There’s a whole new atmosphere percolating at Southlake Regional Health Centre, on the third floor of the east building. You feel it when you get off the elevator. It’s not just the sparkle of a newly renovated department, or the pleasant expressions of people passing by, but something else entirely. A special kind of energy radiates from these rooms that are filled with nurturing, caring, kind words and fuzzy blankets. This is where the children are.
A photograph of an angelic newborn hangs on the wall, with the caption, “What a beautiful way to start people”. It’s a favourite for Stella Wadsworth, Director of the Paediatric/Perinatal Centre at Southlake. Expectant mothers are not the only folks walking around aglow. Equally radiant are the nursing staff, who obviously love their work.
“When you work in a community hospital, it’s not just a job,” says Stella, “Many people who work at this hospital feel that way. It’s good when you see people come in and you know their families. I remember the first time that someone I went to school with came into the hospital. I grew up with her since first grade, and there she was, a grandmother, and I thought ‘wow!’ The evolution of the families, the generations of people… it just hit me, how important it all is. If that isn’t a reason to work in a hospital in your own community, what is?”
“I was born here, “ says Judy Swaile, Manager of the Maternal Child Program. “I had my own children here, and my sister’s children were born here. You don’t feel so anonymous in a community hospital. Patients are just as likely to meet someone that works at Southlake when they are out grocery shopping or at a restaurant or at the movies. They’re neighbours.”
The staff are just as pleased about the new redevelopment. “Birthing/maternity, obstetrics, post-partum, special care nursery and paediatrics are all found here, together at last,” says Stella. “In 1997 the department was designated a Regional Paediatric and Perinatal Centre. Southlake has a long history of providing excellent care, but the re-design of this floor in 1998 re-grouped the departments all on the same floor. That fact and the modernization of the units enable the staff to give the very best in family centred, patient focused attention. The nurses contributed significant input in the planning stages of the new building expansion, and many areas have been designed accordingly.”
“We felt like we had an edge with the renovation a few years ago, because we were able to see what worked”, says Judy. “It has allowed the department to try various ideas on for size, before the future wing is built.”
The department has developed what they call a One Stop Shop. Gone are the days of entering through the hospital emergency doors. “Patients are admitted directly to hospital via the third floor, and generally have already completed pre-admission so all their information is in the computer,” explains Judy. “This means minimal time that they have to stop and answer questions, because they are most often already in labour and under stress. They just hand in their health card. We also do all the financial services through this central station so it’s much more convenient.”
The nursing station in the new phase will be more of a central hub accessible by all the areas. Currently there are 12 birthing units, which will expand to 21, with 16 post-partum beds. There is no common nursery, all babies stay with their mothers. The Neonatal Intensive Care Nursery has 10 to 12 spaces for babies, and that will grow to 20. There are also three beds available for families whose babies are in hospital. The mothers can stay near their newborns and get a breastfeeding routine established.
Having the baby, child and adolescent related areas grouped together is working beautifully. “A mobile portable ultrasound machine allows obstetricians to perform tests right on the spot, after-hours when a diagnostician is not available or when an ultrasound is required immediately,” says Judy. “It is yet another example of focussing on the patient’s needs. During labour if an emergency instant C-section is required we have everything we need on hand for any situation, without moving the mom.”
In addition, a triage area and large new waiting room with play area and separate washroom will be in place for outpatient testing. Part of the admitting process when women first come in is an assessment. Expectant mothers are questioned and have their blood pressure and foetal heart rate checked. The new wing will also include a post-partum /maternity area, which caters to women who have high-risk pregnancies and need to be hospitalized for periods of time.
“Pregnancy is not an illness, but a life and body event”
In one of the birthing units, Anne Forsey lies contentedly with her newborn baby Alison. Her husband Stephen arrives with their other two daughters, 6 year old Laura and 3-year-old Carolyn. They descend upon Anne with loving kisses and hugs, and the giggling girl’s only interest is in caressing Alison’s soft head and counting her tiny toes.
This welcoming room has no sign of any old-fashioned cold metallic bed rails. There is, in fact, a wide comfy chair that pulls out into a bed for a new mother’s partner, friend or relative to sleep on, and a round table and chairs in the corner invites siblings to sit and play or colour.
