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Small-Community Care

“A web of support built within spokes in a wheel”:

the roots of small-community hospice care on the Sunshine Coast

 

by Heather Con

“A supportive, loving, caring atmosphere”

St. Mary’s Hospital

Amidst a small-town hospital atmosphere of loving, friendly attention, it took one caregiver’s disturbing assessment of palliative care to help launch the seeds of hospice on the Lower Sunshine Coast in 1985.

With no hospice beds at St. Mary’s (now Sechelt Hospital), end-of-life patients were placed at the far end of a busy hall on the first floor. People who visited the dying often had to walk past the nursery on the right by the entrance, and cardiac care and intensive care on the left. End-of-life patients were frequently placed at one end of the hall, and surgical at the other, with the nursing station in the middle.

“We thought we had loving, caring, small-community care,” remembers hospice co-founder Heather Blackwood (formerly Myhill-Jones), who had worked as a part-time nurse and served in the late 1980s as president of the local chapter of the Registered Nurses Association. “It was a really supportive atmosphere. Housekeeping helped you out, as did the foods people looking after people at times when it was crazy. St. Mary’s was not a unionized hospital at that time.”

Heather Blackwood

British caregiver calls husband’s pain management “appalling”

But Sybil McGinnis, a physiotherapist familiar with hospices in Great Britain, found the pain management of her dying husband at St. Mary’s “appalling,” says Blackwood. McGinnis expressed her concerns to Wendy Hunt, the hospital’s director of nursing.

Blackwood recalls her response to this harsh assessment. “‘Appalling’ is a very big word to use when you think that you’re giving loving care. When you’re a nurse working on the floor, you knew half the people from the community and so did the cleaning staff and everybody else. It was a caring environment. So that [criticism] was a big shock.”

Looking back at that crucial period in Sunshine Coast hospice history, she adds: “I feel really grateful to Sybil who planted the first seed and said that. You open your eyes.”

Hunt took McGinnis’ concerns seriously, says Blackwood, and wanted to know what conditions this critical yet perceptive caregiver knew about in Great Britain. Nurses on the Lower Sunshine Coast were working closely with Home Support Services. And unlike their urban colleagues, whose treatment of patients at the end of life focused on one centralized area, local nurses (and later, hospice volunteers) served about 10 rural communities scattered from Langdale to Egmont. They treated patients as dear friends, neighbours, and relatives — and most of them were.

When you have a small community like ours, your connections are all there, like spokes in a wheel,” says Blackwood. “A spider web of support builds in those spokes.  I think that can happen much faster than in a big city because everyone knows each other. Everybody wants to make it better. It’s your friends and your neighbours and your relatives that are having these bad experiences. You want to fix it. You want to make it better. I think that was our motivating factor.”

Dame Cicely Saunders

These close-knit relationships in a small region like the Sunshine Coast helped inspire local nurses to want to change conditions for dying patients both at home and in the hospital, says Blackwood.

Unwittingly, McGinnis’ deep caring for her dying husband and her demands for better pain management mirrored the actions of Brit Dame Cicely Saunders. Saunders’ love for a dying man was a primary catalyst in her drive to launch a new approach — hospice — in the mid-1960s in Great Britain. Today, she is credited with creating the roots of our modern hospice movement. Such seemingly unrelated yet parallel events appear repeatedly in the history of the Sunshine Coast Hospice Society, revealing a true legacy of love.

There had to be a better way

Before volunteer hospice services began in 1987, nurses found end-of-life procedures challenging at Shorncliffe Care Facility, built four years earlier, says Blackwood. In those days, the facility had no designated hospice beds. Again, the small-town closeness between patients and nurses was a key factor in seeking better care for those who were dying.

 

            

“When Shorncliffe was first built, the policy was, when somebody was dying, to send them to St. Mary’s,” says Blackwood. “The nurses found that very hard. I worked with Shorncliffe for a little while too. Here you had these people as a resident, you loved them up and then you had to arrange for an ambulance to take them to die at St. Mary’s? They wanted to have them die there [at Shorncliffe].”

Local nurses knew there had to be a better way to care for the dying on the Lower Sunshine Coast. At a monthly Registered Nurses Association meeting in Sechelt in 1985, McGinnis told nurses her concerns about poor pain management of the local terminally ill. Soon afterwards, the nurses hosted a well-attended public forum on hospice care. After their guest speaker from Lions Gate Hospital hospice spoke in a St. Mary’s Hospital board room, the group asked their audience: How can we better meet the needs of people who want to die either at home or in the hospital?

Note: Any opinions expressed in this content are those of a specific individual. They do not necessarily reflect the policy or position of the Sunshine Coast Hospice Society (SCHS) or any SCHS volunteers, past, present or future.