioned a kitchen, there's a workshop, there's other therapy areas.
And really some of the unsung heroes of our care team are...
the therapists, the rec assistants, the occupational therapists, the physiotherapists, the physiatry physicians.
There's a lot of folks that we probably don't think of enough and we need to give them the gratitude for the extreme efforts that they put in to get these patients and families back
to a state of discharge and living their lives in a quality fashion on the side of the hospital.
As we make our way out of the rehab facility, we run into our final interview of the day.
Harminder, the supervisor of housekeeping.
Housekeeping is likely the most overlooked but absolutely important and essential part of the hospital.
As Harminder will explain, even their roles are affected by outdated technology.
Hi, my name is Harminder and basically I'm from India, from Punjab.
And I came here like five years ago.
From last five years I'm working here in hospital.
Before I was a housekeeper, then I got promoted as a supervisor.
and a trainer and an auditor.
uh So yeah, my role is to make everything running.
It's a, every day we have like 70 or 100 housekeepers to take care of.
This hospital is a huge area and uh yeah, we are trying our best to.
70 to 100 housekeepers on every day.
Every day.
On multiple shifts, 24 hours a day we know.
As health care is a 24 hour a day, 7 day a week service.
And so those numbers are beyond what I even thought.
So speaks to the volumes and the demands placed on your team, but just care in general at the hospital.
So tell us.
uh
What excites you most about your job?
The best part, I like what my job to be busy and to fix things.
uh
To be frank, we have old equipment.
We are still using old equipment.
Even right now, the phone in my hand, it's old phone.
so old technology means we need to do more work.
oh But I like the way it is.
just trying to...
um I like to be busy.
That is a fun part of this job.
Like, they just fly.
It's the best thing I like about it.
And do you see yourselves and do your team see themselves as important pieces of the patient care journey?
Without housekeeping, nothing can run.
Housekeeping is the most important part.
I want to say on behalf of the patients and the families who utilize our services, on behalf of the Foundation, on behalf of the clinical team and the leadership team, want to
thank you for your leadership.
and how you uh focus each and every day on patient care and cleanliness and safety and all the rest of it.
So thanks for letting us put you on the spot.
Thank you so much.
All right, thank you.
All right, Damian, thank you so much for your time today.
You're like the busiest guy here.
So really appreciate taking an hour with us to walk around and terrify half the people who worked here.
So thank you.
Always my pleasure.
It's great to get out with you and see the teams that really make it all come together.
It's really an honor to be out there on the units and ask these questions, put them on the spot.
see what it's like to hear them have a voice and hear what the walls have to say around NRGH.
If only these walls could talk.
And I think what lot we heard about was there's passion and there was kindness at all levels.
I think that was really interesting.
And we saw, as you said earlier, from the intake from emergency all the way through to rehab, if people need that, we've talked to the cleaners, we've talked to the kitchen.
So it was awesome.
So thanks for leading us through this.
My pleasure.
Let's do it again.
As we wrap up this episode,
We hope you've gained a deeper understanding of the people and the purpose behind the Nanaimo Regional General Hospital.
Their dedication to compassionate care and commitment to excellence is what truly brings our values to life.
At the end of the day, it's about more than just medicine.
It's about harbouring hope, right here in our community.
In the next episode of Harboring Hope, we will meet Tony Harris, the chair of the board for the Nanaimo and District Hospital Foundation.
We have a facility in NRGH, which is the tertiary hospital for care beyond community care north of the Malahat that was built 50 years ago, 350 beds, just not capable of serving
the community the way it's grown to be what it is today.
More than half of the population of Vancouver Island lives north of the Malahat.
nearing half a million people.
We two hospitals in Victoria that deliver a higher standard of care in much newer and appropriate facilities than the one hospital north of the Malahat at NRGH that is, as I
said, over 50 years old and dramatically too small and limited in what it can do.
Thank you for joining us today on Harbouring Hope.
To learn more about the Nanaimo and District Hospital Foundation, please visit NanaimoHospitalFoundation.com.
I'm your host, Barney Elsperry.
If you are a current or future partner of the Foundation, thank you.
With your unwavering support, we are delivering a new standard of care for all who call this amazing region home.
Together, it's in our nature to give.
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