Nurse’s Pledge
n full knowledge of the obligations I am undertaking, I PROMISE to provide a competent standard of care for the sick, regardless of race, religion Iand status, sparing no effort to alleviate suffering and promote health and to refrain from any action which might endanger life.
I will respect at all times the dignity of the patients under my care, holding in confidence all personal information entrusted to me.
I will maintain my professional knowledge and skill at the highest level and give support and co-operation to all members of the health team.
I will honour and abide by the Singapore Nursing Board Code for Nurses and Midwives, and be responsible and accountable at all times for my nursing actions and decisions.
I will uphold the integrity of the professional nurse. 4 MINISTER’S MESSAGE
5 CONTENTSDIRECTOR OF MEDICAL SERVICES’ FOREWORD
6 CHIEF NURSING OFFICERS’ INTRODUCTION
CHAPTER 1 14 FACES OF CHANGE, MAKING A DIFFERENCE This book is dedicated to all nurses in Singapore – past, present and future – for your courage to care CHAPTER 2 selflessly for patients in hospitals, nursing homes and 28 TEACHING TO CARE, CARING TO TEACH in the community 42 CHAPTER 3 Special thanks to our talented nurses who BREAKING NEW GROUND, CREATING A BETTER TOMORROW took photographs and produced amazing CHAPTER 4 artworks for this book 56 PUSHING FRONTIERS, IMPROVING PATIENT CARE
70 CHAPTER 5 HEALING HANDS, CARING HEART
CHAPTER 6 84 CHAMPIONING CHANGE, ADVANCING CARE
© MINISTRY OF HEALTH CHAPTER 7 First published in 2020 by MOH Holdings Pte Ltd for the Ministry of Health 96 BEYOND HOSPITAL WALLS, INTO THE COMMUNITY Printed in Singapore
All rights reserved. No part of this publication may be reproduced, stored in CHAPTER 8 a retrieval system, or transmitted in any form or by any means, electronic, 114 CELEBRATING ACHIEVEMENTS, INSPIRING FUTURE GENERATIONS mechanical, photocopying, recording or otherwise, without the prior permission of the copyright owner. 130 BOOSTING THE NURSING POPULATION ISBN 978-981-14-5823-1
134 MEET OUR NURSE PHOTOGRAPHERS AND ARTISTS
Download the e-book here 138 THANK YOU, NURSES MINISTER’S MESSAGE MESSAGE FROM DIRECTORS OF MEDICAL SERVICES Nurses truly care to go beyond Doctors cure, nurses care
2020 has been designated by the World Health Organization as The Year AS WE transform our healthcare system to support the challenges of an ageing population and of the Nurse and Midwife. It also marks the 135th anniversary of nursing rising chronic disease prevalence, our healthcare workers need to evolve in tandem. in Singapore. Nurses make up the largest proportion of (wo)manpower amongst healthcare professionals The healthcare landscape in Singapore has seen tremendous change and play a critical role in leading as well as effecting transformative change in healthcare in the last century. Advancements in medical knowledge and technology delivery. They form the most resilient workforce, as evident in how they launched into action have brought about new possibilities in how we prevent, diagnose and treat to manage the COVID-19 outbreak that we faced. They had to adhere to revised updates on diseases, as well as how we care for our patients. infection control procedures and many acquired new skillsets so that they could be deployed to Our nurses have been pushing boundaries and embracing change other areas of need. along the way. When digitisation and technology changed the way we For long-term sustainability, we must continually ensure that our nursing workforce grows, delivered care, nurses not only equipped themselves with new skills and adapts and develops skillsets that ensure their knowledge and practices are relevant. Over the competencies, but also adopted the use of technology to enhance patient years, the Ministry of Health introduced initiatives to grow the nursing workforce. For example, care. the Professional Conversion Programme in Nursing to encourage mid-career switches to A/Prof Benjamin Ong Our nurses’ scope of practice has also expanded. Advanced Practice nursing, and the Care To Go Beyond campaign to promote the profession to a wider audience. Director of Medical Services Nurses may now collaboratively prescribe medication, while Community These initiatives boosted our nursing workforce by some 17 per cent between 2013 to 2018. (2014 – January 2020) Nurses lead the community nursing posts to help clients manage their We now have more than 42,000 nurses, forming the backbone of our healthcare system. conditions in the community and at home, enabling them to age in place. To support their professional growth and development, we have introduced new More recently, as Singapore tackled the COVID-19 outbreak, nurses opportunities and pathways for upgrading. For example, the Community Nursing Competency stepped forward to the call of duty. Many were amongst the first to be Framework articulates the skills and competencies required of nurses practising in different deployed to our border checkpoints to step up temperature surveillance community care settings at various stages of their career. This facilitates the development and health screening. They work tirelessly in our healthcare institutions to of nurses within the sector and prepares those in the acute sector to move into community care for our patients. Together, nurses and our healthcare colleagues on nursing. The National Nursing Academy was set up to coordinate and support lifelong, the frontline work as a team to fight the disease. workplace learning for nurses across institutions, schools and training providers. It will develop We can always count on our nurses’ resilience and dedication in times of competency frameworks, enable course accreditation, skills recognition and qualification emergency or crisis, to deliver the best care to their patients. systems. It will also allow workplace-based training to be portable across institutions and This book, “Nursing: Our Profession, Our Pride” is a celebration of this settings. meaningful profession. I am encouraged to read about the lives of so many This book, “Nursing: Our Profession, Our Pride” captures the developments of the nursing who have chosen to dedicate themselves to serving the frail and the sick, profession through the eyes of those who have made nursing their career. As the stories of A/Prof Kenneth Mak and be an advocate and source of support to our patients. our nurses – whose lives speak of their commitment and dedication in caring for our patients Director of Medical Services I would like to thank all nurses in Singapore for giving yourselves and – are panned out in the book, it affirms in us that we have steered the profession in the right your time to care for others. Truly, you care to go beyond! direction. While the focus of doctors is to cure, it’s the prerogative of nurses to care. We sincerely thank Mr Gan Kim Yong all our nurses for rising to the occasion whenever called for. Thank you for caring! Minister for Health 4 5 MESSAGE FROM WHAT you hold in your hands is a huge chunk of acknowledgment of the work done by nurses and CHIEF NURSING OFFICERS Singapore’s nursing history, which dates back to midwives as well as a reminder of the critical role 1 August 1885 when the French nuns stepped out of they play in keeping the people healthy. Yes, this is a Nursing Then, the Convent of the Holy Infant Jesus to nurse patients profession we are proud to belong to. at the Sepoy Lines. The first part of this 135-year history was Visioning and Leadership Development documented in a book titled More Than A Calling. In 2009, nursing leaders from the acute hospitals Nursing Now Published in 1997, it charted our noble profession’s came together for the Director of Nursing Leadership milestones from those humble beginnings all the Team workshops to brainstorm their shared vision way to that year. This book picks up from where it for nursing and to develop their collective, individual left off, and captures the salient aspects of nursing and team leadership skills. These development efforts development thereafter… through the experiences of were expanded to include second-level nursing leaders our very own nurses. and were the precursor to the establishment of the At the time of writing, we are in the midst of fighting Healthcare Leadership College in 2012. the global COVID-19 (Coronavirus Disease 2019) In addition to the united vision for nursing, two pandemic. It is reminiscent of the SARS (Severe Acute major reviews took place in recent years. Their of nurses. Comprising more than 60 nurses from Respiratory Syndrome) outbreak in 2003 and, once recommendations were wide-ranging and aimed to across the healthcare system and related healthcare again, our nurses are at the forefront of the battle take the nursing profession further and ensure its sector colleagues, the NNT recommended the CARE alongside other members of the healthcare family. sustainability. package – with 15 recommendations in the areas of They are caring for patients infected by the virus, as Career development, Autonomy, Recognition and well as ensuring that patients with other illnesses National Nursing Taskforce Education. This included increasing opportunities for continue to receive the care they need. The loss of In 2012, the National Nursing Taskforce (NNT) was professional growth to meet career aspirations and one of our own in 2003, Nursing Officer Hamidah formed to make recommendations for enhancing sponsorships for upgrading; increasing nurses’ base Ismail who was infected by the index SARS patient, is growth, professional development and recognition monthly salary; re-designating the top nursing role in a stark reminder of how nurses put their patients first, often disregarding the pleas of loved ones to quit the profession and “come home”. 1999 2000 Not only have nurses displayed immense courage Enrolled Nurse President S.R. Nathan – this was recognised when Mdm Kwek Puay Ee, then education is presents the inaugural Director of Nursing at Tan Tock Seng Hospital, received transferred President’s Award for from the School Nurses in recognition the Medal of Valour in 2003 for leading her nurses of Nursing to of their outstanding through the SARS crisis – they have also notched the Institute performance and of Technical contributions to the TAN SOH CHIN PAULIN KOH up many achievements to be proud of. This had led Education. profession. MILESTONES CNO (January 2015 – June 2020) CNO the World Health Organization (WHO) to designate 2020 as The Year of the Nurse and Midwife, a timely
6 7 restructured hospitals as Chief Nurse and effectively Technical Education (ITE) and graduate diploma programmes. allowed for a nurse to be the Chairman of the Board, a recognising them as part of the C-suite in hospital in 1999. Over the years, Looking forward, we established the National first for the profession. Nurse Nellie Tang was formally senior management. the nursing education Nursing Academy (NNA) in 2019 to promote continuing appointed to the position in 2006. system has evolved education and training, enabling nurses to continue Future Nursing Career Review Committee with the enhancement their professional development through workplace- Advanced Practice Nurse Development Established in 2016 to identify areas of transformation of training curriculum. based learning. The introduction of the APN role in Singapore was in for the nursing profession, the Future Nursing This has equipped our line with the global development of nursing, where Career Review Committee (FNCRC) had nine nurses with the right Nursing Regulation Master-prepared nurses were able to take on more recommendations. They were assembled under skills and competencies The Nurses and Midwives Act 1975 was repealed in complex nursing 3Cs – CARE: Enable nurses to focus on patient care; to practise in a 1999 and replaced that year, enhancing the role of and make care COMMUNITY: Strengthen community nursing; and transformed healthcare the Singapore Nursing Board. It also improved the more accessible for COMPETENCY: Develop competencies to prepare system, and in protection of the public by making it an offence for patients. nurses for the future. Job-redesign and more expanded roles. unqualified persons to call themselves nurses or The APN automation were introduced. With a greater emphasis The Alice Lee Centre for Nursing Studies (NUS midwives, and for employers to hire people without certification on community nursing, nurses were also equipped Nursing) was established in 2005 to provide the right qualifications to practise as such. Practising requirements with broad-based skills – all to enable better patient Singapore’s first Bachelor of Science (Nursing) certificates were issued for practising nurses and and register were care, especially in the community. programme. Its first cohort began their studies a year midwives; provisional registration and temporary established through the Nurses and Midwives Act later. In 2009, it also took over the running of the registration were also introduced. in 2005, and APNs were certified under one of four Nursing Education Master Degree in Nursing (the training of Advanced The Act was amended in 2005 to provide for the specialised branches of nursing: Acute Care, Medical/ With the closure of the School of Nursing, the Practice Nurses or APNs) which had been introduced regulation and certification of APNs and introduced Surgical, Community Care and Mental Health. In 2007, polytechnics took on the role of preparing our in 2003, under NUS Medicine’s Division of Graduate Continuing Nursing Education as a condition for we saw the first batch of APNs certified. Registered Nurses (Nanyang Polytechnic in 1992 and Medical Studies. Post-registration nursing education the renewal of APN practising certificates. It also Ngee Ann Polytechnic in 2005) while the Enrolled was also augmented, with the introduction of diploma- provided for the Director of Medical Services or his Collaborative Prescribing Nurse education was taken on by the Institute of to-degree upgrading programmes as well as advanced representative to be a member of the Board. This A further enhancement to the APN role was the
2003 2005 2006 2009
Nurses are hailed The Alice Lee Centre The Tan Chin Tuan The Director of as heroes for for Nursing Studies Nursing Award is Nursing Leadership their frontline (NUS Nursing) is established by the Team workshop role in the established to offer D.S. Lee Foundation to is held and nurse nation’s battle Singapore’s first honour outstanding leaders develop against Severe full-time Bachelor Enrolled Nurses in a common vision Acute Respiratory of Science (Nursing) Singapore’s healthcare for the future of Syndrome (SARS). programme. institutions. nursing. MILESTONES
