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RIVERVIEW STORIES: Nursing through the decades

For a nurse at Riverview Hospital, work was about much more than folding crisp hospital corners on bed sheets and dispensing pills.

For a nurse at Riverview Hospital, work was about much more than folding crisp hospital corners on bed sheets and dispensing pills.

Nurses coaxed patients into all manner of activities, from fashion shows and embroidery work to dancing, gardening and pub therapy.

They aimed to make life as normal as possible for patients, in a way that would complement the medical care administered by doctors, always with the hope that each individual could somehow find their footing again in society.

The common element in whatever service the nurses were delivering, from the first graduating class of 1932 through to the last handful caring for the remaining patients in the summer of 2012, is compassion.

"Essondale was the ultimate in care at some point in its existence," said Fred Bennett, a Riverview nurse from 1959 to 1998. What struck Bennett most from his nearly 40-year career was the initiative nurses took to implement programs that would benefit the patients, often at the nurses' own expense.

Bennett spearheaded the pub therapy program, which started in 1973, to offer patients a "normal" social experience. With little to no funding available, Bennett tracked down donated materials and wrangled help from the occupational therapy department to build what was dubbed the "Longhorn Saloon."

It was located in one of the East Lawn wards; male patients were invited to enjoy a couple glasses of beer, and to invite women from other wards for a glass of shandy or ginger ale.

"The idea was to provide an atmosphere that would promote socialization between patients," Bennett explained. "One of the aspects of mental illness is isolation and an inability to interact with other people, so we tried to promote that."

Anna Tremere, a nurse from 1965 to 2001, remembers that nursing duties differed depending on whether you had a morning or afternoon shift. Mornings focused on giving patients their medications and sending them off to their various jobs and activities for the day.

Afternoon shifts, however, meant trying to find ways to keep patients entertained in the large day rooms. "You learned to play every card game imaginable," Tremere said.

HOME AWAY FROM HOME

In Riverview's early days, the introduction to nursing came with the first taste of life away from home.

It was March 17, 1941 when S. Fraser (she asked that her first name not be used), then 20 years old, left her New Westminster home for life as a Riverview nurse. Her family doctor had mentioned Essondale was looking for nurses and, eager for a change from the long days at her family's store, she didn't hesitate.

"When I got home, I phoned another girlfriend I knew and we went together and applied," Fraser said.

When she arrived, however, Fraser remembers feeling shocked.

"It's different than at home but I was fortunate because... in those days, if you knew somebody they helped you," and there were a couple of young women Fraser had known in high school already at the junior nurses' residence.

"It was fun for me," Fraser added, despite the long days of work and study. "We worked 11-hour days, and we often had classes at night. Now, they do all the learning before [putting it into practice], but we didn't have that. It took us three years and we had classes during the summertime. I still don't approve of the way they do things now."

The training was "very formal," Tremere added. "There were great expectations in how you carried yourself and wore your uniform. We stood up when the head nurse, a supervisor or doctor entered the room... and we were never on a first-name basis. We learned respect; we wore the uniform and we wore it correctly."

Students rotated between classroom study and shifts on the wards, always putting into practice what they had learned.

Part of that work involved keeping the hospital gleaming.

"We cleaned floors, we polished the furniture," Tremere said. "Because we lived there, there was really a sense of community."

Bennett said each nursing student carried an "experience book" listing the skills, tasks and responsibilities they needed to master, and those books were then signed by supervisors.

"You did everything," Bennett added. "One of the first things you learned how to do was running the floor polisher."

It wasn't the most glamorous job but it was a solid career path for Bennett and many others at a time when there were few options.

Bennett was 19 years old, a year out of high school with little in the way of job prospects, but a chat with a friend's older brother who was already a year into the psychiatric nursing program piqued his interest.

It didn't hurt that nursing students received a small stipend during their training period: $150 per month for the first six months and $225 by second year.

Female nursing students, who were treated differently than their male counterparts on many levels, received a smaller stipend.

Fraser remembers chronic staff shortages during the war years.

At the same time, the hospital's patient ranks were swelling to more than 4,000. Essondale hired more aides to cover the shortages and, in 1944, it scrapped the policy preventing married women from working at the hospital.

Tremere said she always knew she would go to work at Riverview one day. Her mother and aunt were both psychiatric nurses and Tremere never questioned she would do the same thing.

"It just seemed the most natural thing to go out there and nurse," she said, though she remembered walking into a ward for the first time and seeing 175 patients. "It's quite something when you're 18 years old."

PATIENT CARE

Both Bennett and Tremere started their nursing careers after the introduction of chlorpromazine, the anti-psychotic drug that revolutionized treatment for the mentally ill.

But Fraser remembers one of the first patients she cared for was one of the first at Essondale to undergo a more invasive treatment: a lobotomy.

Tremere acknowledged that caring for the mentally ill has come a long way since Riverview opened in 1913.

"Nobody knew how to deal with the mentally ill," she said. "There were no therapies and it was a very difficult learning process."

One of Tremere's first memories of Riverview was arriving in the spring, when the trees were ablaze with delicate pink and white blossoms. The idyllic scene was at odds with what she was hearing, however.

"I could hear these sounds and it was people, it was the patients on the verandas and they were yelling. It was very noisy," Tremere said.

When Essondale opened, patients were treated mainly with hydrotherapy baths, sometimes for up to nine hours; the more stable patients worked at Colony Farm and did other occupational therapies.

There was also shock therapy, insulin coma therapy and surgery.

Tremendous change was ushered in with the introduction of new medication in the early 1950s. Patients were stabilized, and the hospital was able to open its previously locked wards so patients could move about the expansive grounds and take part in more activities.

Treatments continued to evolve even as care for the mentally ill began shifting to smaller, community-based facilities in the late 1970s and early '80s.

Fraser, Bennett and Tremere moved up the nursing ranks before retiring, and look back on their careers - and Riverview - with fondness.

"I think back over the years and the thousands and thousands who were given treatment successfully, either in long-term or short-term care," Bennett said. "A lot of those people are in not as good of a circumstance as they were when they were in hospital. It rankles with a lot of us."

Shutting down Riverview, the three nurses agreed, was a step in the wrong direction.

"Those 244 acres represent so much of our community, and not just Coquitlam," Tremere said, noting the space is about more than parcels of land to be divided and developed.

"I think it would be a travesty, it would be disrespectful to do that," Tremere said. "If you take away what's there, you take away the history, you wipe out the legacy of the lives that were there."

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