Julie Kille has been a part of the Providence Health Care team for over 10 years, starting as a staff nurse and working her way up to operations leader of Urban Health & HIV.  Recently, Julie was seconded to work as the clinical practice lead for HIV for the Regional HIV Program, encompassing both Vancouver Coastal Health and Providence Health Care.

Julie, what is it about the culture at St. Paul’s that made you want to make it your home?

It is really the people and the populations we serve that I feel a strong connection with. The principles of social justice are central to our program, and guide the work we do. It is important as we reach populations that have difficulty accessing health care in general.

Your passion for social justice and reaching marginalized populations is definitely evident in your works focus. Julie is also the President of CANAC (Canadian Association of Nurses in AIDS Care)

What did your career journey to here look like?

I really had a strong interest in HIV and Addictions, initially in addictions. The HIV part came from working on 10C and seeing that some people were starting to get better because the medications at that time were working but there were still patients who were failing on treatment. Being able to see people over a longer period on medications allowed me to see how life changing they could be; people who were near death rebounded and got healthy. I think it’s very interesting to work with a disease where there is still no cure yet there is a lot of hope. Additionally, HIV and addictions care rely a lot on clinical practice to change outcomes for patients.

What’s been the most challenging part of your job? 

The operations role is busy. I think the transition from frontline staff to operations was definitely a big learning curve for me. There was a lot of support around and I certainly had the support of a lot of the other operations leaders. That was easy because I felt that I could ask questions and never needed to be worried about somebody thinking I was not doing something right. That was really helpful.

Julie was seconded in May to work with Vancouver Coastal Health and Providence in the role of clinical practice lead for HIV for the Regional HIV program. 

Can you tell us about your new role and how it differs from your Operations Leader role?

In my operations role I had about 100 employees that I was responsible for. In this role, the clinical practice lead for HIV, it is quite different in that I am doing more project work and things move slower because I am gathering more information and working through things at a different pace. The work itself is more community based and coming from an acute care setting, although I had two community clinics in my portfolio, I am able to see the uniqueness of each area. It will be really interesting to come back and think about how the community and acute care interact in a new way.

In the1980’s, SPH was the only hospital to welcome patients with HIV. How has the HIV community changed over the years?

When people who worked here in the 80s talk about what was different, they talk about how this was one of the first places where people were not wearing hazmat suits to see HIV positive people in the hospital and maybe they were scared, but still did their job and really felt a connection to the work that they were doing.

Do you feel the stigma has changed?

I think that the stigma has changed in some ways but I think that there is still a lot of stigma and discrimination against people living with HIV and more so actually I think these days its people who are living with addictions really suffer a lot of stigma and discrimination both within the community and sometimes within the health care setting. I think this is a group that we feel quite passionate about advocating for because a lot of our patients do fall in that group. Certainly, there are better outcomes for a lot of people but it really depends on the social determinants of health as to how well someone will do with their HIV, along with their addictions and their mental health.

What are dreams for the future of HIV and Urban Health?

We have already moved away from the need for a lot of acute care beds, our occupancy has continued to decrease over the years and I think that is a good thing. I think that with a greater focus on keeping people well in the community I think that our program can play a large part in that and I am really looking forward to seeing how we help people be well and not need acute care services any more.

At Providence we have a patient & family centred care, how do you incorporate that into your continuum of care?

Sure, we have developed some very unique programs in our area and trying to look at things such as connecting people back to their culture or really looking at innovated ways to provide healthcare where it doesn’t feel or look like traditional health care where they power dynamics are where the clinician has the power and the patient doesn’t.  Our program has really made a big effort to ensure that patients are directing their own care and are collaborating with us as team members to really ensure they are getting to where they want to go at the pace they want to go at and to see the outcomes that both of us want in the end, to see them well and be able to live with HIV or live well with addiction.  Certainly people who feel they have ownership over their own help are going to do better if they need to rely on we are there and we are always happy to share our expertise but patient has to lead their own care and it is quite empowering.

Vancouver is the host of the 8th biennial IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS2015) July 19th – 22nd.

Will you be attending this weekend? What are you most looking forward to?

I am going to be attending. I am really excited to see what is going to be new about PreP there is a lot of discussion about rolling that out in our community so it will be nice to see world experts talking about implementation.  I am also very interested in the sessions on sex work and I think that is still one area where there is a lot of stigma and discrimination and with some of the activities being criminalized they are one of the most at risk groups for being unsafe in our society.