8 9 introduction of collaborative prescribing rights even have their own hard hats for use during on-site A Community Nursing Competency Framework (CTGB) campaign was launched in 2013, engaging for APNs in 2019. This enabled APNs and senior inspections in the building process. (CNCF) was also developed in 2019, articulating the current nurses to share stories about their lives and pharmacists who had completed and passed the roles, responsibilities and competencies required their work. Nurse ambassadors are also engaged to National Collaborative Prescribing Programme, and Strengthening Community Nursing of community nurses in various care settings. The reach out to the young ones through social media who had been credentialled by their institutions, to Faced with an CNCF serves as a reference for nurses to develop the platforms and outreach activities at schools and prescribe medications for their patients, thereby ageing population, competencies required to care for patients in those community events. We also ran three seasons of a affording the patients greater convenience. community nursing settings, and for employers to plan for the necessary Channel 8 nursing drama, You Can Be An Angel Too. has become training and development of their nurses. Nurses provided consultation and inspiration to the Nursing Role Development an increasingly story planning and scripting teams as well as on-site Over the years, nurses have developed their skills to important aspect Outreach, Branding and Recruitment guidance to ensure that nursing procedures were expand the scope of patient care. Nurse-led clinics, of nursing in recent Programmes such as the Asian Nursing Scholarship accurately portrayed. Nurses also played cameo roles new nursing procedures and nursing innovation have years. Community nursing teams have been making and the Professional Conversion Programme (PCP) in all seasons. all come to the fore, backed by research, and more home visits to patients and Community Nursing Posts were introduced to help build up the nursing We are pleased to say these efforts have paid off, often than not conducted by nurses. Many of the have been set up around the island, to make care workforce. Since its introduction in 2003, the PCP has and nursing intakes at the schools increased by 30 per hospitals have nursing innovation teams which have more accessible to Singaporeans. Regional Health been an avenue for many mid-career switchers to find cent from 2013 to 2018. developed devices, products and procedures that all Systems have also been piloting community nursing their true calling in nursing. In contribute to better patient care. models in an effort to meet the unique needs of the 2018, NUS Nursing introduced Recognition Nurses have also played a big role in the patients in their geographical service areas. a two-year Bachelor of Science Many know that nursing is a noble profession – and we development and building of hospitals and other To develop nurses and nurse leaders for the sector, (Nursing) programme for such were deeply honoured when, in 2000, then President healthcare facilities to care for our growing and ageing a Community Nursing Scholarship was launched in mid-career switchers. of Singapore S.R. Nathan inaugurated the President’s population. Unknown to people outside the healthcare 2017 and the Singapore Nurse Leaders Programme in In an effort to encourage Award for Nurses. As the nation’s highest accolade sector, there is a substantial number of nurses on the 2018. These were designed to equip nurses with the more young people to for nurses, the award is presented to “role model” teams which provide inputs to the development and necessary knowledge and skills to lead across settings choose nursing as a career, nurses who have made outstanding contributions commissioning of the new hospitals – some of them from acute to community care sectors. the Care To Go Beyond to the nursing profession and the community. The
2013 2014 2014 2017
The national The Ministry of The School of The Future branding campaign Health’s National Nursing, which Nursing Career Care To Go Beyond Nursing Taskforce closed in 1999, is Review Committee is launched to recommends a CARE demolished. The site recommends 3Cs – promote the package to improve is used for the new Care, Community nursing and allied Career development, Outram Community and Competency – to health professions Autonomy, Recognition Hospital (which was transform the nursing in Singapore. and Education of nurses. completed in 2019). profession. MILESTONES
10 11 award continues to be Observatory for Licensure said: “Save one life, and greater insight into the presented annually by the and Registration. you’re a hero. Save a broad realm and possibilities President of Singapore at Singapore also became hundred lives and you must of nursing, thereby inspiring the Nurses’ Day Reception associated with the be a nurse. It is an honour more to respond to the held at the Istana. International Nurse to be among so many calling of being a nurse. Other awards for Regulator Collaborative heroes this evening.” Last but not least, we nurses include the Nurses’ as well as an Associate would like to make a special Merit Award and the Tan Member of the American Conclusion mention of the nurses Chin Tuan Nursing Award National Council of the We hope that our who were involved in the for Enrolled Nurses. We are also proud that nursing State Board of Nursing. President’s words above creation of this book – the students have topped their cohorts across the School In 2019, the Singapore Nurses Association hosted will continue to inspire artworks and photography of Health Sciences, and won the Tay Eng Soon Health the International Council of Nurses (ICN) Congress in our nurses and the many more who will walk in their that fill these pages are original works by nurses. The Sciences Award and Tay Eng Soon Gold Medal (the Singapore. The theme for the five-day conference was footsteps. As nurses, we have a responsibility to Resource and Advisory Committees, responsible for latter recognises the top student in the polytechnic ‘Beyond Healthcare to Health’, and it was attended develop our knowledge and skills, our profession and content development, comprised nurses too. So you cohorts who came from an ITE). Such awards recognise by more than 5,000 delegates from 140 regions and future generations of nurses so that we can continue could say that this book is really… made by nurses, the importance of nursing and encourage nurses to territories. We were honoured that the event was to care for those who need us. We want to thank all about nurses and for nurses. We hope you will continue to give their best. We are heartened by the graced by the Director-General of the WHO, Dr Tedros nurses for the care, compassion and warmth they enjoy reading it as much as we have enjoyed seeing it nominations received from the public and healthcare Adhanom Ghebreyesus, and Singapore’s President bring to their patients and people around them; and come together. We would also like to thank the MOHH sector colleagues which express their admiration and Mdm Halimah Yacob was the Guest of Honour. The nurses who have dedicated their time and career Corporate Communications team for coordinating the support for nurses. presence of our President at the ICN Congress was to help to shape and advance the profession. We overall work – from conducting interviews, to writing a strong signal that the voice of nurses is heard in are thrilled that some of these talented nurses and the stories and providing direction for the artwork for Singapore Nursing on the International Stage Singapore at the highest level. In her speech, President outstanding role models are featured in this book. the book. Having run the Care To Go Beyond campaign In 2011-2012, then CNO Pauline Tan was invited to be Halimah lauded the nurses for having the passion, We hope their stories will make existing nurses proud for almost a decade, they are truly a part of the part of the 10-member International Council of Nurses resilience and stamina to carry out their roles. She of their passion and profession; and give readers a nursing family.
2018 2018 2019 2020
Collaborative The Singapore Nurse The National The Community Nursing Prescribing privileges Leaders Programme is Nursing Academy Competency Framework are introduced to introduced to develop is established is launched. It defines enable Advanced mid-level nurses for to coordinate what is expected of Practice Nurses to better collaboration and strengthen community nurses prescribe medicines and support to the workplace-based by describing the in a collaborative community care training and develop competencies required framework. sector. nursing capabilities. and the scope of work. MILESTONES
12 13 Faces of Change, Making a Difference FACES OF CHANGE, MAKING A DIFFERENCE
Strengthening the It was very sudden as norms for general wards the original scholarship and intensive care units approved by MOH.” recipient resigned with “ To address the need to have one day’s notice and advanced clinical education for threads of care nurses, Beng Choo and her I was asked if I was team started the Master of open to nursing Nursing course at the National ANG BENG CHOO administration. Though University of Singapore (NUS) Chief Nursing Officer (2001-2007) I knew administration in 2003. The 18-month course trains Advanced Practice Nurses Ministry of Health would be tough, (APNs) who collaborate with doctors I thought I might as and other healthcare professionals A SINGULAR belief took Ang Beng well give it a try. to diagnose and manage common Choo to the School of Nursing in 1969… medical conditions, including chronic responsibilities and raised their status that nursing was her calling. Once a illnesses. The team also worked with as an important contributor to the nursing student, she expected to stay After getting her degree, this NUS to start the three-year Bachelor of healthcare system. on the clinical path through her career. soft-spoken lady took on management Science (Nursing) at the Alice Lee Centre Another key milestone for nursing However, serendipity had other ideas. roles in various hospitals and at the for Nursing Studies in 2006. was having a nurse chair the Singapore At age 35, while working at Singapore Ministry of Health (MOH), where she was “I was fortunate to work with a Nursing Board, a role previously held General Hospital as a Nursing Officer, Chief Nursing Officer (CNO) from 2001 great team during my stewardship as by the Director of Medical Services she was offered a World Health to 2007. Overseeing policy development CNO,” Beng Choo said. “Many people who was a doctor. In addition, a Organization scholarship for the for the nursing profession in Singapore, helped me along the way, including structured career path was introduced Bachelor of Applied Science (Nursing) at she realised “nurses were stretched on (Nurse Educator) K. Premarani, who for registered nurses who could grow Curtin University in Australia, majoring in the ground”. was instrumental in designing and and develop their skills in three areas: administration. In response to the manpower crunch, coordinating the master’s and bachelor’s clinical, education and management. “It was very sudden as the original Beng Choo and her team introduced courses as I was not a Nurse Educator.” Not surprising then that this scholarship recipient resigned with one staffing norms in the acute hospitals to Thanks to the team’s efforts, the unassuming nurse has had a passion day’s notice and I was asked if I was ensure patients’ safety. Nurses and Midwives Act was amended for needlework – sewing, knitting and open to nursing administration. Though “There were only broad guidelines in 2006 to include the regulation of crocheting – since her school days. I knew administration would be tough, then and staffing was left to the APNs. This was a key milestone in the After all, she did play a significant role in I thought I might as well give it a try,” discretion of each hospital,” she said. profession’s progress as it recognised stitching together the nursing tapestry Beng Choo, now 68, recalled. “We got staffing ratios and manpower the nurses’ potential to take on added in Singapore.
16 17 FACES OF CHANGE, MAKING A DIFFERENCE
Now 60, Pauline considers nursing empowerment and self-leadership a calling and a service to mankind. programme for nurses, or Nursing “So, I served with my whole heart,” DIY. The sky is her limit she added. “And I think my These paved the way for the leaders noticed; they gave me National Nursing Taskforce in opportunities.” 2012 and the Future Nursing One such opportunity was Career Review Committee in PAULINE TAN a World Health Organization 2016. Pauline’s sense of mission Scholarship which armed her caught the attention of the Chief Nursing Officer (2007-2014) with a Bachelor of Nursing and International Council of Nurses, Ministry of Health Graduate Diploma in Nursing which invited her to sit on the Administration from La Trobe 10-member International Observatory University in 1983. More than a for Licensure and Registration. As a FROM Enrolled Nurse to Chief Nursing decade later, she added the Master of result, Singapore had a place on Officer to Chief Executive Officer… not Science in Asia-Pacific Human Resource the international nursing map. This bad for someone who, at age 18, joined Management at the National University was followed by four years at Yishun nursing to supplement the household of Singapore. Don’t be afraid to take Community Hospital where, as its first income. No wonder Pauline Tan says By 2007, when she was the Institute risks and don’t discount Chief Executive Officer (CEO), she set her personal motto is “to be the best of Mental Health’s Director of Nursing, yourselves. You can be up the hospital to serve patients in the that I can be”. the Ministry of Health (MOH) came “ north. Drawn to nursing after being inspired knocking: they wanted her to be its Chief anything you want to be. “Nursing taught me to care for by a close nurse-neighbour, Pauline Nursing Officer. The sky is the limit! patients in so many aspects, including started her career at Tan Tock Seng The avid learner agreed, taking on a the psychosocial, emotional, financial Hospital. She still remembers a patient Master in Public Administration at the and spiritual. I’m glad my nursing who suffered from lupus (a disease Lee Kuan Yew School of Public Policy to The 2006 President’s Award for background enabled me to approach where one’s immune system attacks be better at her role. Nurses recipient recalls inviting things as CEO in a holistic, systematic the organs and tissues). Although the Pauline faced three key challenges organisational development thought and objective manner,” she said. patient was very demanding, she recalls during her seven years at MOH: unifying leaders Daniel Kim and Diane Cory Now, having moved to private building rapport with her and they the nursing community to pursue (D&D) to conduct workshops for healthcare, she affirms that she’s still a corresponded via letters for many years: national objectives over institutional nursing directors and leaders in 2009. It nurse at heart. And here’s her advice to “Years later, after seeing her obituary in and cluster goals, enhancing the turned out to be the “galvanising move nurses: “Don’t be afraid to take risks and the newspaper, I went to her wake to intermediate and long-term care sector for collective envisioning of what we don’t discount yourselves. You can be say goodbye because of the bond I had and developing the profession at the wanted nursing to be”. Subsequently, anything you want to be. The sky is the built with her.” national level. a local consultant customised a self- limit!”