Anne’s first two births were in a conventional hospital. The differences are substantial. She describes a wonderful sense of being “looked after” here. Ironically, patient self-administering is part of the hospital program. Anne does her own point-of-care medical charting for herself and baby, indicating medication and feeding times on a clipboard beside her bed.
Each woman is in one room from the onset of labour. They have their own shower for pain management, and a Jacuzzi is just down the hall. The extra-large private room includes a storage area for the patient’s belongings.
The sliding doors of decorative wall cabinets conceal equipment for blood pressure, oxygen and medical supplies. “It’s a beautiful room, and the amount of space is great, ” says Anne, with Alison asleep in her arms. “It’s like a hotel room, not at all clinical.”
“During my first labour, I heard screaming out in the hallways,” remembers Anne, “It was a little disconcerting. This is so very private you really can’t hear much else going on. It’s surprisingly quiet the way the rooms are built. You wouldn’t know there are six other women in labour here right now.”
There was one nurse with Anne during her entire labour with Alison. Her previous hospital birthing experience recalls a stream of different faces throughout the process.
“Part of our philosophy is one-to one nursing care,” says Judy, “We know from our research that aspect actually reduces Caesarean sections, reduces the forceps rate, even the required anaesthetics, because if women get support through the early stages, they can manage the final stages too. When they are in a relaxed setting they don’t ask for anaesthetics, they want to birth naturally.”
“Pregnancy is not an illness, but a life and body event. Most women enjoy a quick recovery and our focus is on preparing mothers to take care of themselves and their baby going home, rather than illness.”
Down the hall the Neonatal Intensive Care Unit (NICU), is a warm, bustling room filled with wee babies, soft-spoken nurses, and attentive mothers. The extra machinery and medical equipment here is hardly noticeable, partly due to the Quilters Guild, a wonderful group of women in the community who regularly donate a little bit of love to this room. They make tiny little blankets to fit the premature newborns in isolettes, to brighten up the already cozy area with a little colour.
“One of the best things about having these areas integrated on the same floor, is that sometimes a baby born here has to be readmitted into the NICU,” explains Judy. “We are familiar faces for the family, we know them already. It’s very frightening to have your child hospitalized. They have had a positive experience with us during the birthing so they already feel secure and confident.”
“It’s a very nice thing for the parents, it helps reduce some of the anxiety. It’s like coming back to friends instead of to a cold, clinical atmosphere. It’s a large part of the reason why the departments were designed as a group together, and why it will continue to function the same way with the new building.”
Multiple births run in the family of Catherine Calabretta of Kleinberg, and on February 6, 2001, she held with tradition by delivering triplets. Born early at only 28 ½ weeks in a well known Toronto hospital, the premature trio are now tucked safely in the NICU at Southlake, where Catherine spends pretty much all of her time.
She was encouraged to sleep nights at home, to try and build up the strength needed to tackle the job of raising triplets. It was an easy decision. The nursing staff creates such a nurturing environment in the NICU, that faith and trust in their ability to watch over her babies came naturally. She jaunts back and forth to the hospital daily, with additional trips back with her husband in the evening.
Catherine is the epitome of motherhood as she sits smiling midst her newborns, pumping endless milk for the endless feedings. “This is what I do.” she grins, flushing with joy as she gazes at them through the clear protective walls of the isolettes. “Anthony is the tiniest, he is more frail. I had Maria first and eight hours later had the boys. I think if Maria wasn’t in such a hurry to be born the boys would have stayed on longer.”
“It is just a miracle. You have to be so happy in life for what you get. God willing, we will be ready to all go home together in another four weeks.” says Catherine.
“Southlake gives me a real feeling of…” she pauses, searching for an apt description. “…youth. It’s growing…it’s progressive. They are so open to new ideas and methods. My husband said the same thing; we were talking about it yesterday. Everyone here is so full of energy, they always look so happy.”
“And the food selection here,” she adds, “is amazing.”
New mothers Anne and Catherine are not the first patients to appreciate and comment on the excellent food prepared at Southlake.
“We looked at patient feedback and the majority of comments were about food, either the quality, or not enough food, or it was hard to access.” says Judy. “We have women who are healing, women recovering from labour and birth, women creating breast milk, and they all need good nutrition.”
“So we came up with the idea to have a buffet meal three times a day, and a kitchen so anyone can get toast or cereal or a snack. The fridge is stocked so anyone, anytime, can have it. Now the focus in patient feedback is no longer on food. We also try to meet everyone’s needs.” explains Judy. “Diabetics or those with allergies.”
