Royal Columbian’s Littlest Patients

In early New Westminster, births that did not occur at home, usually took place at the Women’s Hospital, established in 1894/95. The year after that hospital joined the Royal Columbian Hospital in 1901, a special Maternity cottage with 20 beds opened at RCH.

Fast forward to 1978 and the opening of the Health Care Centre, and we find a delivery room with an adjacent intensive care nursery unit. While that might sound like what we have today, it was much less sophisticated. But major changes were on the horizon.

Five years later, in June, 1983, RCH officially opened its new Ante-natal Assessment Unit, named in memory of Dr. Angus E. Wood who was chief of the Department of Obstetrics and Gynecology from 1964 to 1978. The $16,000 unit was funded by private donations from the medical staff and the Wood family, and the A.E. Wood Memorial Fund financed a fetal monitor valued at approximately $10,000.

Nurse Norma Foster, practitioner in the new RCH ante-natal unit, demonstrates fetal monitor used to check the progress of fetus. From left are unit director Dr. Peter Beresford, Dr. Marcia Wood and Dr. David Allan chief of obstetrics.
From New Westminster Today, 29 June 1983.

Located on the first floor of the Health Care Centre, the ante-natal unit, directed by Dr. Peter Beresford, was to conduct assessment tests on “at risk” pregnant women. “These may be women who have diabetes, are overdue in their pregnancies, have some degree of toxaemia, some medical problem, or in which some problem has been diagnosed with the fetus,” explained Norma Foster, nurse in charge.

At that time, the unit did not deal with “high risk” cases, referring those to Grace Hospital in Vancouver. Prior to the establishment of the special unit at Royal Columbian, assessment tests were done in the case room, but a special unit was deemed necessary since the volume of patients had increased considerably in recent years.

In July 1985, an article appeared in the Royal City Record describing the care given to premature babies at RCH where pediatricians with special training in neonatology and some 40 high-skilled nurses staffed the intensive care nursery. The unit, headed by Dr. David Ou Tim, opened in 1978 as a secondary level regional referral centre serving nine hospitals. Sick babies were admitted from RCH’s own delivery rooms or were transferred in from regional hospitals.

Photo in The Royal City Record July 20, 1985
showing premature infant in incubator at RCH.

“An ICN team member attends all RCH Caesarian births and is ready to administer expert care to newborns in distress. If the unit is alerted to the birth of a sick baby at another hospital, an experienced nurse attends with an Emergency Health Services transport team to make an assessment before a transfer is made.”

In 1979 the RCH unit cared for 1147 small patients. In 1984 the number was 1524. Although technology is the key ingredient in keeping premature babies as small as 500 grams alive, it is the commitment and dedication of staff that families remember most. But as head nurse Marilyn Chung pointed out, the high standard of care is the result of cooperation between a wide range of disciplines including physiotherapy, respiratory therapy, biomedical engineering, laboratory, pharmacy, radiology, social services, housekeeping and maintenance. RCH’s Auxiliary has also contributed equipment for the ICN.

The following year, in 1986, the BC Ministry of Health announced a million dollar grant for the renovation of the Intensive Care Nursery at Royal Columbian Hospital. It was to increase the floor space of the chronically crowded unit by at least 60% and also provide at least six, perhaps as many as twelve new bassinets.

Prior to the renovation, ICN was crammed into a room that was never designed as an intensive care nursery. Basinets were arranged along walls and around pillars, monitors and IV units added to the clutter and “the constant chirping of monitors added up to quite a chorus”.

The nursery’s “family centred care” concept recognized the importance of the bonding process between parents and newborns and encouraged parents and grandparents to sit with and take care of their babies as much as possible. The Winter 1986/87 issue of Focus said, “It’s a great philosophy, but when there’s several parents around the nursery, three grandparents and a mother giving her child its first bath, the ward can be positively claustrophobic.”

Finally, in June 1988, the renovated special care nursery was ready and the media arrived to record the procession of babies, incubators and staff from the interim nursery on the floor below. The Royal City Record of June 11, 1988 described it like this.

“High risk and premature babies will be getting more special care from the Royal Columbian Hospital beginning this week. An upgraded Special Care nursery has been completed with 10 new beds offering more services traditionally consider higher acuity for newborns.

“A $1 million grant from the provincial government was used in expanding the 28-bed Special Care Unit on the third floor of RCH. The unit will take referrals from nine other area hospitals.

“The newly upgraded nursery, painted in shades of salmon and cream, has a homey, relaxed atmosphere,” says head nurse Marilyn Chung. “It’s a lovely, spacious unit,” she said. “The upgrading means that some critically ill newborns, who used to be sent to Vancouver Children’s Hospital, can now be treated in RCH, and be kept closer to home and family,” said Chung.

Staff transfer premature and high risk babies into new Special Care Nursery. Above, nurses Bevery Stonoski and Justina Chan and Dr. John O’Toole move Air Shield Intensive Care Unit into place in the new nursery. A ceremonial ‘parade of premmies’(sic) took place when all was ready.
Photo from The Royal City Record June 11, 1988

“Most premature babies suffer from not being able to breathe properly because their lungs are not fully developed. The babies are kept in an incubator for warmth, and given extra oxygen to help them breathe. Acute babies are put on ventilators. Twins and triplets, which are often born premature, are regulars in the unit, said Chung, adding that a month ago the unit contained five sets of twins.”

Currently the NICU at RCH delivers and cares for about 40% of the province’s premature infants born at under 30 weeks – the most tiny and fragile newborns in the province. An average of 3,000 infants are born at RCH and 800 are admitted to the Neonatal Intensive Care Unit each year.

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