18 19 FACES OF CHANGE, MAKING A DIFFERENCE
GROWING up, Yong Keng Kwang, Paulin Koh and the development of the nursing profession, and Margaret Lee never thought they would become the Future Nursing Career Review Committee nurses. However, Keng Kwang and Margaret are (FNCRC) in 2016 to develop future-ready nurses. now Chief Nurses (at Tan Tock Seng Hospital and Agents of change NNT was “a springboard to APNs’ rights to Alexandra Hospital respectively), while Paulin prescribing today” and there are now “more has just moved from the Chief Nurse role at stories about nurses in the public domain”, Keng Changi General Hospital to take on the mantle Chief Nursing Officer’s Office at MOH from 2003 Kwang observed. of Chief Nursing Officer at the Ministry of Health to 2005, where she had a hand in amending Meanwhile, FNCRC increased awareness that (MOH). All three still have a common mission… to the Nurses and Midwives Act to introduce the nurses must embrace technology and build inspire nurses to propel the profession to greater Advanced Practice Nurse (APN) role. Now, capability in the community. Paulin explained: “As heights. the 52-year-old mother of two and jogging our population ages, nurses must help people Keng Kwang and Paulin signed up for enthusiast is back for a second stint at MOH live well, get well and age well, playing a role from nursing through the Public Service Commission as the Chief Nursing Officer. preventive health all the way to end-of-life care.” Scholarship. However, Keng Kwang – an Margaret joined the National University She is heartened that perceptions of nursing avid football player in his younger days and Hospital in 1996 and was an Assistant are changing. Instead of bedside care providers regular gym-goer to this day – wanted to be a Director of Nursing when she was offered who do mundane work, Paulin feels nurses are physiotherapist while Paulin was originally a the opportunity to lead the nursing team at now seen as highly knowledgeable and skilled National University of Singapore biology graduate. Alexandra Hospital (AH, which came under professionals who work with many care providers Margaret only chose to take up nursing after her the National University Health System in and deal with IT and data processing. Margaret O levels. June 2018). The 44-year-old mother of added: “Nursing has progressed from a role that Thankfully, they found their calling; nursing is three is now the Chief Nurse at AH. was more about taking orders to a thinking role their first, and only job. In their decades of nursing, the three of which develops thought leaders.” At Tan Tock Seng Hospital, which he joined in them have witnessed and been agents of As a result, she felt nurses are now increasingly 1996, Keng Kwang played key roles in the Nursing the profession’s transformation. involved in decision-making, governance and Division’s quest for ISO, SQC (Singapore Quality The Daniel Kim and Diane Cory (D&D) policy-making. Class) and Joint Commission International (JCI) workshops in 2009, where Singapore’s nurse This trio has great hopes for future nurse accreditations. The 49-year-old father of three leaders brainstormed for the future of nursing, leaders to continue the good work and they actively championed Lean initiatives, quality were particularly memorable for Keng Kwang. have a wealth of experience to impart. Margaret improvement projects and the use of innovative The recipient of the 2014 President’s Award for summed it up best: “We must be certain of our technology. Nurses said: “Those sessions convinced us that value as nurses before we can take the leap of Paulin, meanwhile, rose through the ranks over nurses have more to contribute and united us YONG KENG KWANG PAULIN KOH MARGARET LEE faith to do things that were not done before. We 20 years at KK Women’s and Children’s Hospital to pursue a national agenda.” Chief Nurse Chief Nursing Officer Chief Nurse must also look beyond our clusters’ diversity and before joining Changi General Hospital as Chief MOH subsequently set up the National be united in striving for what’s important. After all, Tan Tock Seng Hospital Ministry of Health Alexandra Hospital Nurse in 2014. In between, she did a stint at the Nursing Taskforce (NNT) in 2012 to strengthen we exist only because of the patients we care for.”
20 21 FACES OF CHANGE, MAKING A DIFFERENCE
THERE is a group of cheerleaders within Singapore’s nursing fraternity Spreading #happinurse who spread the word about nursing to everyone they meet, debunking myths and stereotypes, and share why they chose to be a nurse – one story at a time. Meet the Care To Go Beyond (CTGB) ambassadors! When Muhaymin Sopii had an offer to join the police force after his National Service, he passed on it as he was more drawn to the heartwork of nursing. That said, not everyone was open to the idea of him becoming a nurse and he revealed he was called siao (crazy in Mandarin) for choosing the profession. Which is why Muhaymin, 37, uses his ASHLEIGH PANG IAN ELANGKOVAN MARILYN DAVID MUHAYMIN SOPII THOMAS LEE role as a CTGB ambassador to share Staff Nurse Staff Nurse Lecturer Staff Nurse Senior Staff Nurse his experiences in nursing and the Tan Tock Seng Hospital KK Women’s and Children’s Hospital Nanyang Polytechnic Changi General Hospital National University Polyclinics enormous satisfaction he gets from his career: “Hearing parents tell their children ‘next time, you can be a nurse a couple gained a new perspective of said he was initially apprehensive ambassador – from a nursing student to the reason I joined.” 14, as the main caregiver to her mother too’ makes me feel like I’ve hit a home nursing after speaking with him. “They about talking to people about his a full-fledged nurse – helped her see the The Healthcare Merit Award who was diagnosed with cancer, she run!” were surprised to learn about the profession: “As a student nurse, I felt growth of the profession over time. scholarship recipient added: “With more saw how nurses who cared for her mum Ian Elangkovan and Thomas Lee sing different career tracks available,” he like I had little to offer. But I started “There is not only an increasing people joining the profession, I think the were ever-present and implemented the the same tune. As nursing ambassadors, recalled with a proud smile. sharing experiences about my clinical number of applicants for the nursing future of healthcare looks promising.” care plans for each patient with a smile. they take the opportunity to debunk In late 2016, Ian had just started attachments, and stories I heard degree every year, but also a growing In Marilyn David’s case, a personal The 32-year-old mother of one said: myths, especially those about male nursing school at the National University from my professors, which made a cohort for the course at NUS,” observed tragedy spurred her to join the “As an ambassador today, I believe that nurses. of Singapore (NUS) when he was difference.” Ashleigh, 25. “Being an ambassador profession… and she shares this openly nurses contribute to something greater Thomas, 33, recalls his most gratifying nominated as an ambassador. The His former schoolmate Ashleigh allows me to change negative with the young people she meets at than themselves, and I want to spread moment at a CTGB outreach event when 25-year-old, now a Paediatric Nurse, Pang recounts how her years as a CTGB perceptions of nursing, and to reflect on CTGB outreach events. At the age of the word far and wide.”
22 23 FACES OF CHANGE, MAKING A DIFFERENCE
biology module. “I had to I have no regrets being a nurse and nursing profession. study very hard to catch I’m happy that people view nursing more Despite her success, Never too late for nursing up, but I refused to give this amiable lady up,” said the passionate “positively today. To the team behind the remains humble and GROWING up in rural Malaysia, lady, who used to cope campaign, don’t stop what you’re doing. maintains that her DIONG NGUK SING Diong Nguk Sing was drawn to with the stress by taking And to those interested in the PCP, my biggest motivation nursing. However, her family’s financial a bicycle out for a spin at comes from seeing her Nurse Manager circumstances and the lack of East Coast Park. advice is to give it a shot and not give up! patients recover. She St. Andrew’s educational opportunities led her to Nguk Sing’s dream fondly remembers one Community Hospital administrative jobs in Malaysia and then finally materialised when journey to work, where Singapore. she graduated as a Registered Nurse in a former patient recognised her and “My family was very poor and we 2005 and started work at St. Andrew’s called out to thank her for her care. lived in a kampong (village) in a rural Community Hospital (SACH). The “During her stay at SACH, she was very part of Malaysia. There were limited transition from an office job to nursing ill and could not eat or speak well. I opportunities to study nursing there,” was initially challenging for her as she was very happy to see her looking so she recalled. had to learn how to deal with patients’ healthy!” she recalled with a smile. After graduating in 2001, she joined family members. Being patient and Now a Singapore citizen, Nguk Sing is a biochemical company here. Two years being able to listen were key, she said. also heartened by how the perception later, she heard about the Healthcare Since then, Nguk Sing has made of nursing in Singapore has improved Professional Conversion Programme great strides in the profession, both over the years from being considered (PCP) for nurses – a two-year nursing professionally and academically. Now a a menial job to now where it is seen as programme offered by Workforce Nurse Manager at SACH, she received a promising, fulfilling career. She gives Singapore for mid-career switchers who her Advanced Diploma in Gerontology part of the credit to the Care To Go wish to be nurses. Nguk Sing, who was from NYP in 2011 and a degree in Beyond branding campaign for nursing 26 then, seized the opportunity and nursing from Griffith University in 2013. and allied health. applied for it. The culmination of all this hard work “I have no regrets being a nurse and Her return to school to pursue was the Nurses Merit Award in 2015, I’m happy that people view nursing more a Diploma in Nursing at Nanyang which she was gratified to receive. The positively today. To the team behind the Polytechnic (NYP) was not entirely award is given to nurses who have campaign, don’t stop what you’re doing. smooth sailing though. As English is shown consistent and outstanding And to those interested in the PCP, my not her first language, she struggled to performance in their work, and have advice is to give it a shot and not give keep up in class and had to retake her made contributions to promote the up!”
24 25 FACES OF CHANGE, MAKING A DIFFERENCE
I am very fortunate! Many people supported me, future nurses,” said the mother of two allowing me to get to where I am today as an APN boys, who enjoys visiting art exhibitions, The rebel scholar painting and spending time with her and yet have the chance to teach. This is important “ family. as it is about training our future nurses. As for the big decision she made all those years ago, Wentao has no regrets becoming a nurse instead of a doctor: “Healthcare is 30 per cent It all paid off when, armed with her Neuroscience Institute (NNI). The dual treatment and 70 per cent care, where Diploma in Nursing from Nanyang role enables her to keep up to date nurses play a big part. Nursing is a Polytechnic (NYP), she started work with clinical changes, helping her to be humble profession and, if we work at Tan Tock Seng Hospital (TTSH) in more confident and for her teaching to hard together, we will be able to 1997. As she settled into life here – she remain relevant. Her clinical experience lead Singapore into the next era of became a Singapore citizen in 2002 – and sharing also help students healthcare.” Wentao kept furthering her academic embrace new technology and better qualifications in nursing, with some transit from students in the Master of financial assistance from her employer: Nursing programme to APN interns. an advanced diploma in neuroscience, As a qualified collaborative a bachelor’s degree, a master’s degree prescribing practitioner, and, by 2019, she achieved her PhD. she contributes to It was during her PhD work at the better patient care as National University of Singapore (NUS) she is able to order when the school invited her to become tests and prescribe footsteps to be a doctor. A year later, rebel!” said Wentao, with a laugh. a lecturer, a role she took up to give medications. ZHOU WENTAO driven by a desire to be independent Having qualified for the ANS, she back to the school. “I am very Senior Lecturer and Programme and study overseas, she had signed up convinced her parents that it was a Now, this feisty 47-year-old lady is a fortunate! Many Director, Master of Nursing, for the Asian Nursing Scholarship (ANS). genuine programme and they eventually Senior Lecturer and Director, Master people supported Alice Lee Centre for Nursing Studies “I did not know much about the supported her decision. Determined of Nursing Programme at NUS Nursing me, allowing me to National University of Singapore scholarship. All I knew was that they to not let them down, Wentao worked where she teaches clinical reasoning get to where I am were having interviews at my school, “thrice as hard”, especially since English and neuroscience-related topics. today as an APN and AT 19, Dr Zhou Wentao was a first-year so I decided to go with my roommate. wasn’t her first language. It took hours Her teaching hours allow her to also have the chance to student in Qingdao Medical College I wanted to go overseas and be of practice and a “thick skin” for her to include clinical work as an Advanced teach. This is important in China, following in her mother’s independent, away from my family. I’m a master the language. Practice Nurse (APN) at the National as it is about training our
26 27 Teaching to Care, Caring to Teach TEACHING TO CARE, CARING TO TEACH
kept knocking on her door. In 2014, it came in the form of hospital one day a week. This way, students can benefit from The an offer to head NUS Nursing. Her response: “Being a senior their lecturers’ insights from the clinical setting too.” nurse, how could I simply watch from the sidelines and not Emily finds it gratifying to see that many NUS Nursing extend a helping hand?” students are considered leaders in their fields and Together with her team, the 2012 President’s Award acknowledged for their work with accolades like the Nurses’ accidental for Nurses recipient developed the part-time Bachelor of Merit Award. “Not only are they given opportunities to Science (Nursing showcase their knowledge, but they also move up the career Not only are they Practice) as well as the ladder quickly. My dream is that the school continues to degree programme attract talented students and be seen as a world leader in given opportunities educator for the Professional nursing education,” she added. to showcase their Conversion With her time stretched as much as it is, this cheerful lady “ Programme for decompresses by whipping up scrumptious Peranakan dishes EMILY ANG knowledge, but they Registered Nurses such as ayam buah keluak for her family. “Nothing makes me Head, Alice Lee Centre for Nursing Studies also move up the and the Graduate happier than seeing the satisfied smiles on the faces of my National University of Singapore career ladder quickly. Diploma in Community family after they taste the dishes,” she said. Group Chief Nurse Health Nursing. NUS And then, with a grin, she added: “With the exception of National University Health System My dream is that Nursing also offers nursing, of course!” the school continues a PhD programme THERE are days when being called professor still bemuses to attract talented for budding nurse Emily Ang, Head of Alice Lee Centre for Nursing Studies at the students and be seen researchers. National University of Singapore (NUS Nursing). as a world leader in In 2018, the school As a young student, she expected to be working in the ward had its largest intake as a “regular” nurse. However, as fate would have it, being one nursing education. for the nursing degree of the top nurses in her hospital earned Emily a scholarship programme, with 313 to study oncology in the United Kingdom. On her return in students comprising the late 1980s, she was tasked to conceptualise and launch school leavers and mid-career professionals. the Certificate in Oncology Nursing at the School of Nursing Now, this veteran nurse, who is also the Group Chief Nurse to advance oncology care in Singapore. When the School of of the National University Health System, finds joy in inspiring Nursing closed its doors in 2000, Emily – by now, referred to students and influencing care at the bedside. Even as she proudly as “Prof Emily” by the nursing community – went on to finds herself implementing new pedagogies and developing Nanyang Polytechnic to set up the Advanced Diploma in Nursing curriculum, the self-described “perfectionist” believes in (Oncology). staying relevant in the clinical setting. After all, that is what Even after Emily returned to the clinical setting, academia nursing is all about. As she puts it: “My colleagues work in the
30 31 TEACHING TO CARE, CARING TO TEACH
programme, nurses What gives me the most satisfaction is dressing, lacrimal syringing could not progress, and that the course intake, though small, is and many more! these were excellent Again, Chitra took the slowly increasing. All the students who An eye for education nurses. I felt that I had “ opportunity to come up with to do something,” she have completed the programme so far an in-house programme, explained. have done well and are now eye-trained. the Senior Enrolled Nurse By 2016, she had Development Programme CHITRA VALLEI GOVINDASAMY done something about (Ophthalmology), to train Assistant Director of Nursing it. Chitra co-founded the Enrolled Nurses to take Education Development Unit in SNEC, SNEC clinics. With the introduction of on these tasks. “Now, I’m sure you can Singapore National Eye Centre working towards having a graduate the Intra-vitreal Injection by Registered guess with Enrolled Nurses taking on certificate in ophthalmic nursing in Nurses module in the graduate the work of the Registered Nurses, who collaboration with Curtin University in programme, more nurses have gained would take on what the Enrolled Nurses CHITRA Vallei Govindasamy’s first job Australia. competency in the skill. The outcome used to do? We trained ophthalmic as a school clerk left her wanting more. “Together with an education was double-edged though; the assistants to take on their job scope, “Instead of poring over papers, I wanted to consultant, I developed the curriculum Registered Nurses were stretched as of course! The payoff? The doctors are show care to those in need. Nursing was and this was all very new to me. What they also had to perform ophthalmic less stressed, patients are happier and the first profession that came to mind and gives me the most satisfaction is that procedures such as post-operation eye the nurses are upskilled! I call that killing I dived in head first, without even doing the course intake, though small, is slowly three birds with one stone,” she said, any research,” recalled the unassuming increasing. All the students who have with pride. Assistant Director of Nursing (ADN) with a completed the programme so far When not thinking about how to laugh. have done well and are now eye- improve her nurses’ skills, her She entered the School of Nursing trained. They can finally move family takes up the rest of the in 1986 and joined National University on to do their master’s and headspace of this chatty Hospital when she graduated. In 1999, PhDs,” said Chitra. 57-year-old mother of two. Chitra was in the pioneer batch of students The hard work has She spends her free time taking an Advanced Diploma in Nursing paid off; not just for watching Hollywood (Ophthalmology) at Nanyang Polytechnic. the nurses, but also blockbusters like Star During her time as a Senior Staff Nurse for patients and Wars and Avengers at Singapore National Eye Centre (SNEC), doctors. In the past, with her family – she was concerned about the course only doctors could “basically whatever being scrapped in 2012 due to a low administer an intra- my teenagers want to intake. “Without a post-graduate education vitreal injection at the watch”.