Southlake demonstrates another contemporary approach to wellness by embracing the growing trend in midwifery. “We offer some nice options,” explains Stella, “because we have 10 or 12 family doctors who do births, 8 obstetricians and 4 midwives on staff. Those numbers will increase with the expansion.”
“A midwife is responsible for the care of the mom and the baby and as long as they continue to meet a certain low-risk criteria. If something changes we do a transfer of care, where an obstetrician looks after the mother, and a paediatrician sees to the baby. In normal birth situations, the midwives provide follow up care for the mother and baby until 6 weeks of age. In the event of a Caesarean, the midwife continues to support the family and baby and an obstetrician works with the mom.”
Another highly praised facet is the bereavement and grief-counselling program, for women who have miscarried or have had premature babies and need additional support.
“When they leave here, although they have suffered a loss, they have been taught the initial steps of how to mange their grief, “ says Susan Janes, Maternal Child Counsellor. “They know what to expect from the community, and where to go for help.”
“We have recently expanded that counselling to women and their families that have suffered a loss under the 20th week of pregnancy. They used to go to one of the surgical floors but now we can help. It is just as severe a grief whether or not it happens under or over 20 weeks, and we are here to assist them. We’ve had very positive comments from women that have really appreciated our support, it gives them a sort of closure.”
Southlake initiated a universal Newborn Hearing Screening Program in January of 2000. “We were the first hospital in Ontario to test all newborn babies for hearing,” says Stella proudly. “It has identified some newborns which otherwise may not have been detected so quickly. Early intervention and quick treatment makes a huge difference, it benefits the child and the family.” The screening method is called otoacoustic emissions (OAE) and can be done as early as a few days of age.
In the paediatric unit, the philosophy of caring is very much the same, it’s just not as high profile as the birthing centre. Generally, patients 0 to 18 years old enter through emergency with an accident or illness. Others are surgical patients coming in for same day surgery but sometimes it is necessary to stay on. The peak periods are October through to April, with the rounds of seasonal childhood illness such as various types of flu, bronchitis, pneumonia and related problems.
Colin Zammit is a 16-year-old awaiting surgery. He has three fractures above his ankle, from tobogganing on an over slippery ski hill.
“I tried to bail and hit the sun deck of a ski chalet.” he says matter-of-factly. “They’re putting in metal plates and a cast on my leg. They’re treating me great! It’s like ‘Cheers’… everybody knows your name. The service is terrific, I don’t have to wait for anything, and they’re all really knowledgeable.”
Colin has come all the way from the Orangeville area to have surgery. The same scenario is true for patients who are closer to York Central and Markham Stouffville Hospital. They simply don’t have many paediatric beds available. So they come to Southlake.
But this doesn’t concern Colin too much. He’s trying to decide on what colour his new fluorescent cast will be, orange or lime green. “My friends can still sign it, right?” he asks the nurse.
In paediatrics the bed count will stay the same but the department will be moved completely into the new phase with specialized areas. “It is very challenging to the nursing staff to have such a wide array of diagnosis in one area, ranging from the usual childhood illnesses to mental health.” says Stella Wadsworth. “We already have a very active Eating Disorder Program in place. There are many physical, emotional and psychological issues, related to eating disorders.”
Currently there are no beds in York Region for children or adolescents experiencing mental health issues, in the very near future, Southlake will have 10 beds added to their unit. “Developing this area specifically for our Child and Adolescent Mental Health Program will enable us to continue care in a more family centred, patient focused way.” Says Stella. “It will be easier for us to treat in the special, individual way they deserve.”
“People are pleasantly surprised when they find out the level of care that is available here at Southlake.” says Judy Swaile. “It’s common perception that you have to go to the big city to get the best.”
“Medical personnel who visit from Toronto comment on what a rich hospital this is. I say ‘What do you mean?’ They point out all the new equipment that they don’t have downtown. I tell them it all comes from the community. Like any other hospital we only get so much from the government, we’re not a rich hospital. It’s all money from donations.”
“People come back to Southlake because they feel more ‘cared for’ here. They have their second and third babies here after shopping around, even after having babies at other well-known hospitals with great reputations. Now Southlake has a great reputation. I think I know why. The difference is we give really heartfelt care.”