32 33 TEACHING TO CARE, CARING TO TEACH
had to go overseas to upgrade your skills,” the school’s director Ang Kiam Wee – men said Wei Sern, who saved up for a degree he described as “visionary” – to set up a course in nursing at the University of healthcare simulation centre. Newcastle in 1993. He eventually got Wanting a training centre that a master’s degree from the same guided students in real-life scenarios, university. the team consulted experts from That experience convinced him the United States and Australia. that he could contribute to nursing Said Wei Sern: “At the time it was in more ways than caring for patients. innovative. We called it a SPRING On his return to Singapore in the late model. You spring from classroom 1990s, he became a Nurse Educator in a to reality. It allows students to learn… private hospital. and make mistakes, in a safe and risk-free In 2000, Wei Sern joined the Institute of environment. To give that sense of realism, the Technical Education’s (ITE) nursing programme as a centre has manikins (anatomical human models used TAY WEI SERN lecturer. His timing could not have been better. The School in education) that have physiological changes like a human Deputy Director, Health Sciences of Nursing closed that year and its programme was folded being; they can breathe and have a heartbeat. Students can and Course Manager, Allied Health into the ITE’s Nitec in Nursing course. The first intake had two insert an intravenous cannula (a tube that can be inserted Institute of Technical Education classes, with 80 students. into the body) into the manikin’s arm while the teacher can Fast forward 20 years, and the Nitec in Nursing course simulate vital signs and create scenarios.” has grown to 22 classes with about 500 students each year. In 2013, to align with the Singapore Nursing Board’s And Wei Sern is now the Deputy Director, Health Sciences core competencies, the school developed a critical thinking AT EVERY step of Tay Wei Sern’s journey in nursing, there was and Course Manager, Allied Health at ITE’s School of Applied module. Now an aspirational model for many nursing schools, always a nudge. & Health Sciences. His team has trained over 6,700 Enrolled with many visits from overseas visitors, the centre’s nudge is The first came from his father, who encouraged the then Nurses so far. towards artificial intelligence and augmented reality. Nurturing 18-year-old to join nursing after seeing Wei Sern’s two aunts “This is a significant achievement… That said, Wei Sern – who received and a cousin carve out successful careers in the profession. many of our students have upgraded Empathy, compassion, the 2019 President’s Award for Nurses The second nudge came about five years into his nursing and become Staff Nurses and Nurse care... however far we – believes the human touch is still career, when he was working as a Staff Nurse at Singapore Managers,” said Wei Sern, 55, with some the most important skill for a nurse. go technologically, we General Hospital after graduating from the School of Nursing measure of pride. “ The movie buff who loves to listen tomorrow’s in 1985. He took the leap in 1990 to work for two years in a The nudges hadn’t ended though. as nurses must not lose to classical music adds: “Empathy, government hospital in Saudi Arabia where he realised most The next one came in 2005, when the sight of what is the compassion, care… however far we of his colleagues had a nursing degree. nursing course moved to ITE College go technologically, we as nurses must That led to the third nudge: the desire to upskill himself. East. Wei Sern and his team were asked heart of nursing. not lose sight of what is the heart of nurses “At the time there was no nursing degree in Singapore. You by the then principal Tan Seng Hwa and nursing.” 34 35 TEACHING TO CARE, CARING TO TEACH
LAU MENG ER
Nurse Educator Ng Teng Fong General Hospital Better nurses, thanks to ‘Virtual Nurse’
The future of scenarios. Nurses have to complete all University Health System) in 2013. nursing will change, the episodes in each phase before going Over her six years at NTFGH, to the next level. More than 90 percent she has learnt how to create lesson as we attract a new of the NTFGH nurses have used the app plans, develop a curriculum and even “ and feedback has been positive. embarked on a postgraduate diploma generation of nurses, including myself, who Meng Er, who attended a three- in higher education from the National month course on basic gaming with her Institute of Education. The focus on are digital natives. team so they could communicate better education is reflective of her passion for We need to embrace with the app developers, feels a great helping others that was sparked in her technology to be deal of satisfaction that this app helps teenage years. Learning first aid skills in nurses improve their clinical skills and the St John Ambulance Brigade during better in our work. prepares them for scenarios that they her secondary school days, she enjoyed may encounter. sharing that knowledge with her juniors. “Nurses are very busy. This app Now, Meng Er hopes she and allows them to use it anywhere, any her team can come up with more that uses 3-D gaming technology. time; after their shift or on their way to training apps for nurses, as she “The app is designed to facilitate work or home,” said Meng Er who joined sees them as the way of the future: learning for nurses through practice and NTFGH (now a part of the National “Learning is constantly evolving, not simulation; they can play the scenarios just in healthcare or nursing. We must over and over again on their phones,” embrace new methods of learning and said the mother of two, who had her be open to new ideas that are effective first taste of nursing education as a and relevant. Clinical Instructor at the National “The future of nursing will change, WHEN you first meet Lau Meng Er, she Educator at Ng Teng Fong General using technology on this journey. In fact, University Hospital’s Emergency as we attract a new generation of may remind you of your favourite school Hospital (NTFGH). one of Meng Er’s proudest moments Medicine Department. nurses, including myself, who teacher; warm, encouraging, patient, While the 33-year-old is passionate was being part of the team that The Virtual Nurse comprises are digital natives. We need to and always with a smile on her face. about training the next generation of developed JurongHealth Virtual Nurse, three phases, each containing embrace technology to be better Not surprising, given that she is a Nurse nurses, she is equally passionate about a mobile training application for nurses different episodes or in our work.”
36 37 TEACHING TO CARE, CARING TO TEACH
I came up with a community” tiered system to ensure This mother of two brings the same vigour to her personal life as she does that all wounds will be Giving wings to her professional one. She is an avid “ diver (below), a hobby she picked up to cared for by a team of trained nurses. At the bond with her son (now 34). When she needs to slow down, she turns to her most basic tier, nurses crochet hooks, painting brushes and to wound care knitting needles. who have undergone the basic wound As for that feathered patient, she inspiration to make a crucial decision claims the encounter inspires her to this SUSIE GOH course can manage – taking up wound care as a speciality. day: “My dream, which began in 1998, Master Trainer The move was key in having her efforts simple wound cases. of expanding our wound management recognised with the President’s Award capabilities was met with opposing St Luke’s Eldercare for Nurses in 2011, making her the first views. It frustrates me at times, but nurse from a community hospital to for by a team of trained nurses. At when I think about that eagle, I bounce MOST nurses focus their attention on get that award. the most basic tier, nurses who have right back up.” caring for people. Susie Goh took it Now a Master Trainer at undergone the basic wound course can one step further: she has tended to a St Luke’s Eldercare (SLE) Learning manage simple wound cases. With more feathered “patient” too. Hub – she stepped down from experience and, if they are enthusiastic It happened in 1998, when an eagle her role as Executive Director enough, they can progress into the landed on the floor of Ward 21 at at St Luke’s Community Wound second and, eventually, third St Luke’s Hospital. While her colleagues Centre (St Luke’s Hospital) on tiers. By then, they are able panicked, wondering how to deal with 31 December 2019 – Susie emphasises to manage more complex the bird, the no-nonsense Susie was that wound care is not just about using wound cases.” unperturbed. Noticing a large gash on the best dressing – a perception that The St Luke’s Community Wound in the community, more patients may As for her new role, Susie its beak, she calmly held the eagle down many people have of the speciality. Centre (St Luke’s Hospital), a project suffer from pressure injuries – often added: “My next phase of and actually told it sternly: “Don’t move, “Assessing the wound and knowing Susie spearheaded in 2017, offers basic referred to as pressure ulcers or bed life is to reach out to the I am going to dress your wound!” exactly what to do thereafter are more to intermediate courses which teach sores – but this feisty 63-year-old is a community and boost the Her colleagues were amazed. The important. Above all, our patients must healthcare workers how to better tend firm believer that they can be prevented capabilities of nursing homes eagle, probably grateful, was returned not be in any pain as far as possible,” to their patients’ wounds and thereby and contained. and home care nurses to to the Jurong Bird Park, thanks to an added the nurse who joined the improve their quality of life. As the “I came up with a tiered system to provide better wound care to identity tag on its leg. And Susie got the profession in 1977. nation ages and many will rehabilitate ensure that all wounds will be cared patients and the elderly in the
38 39 TEACHING TO CARE, CARING TO TEACH
made the right career choice. unique is the heartwork we (nurses) put in,” said the talented Her hard work in those three years paid off when she pianist who has been tinkling the ivories since her primary emerged as the Tay Eng Soon Health Sciences Award Gold school days. winner (given to the top nursing graduate of the cohort). The Evangeline attributes her successes to her family’s Inspired cherry on the cake was clinching a Healthcare Scholarship support and she is grateful for their small acts of love. Award from MOH Holdings to pursue her nursing degree at She still remembers nights during her overseas exchange the Singapore Institute of Technology. Again, she graduated programmes when her mum often stayed up past 3am first in her class! (Singapore time) to ensure she was back safe in the hostel. Nursing grants Now 22, Or her dad ironing her nursing uniform and preparing supper to teach Evangeline is close so that she can rest after an afternoon shift. He still irons her you access to a large to completing her uniforms for her. first year as a renal “My parents never imposed any expectations except to do EVANGELINE TAN knowledge bank “ ward nurse in Khoo something I like. This way, the learning process becomes more and it is indeed Staff Nurse Teck Puat Hospital. enjoyable,” she said. very useful... I want Khoo Teck Puat Hospital Transitioning from “When my didi (younger brother) wanted to join nursing, to train future a student nurse to they had no objections… he is now on his way to becoming generations of nurses a professional one a nurse too! It feels really great to have another nurse in the THANKS to a visit to Nanyang Polytechnic’s open house in was challenging as family, we can always check on one another and exchange 2013, Evangeline Tan fell in love… with nursing. and get them inspired she had to learn to patient stories,” added the chirpy missy. Like most visitors to these annual affairs, she was keeping too. What makes think fast on her feet her options open. As a single-pointer O-level student, she nursing unique is and respond to her could have taken her pick from any of the courses available at patients’ needs. the school but she felt drawn to nursing. the heartwork we Seeing the She was almost convinced after a chat with the lecturers (nurses) put in. complexity of some and seeing the facilities. What sealed the deal was realising of her cases has how nursing knowledge could be useful in her personal life. made her realise the That affirmation came soon enough, when her importance of continuous learning and training to keep up grandmother suffered a heart failure and had to be with the advancements in healthcare to be a better nurse. hospitalised. So this young woman has set her sights higher; she wants It was only natural for the filial granddaughter, by then in to pursue her master’s degree, and hopes to be a nurse the final year of her diploma studies, to care for the elderly educator. lady using her nursing knowledge to the full. Providing the “Nursing grants you access to a large knowledge bank and best bedside care she could deliver in those trying moments it is indeed very useful… I want to train future generations ended any doubts Evangeline may have had about having of nurses and get them inspired too. What makes nursing
40 41 Breaking New Ground, Creating a Better Tomorrow BREAKING NEW GROUND, CREATING A BETTER TOMORROW The right dose of care
OW YONG LAI CHAN
Principal Assistant Nurse Nurses. Trained PANs can administer medicines using the Institute of Mental Health machine under the supervision of Registered Nurses and the scheme has since been extended to Senior Assistant Nurses FORTY years ago, Ow Yong Lai Chan watched with awe as her too. Not only has this resulted in less waiting time for patients, adoptive mother and aunt cared for their eldest sister who it eases the nurses’ workload in packing the medications. It struggled with depression. That appreciation matured into a means PANs can spend more time providing better care for desire to help others and, soon, the teenaged Lai Chan was their patients. It has also increased Lai Chan’s confidence as a en route to becoming a nurse. nurse. Having qualified as an Enrolled Nurse in 1985, her “Being empowered to take on more responsibilities displays ingrained passion to help people with mental health issues the confidence that our leaders have in us. This gives me saw her join the Institute of Mental Health (IMH) right away. immense satisfaction as a psychiatric nurse,” said the Now, 34 years on, she is still with IMH and, as a Principal soft-spoken woman who received the Pingat Bakti Setia (Long Service Medal) as part of the 2016 National Day Awards for Assistant Nurse (PAN), relishes the opportunity to care for system’s impact on patient care really captured her attention. Being empowered to take on long-stay patients in the hospital. “The ConviDose system allows pre-packed, patient-specific her dedication and care. “Over the years, my patients have come to trust me,’’ said medication to be administered to patients at the right time more responsibilities displays As an avid baker, she also gets satisfaction from teaching Lai Chan, 58, who has known most of her patients for years. and in the right dose. This personalised management system the confidence that our her patients how to bake and seeing them munch happily on The desire to do more for these recipients of long-term care helps us nurses keep track of our patients’ multiple medicines “ the cookies and cakes they make together. Calling it her form leaders have in us. This gives at IMH also led to the shy mother of three girls upgrading her and when they should get it,” explained Lai Chan. of stress relief, Lai Chan’s baking skills (above) obviously are skills by attending a series of training programmes on using It gives her great pride to be part of a team of PANs trained me immense satisfaction as a appreciated by family, friends, colleagues and patients. the ConviDose system. Introduced by IMH in 2015 for long- to administer medications through the ConviDose system psychiatric nurse. In fact, her grateful patients have an affectionate name for stay wards to improve productivity and medication safety, the which was previously the responsibility of the Registered her. They call her “mum”.
44 45 BREAKING NEW GROUND, CREATING A BETTER TOMORROW
Now that I can independently lead some of these With a steady processes, the total time needed is reduced. My “patients can even be discharged in time to have an hand and heart early dinner. When Jedidah did her first catheter Besides performing patient the femoral vein (main deep vein insertion, she got it right in one attempt. assessments and managing sick patients JEDIDAH LIEOW of the thigh). These flexible tubes She credits her successful debut to in the ward, she runs one of the four Advanced Practice Nurse are inserted into the vein to draw one of several mentors – Dr Yap Eng transplant clinics twice a week and sees blood samples, inject fluids such Soo, her department’s consultant who about nine patients per session. They National University Hospital as medicines and perform blood trained her to make every puncture hit include post-transplant patients or exchange transfusions. If it goes a its mark, with no blood spilling on the even those suffering from severe graft- JEDIDAH Lieow is an Advanced millimetre too deep, it may gauze. versus-host disease (a medical condition Practice Nurse (APN) who specialises puncture the patient’s vital The Alice Lee Centre for Nursing that arises after a bone marrow or stem in Haematopoietic Progenitor Cell artery, resulting in severe Studies graduate explained that cell transplant). Transplant and Cellular Therapy. She is blood loss or, worse, the before each stem cell or bone marrow When she is not seeing patients, also the first APN to lead the Femoral loss of a limb. transplant, the team conducts tests to this trance music fan is either whizzing Central Venous Catheter Insertion Currently she is the ensure that the stem cells are suitable around the floorball court with her service in the National Cancer Institute only APN in Singapore for ‘harvest’, which can take almost an colleagues or attending a Pilates Singapore, located at the National credentialed to do this entire day. session. But her patients are never far University Hospital (NUH). procedure, which has “Patients would have to wait for from her thoughts. Yes, that is indeed in her job been performed over the doctor to insert the line (catheter) Said Jedidah: “I have deepened my description. 200 times at NUH’s High before the apheresis unit can harvest love for oncology nursing thanks to The energetic 40-year-old cares Dependency Unit as of the stem cells. Six hours later, we send the time spent with my patients. Some for patients with blood cancers and 2019. The nicknames her it for further analysis in the lab. Now are like my da ge (elder brother) or da other blood disorders. What she does colleagues give her – Sister that I can independently lead some of jie (elder sister)... I can be a jie jie to my is delicate, high-risk, requires a steady Jedi or Master Yoda (clearly these processes, the total time needed younger patients too. When any of my hand and nerves of steel. they are Star Wars fans) – is reduced. My patients can even be patients pass on, I try to attend their With the aid of an ultrasound suit her well: She is calm, discharged in time to have an early wake. This way, I hope to also provide machine, she inserts a catheter through patient and focused. dinner,” added Jedidah. some closure to their families.”
46 47 BREAKING NEW GROUND, CREATING A BETTER TOMORROW
GAN PEI YING
Advanced Practice Nurse Changi General Hospital The neighbourhood ‘Missy’ post
NOTICING that elderly patients were I thought it was a no-brainer for me to join this constantly being readmitted at Changi team as, during my two years at the geriatric ward, General Hospital (CGH), Advanced Practice Nurse Gan Pei Ying always I always pondered over solutions to help seniors wondered what could be done to age healthily. prevent this trend. The answer came in the form of the Community Nursing Department set up in CGH in 2017. three years later. By 2013, she received he told the nurses his only goal in life In sync with the Ministry of Health’s a master’s degree from New York was to live for another 10 years to care “Beyond Hospital to Community” University. for his daughter who was still in primary strategy, CGH’s model aims to keep Pei Ying is part of the Community school. patients healthy in the community Nurse Posts (CNP) set up by SingHealth Thanks to the efforts of Pei Ying and and thereby reduce their visits to the in December 2017. They are located her colleagues, who patiently allayed hospital. “I thought it was a no-brainer in senior activity centres, faith-based his fears and taught him simple things for me to join this team as, during my organisations and community centres to to improve his quality of life, such as two years at the geriatric ward, I always provide healthcare to vulnerable elderly dietary changes, his health improved pondered over solutions to help seniors with multiple chronic diseases in the and he looked like he lost a lot of weight age healthily,” recalled the poised neighbourhood. in a month. 35-year-old whose dream was to find a Comparing the CNPs to the “Now, he visits the post with his career that challenges her and allows Neighbourhood Police Posts, Pei Ying daughter to say hello and even pays it her to help those in need. said: “If seniors run into trouble with forward by relating his success story to When the work gets tough, she Nursing was a natural fit, something their health, they can get professional other seniors!” she said. turns to baking to “de-stress” and her Buddhist parents encouraged as assistance easily.” The ability to improve patients’ lives in makes cupcakes and cookies for her it allows her to do good. By 2004, Pei She uses the example of a gruff the community has brought Pei Ying joy. colleagues. However, she confessed that Ying had a diploma in nursing from 80-year-old patient to show the value “Often, it can be something as simple she has had less time to bake since she Nanyang Polytechnic under her belt, of the CNPs. Overweight, suffering from as connecting them to the right service joined community nursing: “I’m just too before joining CGH. She added a nursing bad headaches as well as the flu and provider in the community,” she said busy now! But I’ve never been happier degree from the University of Sydney sceptical about the value of healthcare, with pride. doing what I love!”
48 49 BREAKING NEW GROUND, CREATING A BETTER TOMORROW
The dual role of nurse and nun Having an infant and the big picture in order to bring health combined with the ED job brings its fair childcare centre within to someone.” Aspire to inspire share of challenges, especially if she She added that as more trust is GERALDINE TAN has to turn away patients who have the the Home reminds us placed on today’s nurses, they can means to hire caregivers and recuperate take the lead in the long-term care Executive Director of the purpose of life at home. and of the importance sector, being agile to meet the constant St. Joseph’s Home “They come to me saying ‘you are a changes in healthcare, and be an before you expire of play and simplicity... nun… how can you turn someone away’. advocate for those under their care. But we have to make decisions like everyone can find a “Nurses will have to think about how THAT headline (a quote from these for the Home, as there are limited place to co-exist. to serve a population where there are entrepreneur and author Eugene Bell Jr) resources,” said Sister Geraldine who smaller families or people not getting is Sister Geraldine Tan’s personal motto. runs the 412-bed Home in Jurong West, married at all. How will they want to The inspiration started at age five, after with her team of nuns, dedicated staff would at home. age and live? You have to adjust your seeing her grandmother in pain while and volunteers. It was a big jump from The Home also has a childcare centre ministry according to the science of receiving an antibiotic injection. In that the 112 beds it had in the 1970s at Gek and an intergenerational playground, times,” said Sister Geraldine. moment, she wanted to be a nurse and Poh Road. giving the elderly residents and young She added that she has experienced give her Ah Ma (grandmother) a painless What has also changed is the type of children an opportunity to interact with a great deal as a nurse. “You learn a lot injection. Her grandmother told little residents they serve at the Home and each other through play and curated in nursing; the rough, the tough and the Geraldine that nursing is about treating how they serve them. When the Home activities. love. The Home that you build must give everyone with love and not just about was set up more than 40 years ago by “Having an infant and childcare life to people who live in it and it has to treating her family. That was six decades the Catholic Welfare Services, it was to centre within the Home reminds be a blessing to people in society.” ago. provide “shelter, care and love” for the us of the purpose of life and of the After graduating from the School aged and the destitute. importance of play and simplicity... of Nursing in 1975, Sister Geraldine While the Home continues to offer everyone can find a place to co-exist,” worked at the outpatient clinics in Paya nursing and hospice services, its current said Sister Geraldine. Lebar and MacPherson as well as the location has more facilities to meet the Calling community care crucial Singapore General Hospital before changing demographics of Singapore’s to deal with our nation’s ageing going to England to study oncology ageing population, such as an indoor population, the soft-spoken nursing and palliative care in 1980. Two pool for hydrotherapy, introduced as 65-year-old nun sees nurses years later, she joined the Canossian part of its rehabilitation programmes. playing a very important role in Daughters of Charity as a nun and, by Other facilities include a unit for the delivery of care to the elderly: 1985, moved to St. Joseph’s Home where residents living with dementia who are “Nursing evolves with the society. As she became the Administrator/Executive still mobile. It allows them to go about a nurse today, you need to be very Director (ED) in 2007. their regular activities just like they sharp to navigate the system and know
50 51 BREAKING NEW GROUND, CREATING A BETTER TOMORROW
with her colleagues. At the time she was the Director of Nursing at KTPH. She said: “We wanted our patients to feel calm, so we designed KTPH to be garden-like and filled with lush greenery.” Building from As it was her first foray into building hospitals, Beng Hoi had to learn to read maps and interpret complicated construction drawings. The ardent traveller also remembers getting on the floor and measuring the hospital wards’ entrances to ensure the beds could be wheeled through easily! the heart Designing a hospital with patients in mind was also the 2017 President’s Award winner Kuttiammal Sundarasan’s goal when she joined the planning and construction team for Ng Teng Fong General Hospital (NTFGH) in 2009. For the 59-year-old Chief Nurse, better known as Kutti among her peers, patients are at the heart of what she does. This was why she pushed for the ‘window for every patient’ concept at NTFGH. “The windows allow patients to enjoy natural ventilation and a view of the greenery,” said the Tamil literature lover. Like Beng Hoi and Kutti, Christina Lim had her first taste of designing a hospital when she was part of the team that planned for the construction of Sengkang General Hospital (SKH) in 2012. Knowing that patients value their privacy, the SKH Chief Nurse included discussion spaces in the hospital’s wards for medical professionals to discuss patients’ conditions. This prevented other patients and visitors from overhearing their conversations thus maintaining patients’ confidentiality. Christina, 50, an amateur YOU have seen nurses at polyclinics and hospitals, but have you music composer, said: “Nurses are always on the ground and seen nurses with helmets and boots at construction sites? Now, understand patients’ needs. This helped us to better design SKH that’s an unusual sight. LOW BENG HOI KUTTIAMMAL SUNDARASAN CHRISTINA LIM for our patients.” For nurse Low Beng Hoi, 67, inspecting a construction site Director of Nursing, Chief Nurse Chief Nurse Building a hospital is no mean feat. Despite the tight deadlines Population Health and was all in a day’s work over a decade ago. Back in 2004, the Ng Teng Fong General Hospital Sengkang General Hospital and stress, these three ‘nurse-architects’ look back on their Community Transformation Government had just started building more hospitals for our journey fondly. Kutti nicely summarises their experiences: “We put ageing population, and Beng Hoi accepted the challenging task of Khoo Teck Puat Hospital our heart and soul into the projects. That sense of achievement planning for the construction of Khoo Teck Puat Hospital (KTPH) when we finally saw the completed hospital was priceless!”
52 53 BREAKING NEW GROUND, CREATING A BETTER TOMORROW
The cheerful 44-year-old lady is one With more than asked her if she was keen. “Everything of three APN Collaborative Prescribers 1,200 patients walking happened so quickly! Next thing, I was in the National University Polyclinics through the doors of our perched on my dad’s motorbike, on my (NUP) team. Having completed her “ way to grab my second shot at nursing. Master of Nursing from the National polyclinic daily, it is also Voila! Look at where I am now, almost University of Singapore in 2007, and timely that I earned this 30 years in nursing!” said Wei Fong. the three-month National Collaborative privilege to prescribe It wasn’t a completely smooth ride Prescribing Programme in 2018, she is though. In 2007, as she was doing her credentialed to prescribe 14 categories medication... it helps to master’s degree, her father fell seriously of medication for most of her patients ease the load a little. ill. Despite the trying circumstances – without needing a doctor’s stamp of juggling her studies and the frequent approval. trips to hospital to care for her father “Since becoming a Collaborative girl applied for and was accepted into a – Wei Fong’s commitment to nursing Prescriber (CP) in March 2019, my diploma in business. remained steadfast, and she is forever scope has greatly expanded – it is Then her father intervened. About to grateful to her husband for encouraging a good thing! Whether it is for routine retire from the police force, he spotted her and managing the household during check-ups to get their medication a list of bursaries and sponsorships that time. refilled or to seek treatment for the available for nursing studies and The payoff for that period is that she common flu bug, my patients are spared can now provide “more complete care” the wait for a doctor to countersign to the patients she sees – about 20 on the prescription order. With more a day. “Yes, I have to be accountable for than 1,200 patients walking through my decisions because their safety is my the doors of our polyclinic daily, it is greatest concern but, hey, with greater also timely that I earned this privilege autonomy comes greater responsibility, to prescribe medication… it helps right?” said Wei Fong. to ease the load a little,” said Wei In fact, she applies the same zeal Prescription for success Fong, who almost didn’t become to her favourite pastime of bread a nurse. making. When asked what makes THANKS to the stethoscope draped the time they step out, not only have Her mother wanted the her famed focaccia so special, the LIAU WEI FONG around her neck, Liau Wei Fong is often they been prescribed the appropriate 17-year-old Wei Fong to do a affable nurse said: “A touch of love, Advanced Practice Nurse called “missy-doctor” by many patients medication by this Advanced Practice business course. Despite her a dash of passion and a whole lot of who step into her outpatient clinic at Nurse (APN), they also have a new-found desire to be a nurse and having zero heartwork!” The very same recipe she National University Polyclinics the bustling Bukit Batok Polyclinic. By respect for nurses in general. interest in business studies, the filial uses when caring for her patients.
54 55 Pushing Frontiers, Improving Patient Care PUSHING FRONTIERS, IMPROVING PATIENT CARE
K. TAMILARACI
Nurse Clinician I was quite afraid but they encouraged me,” said Tamilaraci. That was put to the test in 2018 when a four-year-old By 2005, she had completed her nursing diploma at patient fell unconscious and could not breathe on her own. KK Women’s and Children’s Hospital Nanyang Polytechnic. Two years later, she had earned her Tamilaraci was part of the team that kept the child on the nursing degree from Curtin University. In 2009, at the age ECMO machine for 90 days, the longest in KKH history. They of 48, she also had an Advanced Diploma in Paediatrics knew the risk: the longer a patient is on the machine, the under her belt. Now, at 59, she works as a Nurse Clinician lower the chance of survival. in KKH’s Children’s Intensive Care Unit (CICU) where she “We had a fear that she would not make it out alive, but handles the Extracorporeal Membrane Oxygenation (ECMO) she did. Slowly but surely, through a lot of rehab, the patient machine, which is another regained her health. She sat up, sang and did simple activities Being part of opportunity to upgrade her on her own. The day she walked out of the hospital, everyone the programme skills. in the team cried,” she recalled, with a touch of emotion. Once a specialised “She proved to everyone that miracles do happen. That’s makes me feel role only performed by what keeps me going as an ECMO nurse – knowing that I’m very empowered perfusionists, who use making small miracles happen every single day.” and confident the machine to maintain patients’ physiological in managing my conditions during patients on ECMO. cardiac surgery and other surgeries that require cardiopulmonary assistance, it evolved to be a key speciality role for KKH nurses since the ECMO programme’s inception in 2011. Tamilaraci was part of the pioneer batch of six nurses Making small miracles trained at Duke University (United States) in the same year for six weeks. On their return to Singapore, perfusionists from AS A teenager, K. Tamilaraci desperately wanted to help hospitals and by 1999, she was at KK Women’s and Children’s the National Heart Centre Singapore assisted them to gain her father deal with his kidney problems and urinary tract Hospital (KKH). confidence and competency with the ECMO machine. “We infection. She didn’t know how to do it. On the day that he That was when the mother of two, who loves watching have to sit by the machine 24/7 as it literally is the patient’s passed away alone in a hospital ward, she decided to be a culinary shows on the internet and cooking for her family, artificial heart and lungs, and we have to keep it working nurse. found the time and energy to upgrade her skills. “I was quite with specific calculations and titrations. Being part of the In 1983, aged 22, she joined the School of Nursing. After settled by then and had a helper at home. My supervisors saw programme makes me feel very empowered and confident in graduating as an Enrolled Nurse, she worked at several public the potential in me and told me I should further my studies. managing my patients on ECMO,” she said.
58 59 PUSHING FRONTIERS, IMPROVING PATIENT CARE Garang for the right reasons
WHEN Agnes Chong and Ahmad Shufi started out in nursing, they were told when he speaks to patients about their condition. He had to prove to them over what to do by doctors. Today, it is different. Senior nurses now lead services and over again that a nurse could take charge of their care and he didn’t need in specialist out-patient centres and, more importantly, are advocates for their to consult a doctor. Over his five years at the NSC’s Department of Sexually patients. Transmitted Infections Control Clinic, which sees about 150 patients every day, The Nurse Clinician, who has just completed 17 years at the National Skin he has developed a confidence that helps him engage the patients in a manner Centre (NSC), recalls her early days in nursing: “It was my first job and, as a junior that makes them trust nurses. nurse, I just did what the doctors and supervisors told me to… no questions “We run the TAG (Test & Go) service for asymptomatic male patients who asked. We were afraid of talking back to them, especially the more garang would like to get tested for Sexually Transmitted Infections (STI) like HIV, syphilis (gung-ho) ones.” or gonorrhoea. Patients will be seen by nurses, Today, the 38-year-old mother of three unless further examinations by doctors are AGNES CHONG AHMAD SHUFI oversees a team of eight nurses at NSC’s Photo required,” said the 35-year-old father of three Nurse Clinician Dermatology Clinic – the only one in Asia that who feels such nurse-led processes ultimately Senior Staff Nurse is equipped to manage a wide spectrum of save patients’ time. National Skin Centre National Skin Centre dermatology cases; from determining the doses “I constantly remind my nurses to pay extra of light patients require during phototherapy attention to details; avoid missing anything treatments to providing consultation services for follow-up patients. during the pre-screening checks. Some may call me ngiao (picky) but we must Agnes is now more confident and, if it helps her patients, will speak with always be professional and not be deemed as incompetent by anyone. Some doctors about their treatment plans. “Doctors map out the treatment but it is patients want to be tested for all the STIs but, after the pre-screening checks, up to us nurses to assess the patient’s condition throughout their treatment. I realise they may not need to do all of it. It can be hard to dissuade them at first, At times, I get to override my doctors’ orders if I sense something is amiss... but since they think I’m just a nurse.” only when necessary, lah!” she said. That’s when his experience comes into play. He builds a rapport with the When her patients are not improving or if the treatment gets too intense patients, eventually getting them to realise that “I am there to help, not to judge”. for them, the bubbly lady brings it to the doctors’ attention and makes Both Agnes and Shufi continue to encourage their junior nurses to be the recommendations on adjusting their treatment. As she puts it: “Naysayers may voice of their patients; to not be afraid to share their knowledge and training to doubt you at first but when they realise that you are right, they’ll learn to trust deliver better care. And the former has these words of advice for those entering you eventually.” the profession: “As nurses, we know our patients best, so just be firm if you Senior Staff Nurse Shufi, on the other hand, had to learn how to begarang believe that you are right.”
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tends to patients with acute conditions This journey has May 2018, TcB measurement was and conducts developmental checks on empowered me as a implemented across all six polyclinics newborns and toddlers to ensure they under NUP. As the other healthcare nurse and enlarged the are growing well. Her job also requires “ clusters were interested to adopt the A gentle her to test for jaundice in babies two nurses’ role in jaundice TcB measurement too, NUP shared its weeks old or younger. Jaundice is screening. workflows and protocols, paving the way caused by excess bilirubin – a yellow for other polyclinics across Singapore to waste material produced by the body – adopt it by the end of the year. touch to test in the blood, causing the skin and whites Jeannette said: “This journey has of the eyes to turn yellow. empowered me as a nurse and “Traditionally, bilirubin levels were enlarged the nurses’ role in jaundice measured via a heel prick test where screening.” The heel pricks were done a small needle is used to draw a blood by lab technicians in a lab but the TcB for jaundice sample from the heel,” Jeannette measurement allows nurses to screen explained. On the other hand, the patients, manage the results and make Transcutaneous Bilirubinometry (TcB) appropriate referrals. JEANNETTE WONG measurement – the process piloted by The bubbly lady’s appetite for Jeannette and team – involves touching learning hasn’t diminished. She recently Senior Staff Nurse the baby’s chest with a small device. completed her Advanced Diploma in National University Polyclinics It is cheaper than the heel prick test, Nursing at her alma mater, Nanyang painless and provides a good gauge of Polytechnic. It was a challenging period – whether the babies need a blood test. she confessed that she goes for runs to AS SOMEONE who has worked with The TcB measurement proved de-stress – but she was determined to babies for most of her career, Jeannette popular, but this nurse’s connection to it excel and prove herself. Wong is well aware of their reaction to wasn’t over. Her next assignment was to After all, nursing is a career that pain. So, when her supervisor invited redesign the workflow for jaundice tests has provided her some unexpected her to join a team to pilot a new and at polyclinics, present it to the nursing twists and turns so far. Right from the painless jaundice test for babies at administrators and train other nurses time she opted for nursing studies National University Polyclinics (NUP) in to use the TcB device. “I didn’t think I to the TcB journey that has brought March 2018, she readily agreed. would be so invested in the process,” her such professional satisfaction. No The 32-year-old Senior Staff Nurse she confessed. wonder Jeannette said: “I did not choose works at Jurong Polyclinic where she The team’s efforts paid off. In nursing… nursing found me instead!”
62 63 PUSHING FRONTIERS, IMPROVING PATIENT CARE
You get her humour when I feel more empowered. Now, As patients are able to receive you realise Diana works with I have the confidence to provide care in the community, it also patients with poorly controlled urgent care and reassurance to keeps them from having to go Taking a breather asthma. In her 12 years “ to an emergency department of nursing, all at Pasir Ris patients in distress. It is satisfying in a general hospital.” Polyclinic, she had seen many to see the patient’s distress slip Not a bad outcome for patients struggling to breathe away with each inhalation. someone who, inspired by her while they were registered, mother who was a nurse for assessed and eventually seen 30 years, decided at age 13 by a doctor. that she wanted to be part of All that changed when the Nurse Intervention for this noble profession. Like her mother who spent close to Breathless Patient Protocol (NIBPP) was put in place. 20 years at Marine Parade Polyclinic, Diana knew primary Developed to equip Registered Nurses with the skills care was where she wanted to do her duty. And she’s now to initiate rescue therapy immediately, this nurse-led ensuring that her patients get even better care. programme at the polyclinics relieves patients’ distress and prevents the worsening of their condition. It involves nurses attending a skills enhancement programme in asthma education and management as well as a lung auscultation course. NIBPP provides nurses with specialised knowledge on the anatomy and physiology of the respiratory system. To ensure they are proficient in handling emergency cases, they are required to perform 20 lung auscultations and are assessed on their skills in asthma management upon the completion of the course. It means Diana and her NIBPP-trained nursing colleagues in community care can now provide adequate WHEN Senior Staff Nurse Diana Mohamed Yusoff needs to treatment for patients with poorly controlled asthma within DIANA MOHAMED YUSOFF unwind after a hard day at work, she turns to an unusual outlet: the polyclinic setting. scrapbooking! The mother of two enjoys bonding with her As the 32-year-old soft-spoken nurse puts it: “I feel more Senior Staff Nurse children over the arts and crafts activity that lets them display empowered. Now, I have the confidence to provide urgent SingHealth Polyclinics their creativity. care and reassurance to patients in distress. It is satisfying “I guess it’s how I take a breather!” she said, with a laugh. to see the patient’s distress slip away with each inhalation.
64 65 PUSHING FRONTIERS, IMPROVING PATIENT CARE
winner pulled over and calmly guided Nurses understand noble profession where one can touch him over the phone to perform that it’s not easy lives”. cardiopulmonary resuscitation (CPR) While nursing has been her passion to live with a heart on his mother while waiting for the “ for the past 35 years, Lee Wah revealed ambulance to arrive. condition. We want our that her other love is to travel around Though the mother did not survive patients to know that the world. “I enjoy planning for trips with the ordeal, the son remained grateful my family to recharge. Europe is my Heart beats we are always here to for Lee Wah’s help. “He visited NHCS favourite place to explore,” said the and gave me some flowers to convey his help and lend them a soft-spoken mother of three. thanks,” recalled the Advanced Practice listening ear. Then, after a small pause, she added: Nurse (APN) with a smile. “I also enjoy training my competent for her patients Such is the 54-year-old’s willingness team of nurses to co-manage the to go the extra mile for her patients, it conditions of our heart failure patients. is no surprise that she was instrumental waiting time at NHCS have also reduced, The enhanced care continues, even in setting up the Heart Failure while patients’ quality of life has when I’m overseas!” Ancillary Clinic with a physician and a improved. It is clear that her heart always beats pharmacist in 2007. The clinic – run The Heart Failure Ancillary Clinic for her patients. independently by Lee Wah, a fellow didn’t catch on with patients easily. APN and a pharmacist – caters to heart Initially sceptical of being attended to by failure patients whose conditions have a nurse instead of a doctor, they were stabilised and only require follow-up eventually won over by the nurses’ visits. competence and empathy. Lee Wah The APNs examine patients, order explained: “Nurses understand that it’s tests and interpret the results as well not easy to live with a heart condition. as teach patients to manage their We want our patients to know that heart condition, while also working we are always here to help and lend with the pharmacist to adjust patients’ them a listening ear.” medication and monitor for any adverse With such a caring and empathetic THE year was 2010. Dr Teo Lee Wah Centre Singapore (NHCS) had collapsed reactions. nature, it is no wonder Lee Wah dreamt TEO LEE WAH was driving home after work when her at home and the patient’s son was This helps the cardiologists at NHCS of being a teacher or nurse as a child. Advanced Practice Nurse phone buzzed – one of the patients frantically calling her for help. focus on patients who require complex She eventually chose the latter after she was overseeing at the Heart Failure Not one to get unnerved easily, the care. Hospital re-admissions among a friend, who was a nurse, helped her National Heart Centre Singapore Ancillary Clinic in the National Heart 2015 President’s Award for Nurses heart failure patients and patients’ realise that “nursing is a challenging yet
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ANNA TAN (Midwifery) at NYP in 2000. Ultimately, we hope midwifery-trained labour, the process On completion of the of delivery including Senior Nurse Clinician nurses will be able to provide a positive diploma a year later, she importance of skin-to-skin and safe experience for women during KK Women’s and Children’s Hospital was posted to the Delivery “ attachment, breastfeeding Labour of love Suite. pregnancy, childbirth and post-natal care and postpartum care. The “I decided on midwifery in the community. nurses who specialise as getting married and in midwifery also check giving birth are close to on the baby’s heart rate, my heart as a woman,” said Anna, adding with a laugh: “Being interpret blood investigation results and scan reports, and a midwife prepared me for the birth of my sons in 2004 and order necessary treatment for the well-being of the mother 2006!” and her foetus. Since 2012, she has been part of a team of 11 midwifery- When patients arrive in labour at the Delivery Suite and no trained nurses who run KKH’s midwife-led clinic. Initiated further obstetrical or medical management is required, the by then-Deputy Director of Nursing Paulin Koh (now Chief midwives conduct the vaginal delivery. Nursing Officer at the Ministry of Health) and Assistant KKH’s midwife-led clinic has managed about 11,000 births Director of Nursing Thilagamangai, the clinic was launched in to date, with many patients returning for their next delivery. March 2010 to give eligible subsidised patients the choice of Anna recalls one patient who returned to deliver in 2015 holistic midwife-led care throughout their pregnancy, because she treasured the memory of her birthing delivery and postpartum period. experience the year before: “She said she pulled The speciality-trained nurses manage healthy, through her labour pain thanks to my soothing voice, low-risk pregnant women from 24 weeks of calm manner and encouragement. She even shared gestation and their newborns. “This allows that she was inspired to be a nurse!” obstetricians to focus on high-risk pregnancies The soft-spoken yet bubbly lady appreciates such as twin pregnancies that nurses have greater empowerment and and patients with high autonomy today as they are trained for role blood pressure or high expansions. However, her dream is that Body Mass Index,” Anna midwives can see mothers-to-be from explained. the time they discover they are pregnant: SENIOR Nurse Clinician Anna Tan is an enthusiastic baker Anna has been doing so for the past 22 years at Parents-to-be attend “Ultimately, we hope midwifery-trained who loves bringing smiles to colleagues’ faces with the muffins KK Women’s and Children’s Hospital (KKH), which she joined scheduled consultation nurses will be able to provide a positive she bakes. Perhaps it shouldn’t come as a surprise then that right after graduating with a Diploma in Nursing from Nanyang sessions run by the experienced and safe experience for women during the 43-year-old looks after “buns in the oven” at work too… Polytechnic (NYP) in 1998. Posted to KKH’s antenatal and midwives, during which they are pregnancy, childbirth and post-natal care in the yes, she cares for pregnant women and their babies! postnatal wards, she took up an Advanced Diploma in Nursing informed on signs and symptoms of community.”
68 69 Healing Hands, Caring Heart HEALING HANDS, CARING HEART
All this, while battling I was touched by how our strong. What we do makes physical exhaustion and fear COVID-19 patients were appreciative a difference in their recovery.” An infectious love for nursing as SARS infected 238 people It has been a long and of us caring for them in spite of us and claimed 33 lives – including “ fruitful career for Margaret, four healthcare workers – in wearing our personal protective one that has seen her Singapore. equipment. It reminded me that they win many accolades, the Driven by the conviction President’s Award for Nurses that new infectious diseases needed us nurses to stay strong. in 2017 being the most can show up any time in an cherished. Some might increasingly globalised world, she armed herself with a PhD find this surprising, considering this plucky lady joined in Nursing from Case Western Reserve University (Ohio) in the profession purely by accident – wanting to help her 2012. Six years later, she took over as Director of Nursing at parents financially when she was 19, she flipped through MARGARET SOON the National Centre for Infectious Diseases (NCID). the recruitment section of a newspaper and the first Director of Nursing When COVID-19 (Coronavirus Disease 2019) surfaced advertisement she spotted was for nursing. in Singapore in January 2020, The 49-year-old, who is always National Centre for Infectious Diseases Margaret was back in the thick of full of positivity, constantly pursues the action: She led her team of clinical knowledge to better care 300 nurses to prepare isolation for patients. She encourages fellow rooms, adapted workflows to nurses to do likewise: “Question rapidly changing information what you do and advance yourself about the disease, held townhalls in a topical subject such as to update the nurses and ensured research or ethics... and pursue they had an adequate supply of higher learning with a master’s or protective gowns and masks. doctoral degree!” Despite clocking 14 to 18 That said, she also encourages exhausting hours at NCID daily, nurses to take moments for DR MARGARET Soon’s eldest child Jannelle likes to tell to be redeployed to a non-clinical setting as she was pregnant, Margaret is grateful she can themselves, like she does with everyone that she is a SARS baby. That’s because Margaret she had a discussion with her husband and decided to stay be part of patients’ lives: “I was regular walks or jogs in any location was five months pregnant with her when Severe Acute as she believed in supporting and following through with her touched by how our COVID-19 which has wide open spaces Respiratory Syndrome (SARS) struck Singapore in March 2003. team’s recommendations. patients were appreciative of and greenery. Margaret calls it Then a Senior Nursing Officer in infection control at Tan Margaret recalls: “We fought against time to ensure wards us caring for them in spite of us “therapeutic”, especially when done Tock Seng Hospital, the designated screening and treatment were ready for patients, conducted refresher training on the wearing our personal protective with family members. In particular, centre for SARS, she found herself at the frontline of the fight use of personal protective equipment and spent countless equipment. It reminded me that one 17-year-old who wears her against an unknown disease. Despite being given the choice hours fit-testing healthcare workers’ N95 masks.” they needed us nurses to stay “SARS baby” tag with pride!
72 73 HEALING HANDS, CARING HEART
This role eases the load on doctors ‘Rapid Response’ and benefits patients. It cuts down “on the delay in treatment as patients don’t have to be transferred to helps save lives different departments unnecessarily. were against it. So I went to a junior college to make them happy,” she said. CLARICE WEE Eventually, with her parents’ blessing, she pursued her degree in nursing from La Trobe University in Melbourne, Advanced Practice Nurse worked in several major public hospitals in Singapore and in Ng Teng Fong General Hospital 2010 took on a Master of Science in Nursing at the University of Pennsylvania. When she is not thinking about ASK Clarice Wee about her job at the Intensive Care Unit (ICU) her ICU patients or her nurses, of Ng Teng Fong General Hospital (NTFGH), and she will tell Clarice is busy looking after you that every day is different. her baby girl who was That’s not surprising, given that the Advanced Practice born in September Nurse (APN) is a member of the hospital’s ‘Rapid Response’ 2019 and participating team where she assesses peri-arrest patients, a role once in activities at church strictly handled by doctors. In the past, the ICU team would come in to resuscitate patients. It cuts down on the delay in treatment as patients where she plays the The 35-year-old’s role in a team of two APNs and about 20 patients if they collapse. Now, with nurses watching out for don’t have to be transferred to different departments piano once a month to 30 senior nurses includes reviewing patients in the ICU, warning signals early and responding fast enough, these unnecessarily.” as part of Sunday changing tubes for tracheostomy patients in cases where patients have a much better chance of recovery. Clarice’s passion for nursing could be traced back to the services. they need help to breathe, as well as training ward nurses on “This job keeps me on my toes at all times and I am time she spent in hospital as a toddler, watching helplessly “I also help out how to pick up signs in critically ill patients who may be on the constantly learning,” said Clarice, who wanted to be part of as her mother battled colon cancer. She can never forget the at any event when verge of collapse. the ‘Rapid Response’ team as it relies on the ICU nurses to be reassuring sight of nurses going in and out of the ward, caring I can, especially if it She said: “Patients don’t stay for long in ICU; they will be clinical experts at the bedside to assess a patient’s condition for her mother who eventually succumbed to the disease. is first aid coverage,” transferred to a general ward as soon they are ready for after they leave the ICU. In a way she acts as a bridge between She even overcame her family’s objections to join the she added with a laugh. recovery. But they might become unstable and collapse in the the ICU and ward nurses. profession. “After O Levels, I took my parents to the Nanyang That could be called “rapid ward.” She said: “This role eases the load on doctors and benefits Polytechnic open house to look at the nursing course but they response” at a social level!
74 75 HEALING HANDS, CARING HEART
according to an established protocol, It took us years of treatment,” he said. He admits it is when it is necessary. This includes the intensive research and idealistic but remains optimistic. administration of Penthrox, an inhaled The adrenaline that Shashi gets from planning to ascertain anaesthetic to reduce pain. “ nursing never fizzles out. Working at Previously, patients with acute pain that it’s safe for triage the fast-paced DEM means he has to had to be examined by a doctor at the nurses to initiate frequently think on his feet and deliver DEM for a painkiller to be prescribed. emergency care to patients who need This often led to patients requesting protocols to help it, in the quickest time possible. “At the the nurses to alleviate their pain while reduce our patients’ DEM, time flies by and, the next thing they waited to see the doctor. Shashi pain. I’m very proud I know, it’s time for me to go home!” said explained: “We desperately wanted to the 33-year-old father of two children. help, but there was not much we could of how the NIPP has In fact, his passion for nursing do. It was very stressful for both the empowered nurses. continues when he gets home. The patients and nurses.” son of a nurse – his mother devoted The NIPP has changed all that. Triage over 30 years to the profession – grew nurses at all hospitals now have the up listening to nursing anecdotes. autonomy to provide faster care to Fascinated by them, a young Shashi was patients in the DEM. Shashi said: “It inspired to follow his mother’s footsteps took us years of intensive research and and signed up for a nursing course at planning to ascertain that it’s safe for Nanyang Polytechnic after his O Levels triage nurses to initiate protocols to in 2004, much to his parents’ delight. help reduce our patients’ pain. I’m very Now he does the same with his proud of how the NIPP has empowered children, telling them about his work. nurses.” And just like how Shashi has lent a A score for nursing With the constant changes in hand in shaping the field of nursing healthcare technology, Shashi believes in Singapore, the profession has also SHASHI Chandra Segaram loves Protocol (NIPP) that the Nurse Clinician there is potential to see how DEM moulded his character. He shared that SHASHI CHANDRA SEGARAM the surge of adrenaline that courses helped conceptualise with a group of nurses can use it in their day-to-day “nursing has definitely changed me. Nurse Clinician through his body when he competes nurses and doctors take flight at the operations to better focus on patient Now, I’m so much more patient and in a football match with his friends. Singapore General Hospital (SGH). care. One of his ideas is an app that will sensitive to people’s feelings”. Singapore General Hospital Off the field, the Manchester United Rolled out at SGH’s Department of allow patients or caregivers to register Then he added, with a laugh: “Not fan experienced a different kind of Emergency Medicine (DEM) in 2017, the before coming to the DEM. that I wasn’t patient and sensitive to adrenaline rush – seeing the NIPP enables triage nurses to assess a “You can register before reaching the begin with!” Nurse-Initiated Pain Management patient’s pain and administer analgesics, hospital so you just come in and receive Good save, Shashi!
76 77 HEALING HANDS, CARING HEART Mums’ support
WHEN new mums need help breastfeeding their newborns, they turn to nurses like Shamini Krishnan, Kang Phaik Gaik and Fonnie Lo for advice, comfort and answers in those first bewildering days of becoming a parent. The three nurses – who work at KK Women’s and Children’s Hospital (KKH), Mount Alvernia Hospital (MAH) and Thomson Medical Centre (TMC) respectively – are internationally- SHAMINI KRISHNAN KANG PHAIK GAIK FONNIE LO (centre) certified lactation consultants who specialise in the clinical Senior Staff Nurse Former Head of Parentcraft/Lactation Assistant Director management of breastfeeding. KK Women’s and Children’s Hospital Mount Alvernia Hospital Thomson Medical Centre Shamini, one of the breastfeeding champions at KKH, the largest maternity hospital in Singapore to be accredited under the Baby-Friendly Hospital Initiative (BFHI), infant nutrition. It also includes practices such as initiating visit new mothers, ran antenatal classes and even visited the Thomson Confinement Food home delivery service in 2012. understands the challenges new mums face when it comes to immediate skin-to-skin contact after birth and ensuring staff – mums at home to provide one-to-one assistance. The 59-year-old nurse said: “The idea came about when breastfeeding. The 55-year-old mother of two said: “Mummies including doctors and allied health professionals – are trained Worried new parents even found her via the internet, like we received calls from mummies requesting for confinement who can’t breastfeed may feel bad, however they need to to support new mothers in their breastfeeding journey. one anxious husband whose wife couldn’t breastfeed their nannies and some of them weren’t able to find suitable ones. know that every mother and baby is different. Therefore, Since its BFHI certification, KKH has seen an increase in baby due to extremely sore nipples. Sister Kang said: “I taught To alleviate the problem, we provided a food delivery service I customise my care to suit my patients’ needs.” new mothers exclusively breastfeeding their babies while in her about food supplements and helped her learn to re-latch for recuperating mothers.” The BFHI is an effort by the United Nations Children’s Fund the hospital. her baby. Within a month, she regained her milk supply and Fonnie worked with a nutritionist, a Traditional Chinese (UNICEF) and the World Health Organization (WHO) to ensure Phaik Gaik, or Sister Kang as she is affectionately known, eventually breastfed her child till she was 2½ years old! I take Medicine physician and two nurses to plan the menus and maternity hospitals meet best practices in supporting new also works hard to get better health outcomes for mothers great pride in helping breastfeeding mothers overcome their taste-test the food to ensure its quality and hygiene levels. mothers to breastfeed. and their babies. difficulties.” From building the babies’ immunity, giving them a good It requires hospitals to fulfil 10 steps to successful The sprightly 69-year-old was highly regarded as a At TMC’s Parentcraft Centre (Clinical), Fonnie has been head start for a healthier life to ensuring better bonding breastfeeding and comply with the International Code breastfeeding advocate at MAH where she spent 40 years, instrumental in rolling out many services over the years to between mother and child and even lowering maternal stress, of Marketing of Breastmilk Substitutes to promote safe before retiring in 2020. During her time at MAH, she used to improve the well-being of her clients and their babies, like the the power of breastfeeding is a win-win for everyone.
78 79 PUSHING FRONTIERS, IMPROVING PATIENT CARE
AZIZ BIN AB HAMED
Senior Nurse Clinician Institute of Mental Health Helping patients grow and heal
NOT many of us know this, but the community. A visit to a farm presented the Nightingale The idea is to believe that Institute of Mental Health (IMH) in Lim Chu Kang in 2016 inspired Award at the IMH Nurses’ people will recover, allowing employees can pick up fresh him with this idea. Day celebrations. An award baby spinach, xiao bai chai, chye He immediately asked his that the 57-year-old man no them to stay functional in the sim or different types of lettuce hospital’s management if he doubt celebrated with a guitar- “ community. at their workplace. could introduce hydroponic strumming sing-along session, No, it’s not some corporate farming as a form of vocational which is his favourite pastime. deal with an online grocery firm. activity. “The idea is to believe With 31 nurses under This is all thanks to the hospital’s that people will recover, allowing his charge to help with his hydroponic farm. them to stay functional in the rehabilitation programmes, this Every week, up to 50kg of community,” said Aziz who refers father of two has seen the role of vegetables – enough to fill 10 to the patients working at the a psychiatric nurse change; from to 15 big sacks – are harvested farm as “clients” as a form of a custodial one to that of from this unique farm which respect and empowerment. a rehabilitator and mentor. is part of a rehabilitation Starting off with a sponsorship As he put it: “In the past, we programme. It aims to help long from a bank in 2016, the farm took care of the basic needs of stayers at IMH with potential initially had eight “clients” whose the patients. Now, we teach them for rehabilitation improve their produce was sold to IMH staff. skills to survive on their own, ability to reintegrate into the The revenue from the sales was to find meaning in their lives.” community. used to buy seedlings and pay Not bad for someone who The brains behind this project the “clients” a small allowance almost didn’t become a nurse. is Senior Nurse Clinician Aziz Bin for their work. Now, the scale of As a young man deciding on AB Hamed. Having been with operations has expanded with a career path, he applied to IMH for more than 20 years, the more than 30 “clients” involved both nursing and the police psychiatric nurse was thinking in the farm. force. The nursing offer came about how to help his patients The efforts by Aziz didn’t first and the rest, as they say, rehabilitate and reintegrate into go unnoticed. In 2018, he was is history.
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I love what I do and it’s very close This makes the time immediately after operations more to my heart. When patients come in bearable for patients. And it may not even be more painkillers they need. With good clinical assessment, nurses may opt very sick and get better after surgery, Providing “ for non-pharmaceutical interventions which may be just as I feel a great sense of satisfaction. effective. “For instance, I learnt that a tonsillectomy patient might be in pain due to the use of diathermy (electrically-induced heat) “I love what I do and it’s very close to my heart. When in surgery and an ice-cold gargle may be sufficient in removing post-op patients come in very sick and get better after surgery, I feel blood clots and phlegm, as well as cooling the patient down.” a great sense of satisfaction,” said the cheerful lady. Kalsom added that the role of PACU nurses has been Kalsom’s interest to help surgical patients spurred her enhanced over time. Today, with the use of the Post- to join the hospital’s Post-Anaesthesia Care Unit (PACU) Anaesthesia Discharge Scores (PADS), they can discharge in 2000. She wanted to give good post-operative care to patients from the PACU to the ward. This has improved the relief patients recovering from the effects of anaesthesia – some efficiency of the recovery room as patients do not need to of them experience pain, nausea and vomiting wait to be reviewed by anaesthetists. – especially when anaesthetists are busy The 50-year-old mother of three, who KALSOM AMIN in the OT and therefore unable to remains a PACU nurse to this day attend to such patients in the Assistant Nurse Clinician because of the difference she can PACU. make to her patients’ lives as Tan Tock Seng Hospital The patient’s experience they recover from surgery, now has changed with Kalsom provides end-to-end care for and the PACU nurses being patients requiring surgery, IN 1989, Kalsom Amin joined National University Hospital empowered to administer a starting with pre-surgery (NUH) as a clerk in the Accident & Emergency (A&E) repeat dose of medication assessment of the patient, department. Two years later, inspired by the hardworking to relieve pain or vomiting. assisting in complex surgical nurses around her, she enrolled in the then School of Kalsom explained: “If procedures and providing Nursing. the anaesthetist has care after the operation. Now, 29 years later, she is an Assistant Nurse Clinician administered a first dose The amiable nurse, who (ANC) at Tan Tock Seng Hospital (TTSH). of painkillers like morphine collects vintage flower-themed Having joined the hospital as a Staff Nurse in 1994, Kalsom or fentanyl during surgery, Pyrex kitchenware as her hobby, did stints in the neurosurgery and medical wards before being PACU nurses can proceed with added: “I do my best as patients’ posted to the Operating Theatre (OT) in 1997. Since then, she subsequent doses when needed. lives are at stake. Seeing them return has been working closely with anaesthetists, surgeons and It helps because when patients are in home safely with no complaints – that other nurses to care for patients undergoing surgeries. pain, they cannot wait.” keeps me happy and in nursing.”
82 83 Championing Change, Advancing Care CHAMPIONING CHANGE, ADVANCING CARE
In the West, it had been around for hospital’s electronic medication 20 years. Even though the macerator record systems to help nurses and pharmacists dispense involves the cost of consumables, the “ the medicines correctly nursing team kept pushing for it. It is and efficiently. The result? Necessary, an example of believing in investing in Improved patient safety, reduced risk of errors and better a system that can help patients. productivity in providing care to the patients. NUH was the first positive hospital in the Asia-Pacific region years ago. “Beds sometimes bump into walls when being to implement the system. moved, leaving cracks and holes which had to be patched Sow Chun, 55, is not daunted transformation up. I thought about car bumpers and we worked with our by delays either, recalling that it operations support services team to come up with a design,” took seven years to get an electric she explained. pill crusher at NUH. Till 2018, She feels innovation must make a positive impact on the nurses were using the mortar lives of the patients and nurses. Like using the macerator, and pestle to pound medication a machine that shreds and flushes away disposable bedpans, into powder for patients who urinals and vomit bowls. Not only is it convenient, it is hygienic, couldn’t swallow and had to be saves water and energy as well as the nurses’ time spent fed through nasogastric tubes. cleaning the equipment. Over the last decade a number of “The nurses knew there had to hospitals in Singapore have followed NUH’s lead to use it. be a better way and it took that hospital for the National University of Singapore’s schools of Said the methodical Sow Chun: “In the West, it had been long because we were trying to see which technology was the NG SOW CHUN medicine and dentistry. around for 20 years. Even though the macerator involves the best,” she said. Deputy Director of Nursing When Ng Sow Chun joined NUH as a Staff Nurse after cost of consumables, the nursing team kept pushing for it. It is The unassuming nursing veteran, who exercises regularly graduating from the former School of Nursing in 1985, she an example of believing in investing in a system that can help despite her hectic schedule, is proud of the innovations that National University Hospital knew her job went beyond delivering great care to patients. patients.” she worked on with many stakeholders – especially since Now a Deputy Director of Nursing at NUH, she is still looking Another innovation at NUH which was a collaboration she believes that nurses are one of the drivers for a better INNOVATION and learning have been among the National for innovative ways to improve patient care and make nursing between the nursing and pharmacy teams is the Closed healthcare system. It is a belief she has had since she was a University Hospital’s (NUH) mantras ever since it opened in processes more efficient. Loop Medication Management System that ensures sickly child who was frequently hospitalised. The nurses who June 1985. As one of the hospitals that opened in the 1980s It could be as simple as coming up with a bed bumper patients in wards get the right medicine from prescription cared for her left a deep impression on her and inspired her with modern facilities, it was also the principal teaching for the hospital beds, which she and her team did several to dispensation. The intelligent system incorporates the to don the nursing uniform.
86 87 CHAMPIONING CHANGE, ADVANCING CARE
nurse,” he explained. I wanted to show that I can I speak with Today, Kok Cheong is expanding the frontiers in healthcare be as good as a female nurse. innovation and research. One example is i-COMM, a mobile application that helps nurses communicate better with patients who Being a man does not make me only speak Chinese dialects and Malay. “ any less of a nurse. Short for ‘Integrated Healthcare Communicator’, i-COMM was developed by a group of 13 nurses, which included him, six other CGH staff and the hospital’s Office of Innovation in 2014, after it i-COMM was noticed that some nurses were struggling to communicate with dialect-speaking elderly patients. WONG KOK CHEONG It is the first application in Singapore to include commonly used Deputy Director of Nursing nursing phrases translated from English to Cantonese, Hokkien and Malay. Clicking on a phrase reveals a phonics guide and allows for Changi General Hospital audio playback while accompanying images reinforce the message. Developing i-COMM was challenging, but the nurses displayed ASK 54-year-old Wong Kok Cheong for his favourite music genre ingenuity. For example, they created a makeshift recording studio in and, chances are, his reply will shock you. “K-pop,” comes the answer, a cramped storeroom at CGH to record the audio translations. without missing a beat. His passion for Korean pop music may raise “The nurses used whatever technological devices they had to eyebrows, but the Changi General Hospital (CGH) Deputy Director of record their voices and even turned the fans off to get a clear Nursing remains unfazed. recording!” the 2017 recipient of the President’s Award for Nurses “People have commented that it’s quite odd for someone of my recalled with a laugh. age to like K-pop, but I’m not offended. I enjoy listening to K-pop All that effort paid off when patients and nurses benefited from when I hit the gym and in fact, I’ve influenced my teenage son to i-COMM and Health Minister Gan Kim Yong lauded it at a gala enjoy it too!” said the cheerful man, who is a fan of Korean pop dinner held in conjunction with the International Council of Nurses groups like Girls Generation and Big Bang. Congress last year. It is this spirit of pushing boundaries that led to Kok Cheong But Kok Cheong is not resting on his laurels. Heartened by how abandoning his science studies at the National University of nurses play a “crucial role in healthcare innovation”, such as the Singapore in the second year for nursing studies over three decades Radio-Frequency Identification (RFID) tags to track thousands of ago. A combat medic during his National Service, he was inspired by pieces of surgical equipment, a customised motorised trolley to nurses who went the extra mile to help patients. carry up to 200kg of surgical instruments and real-time location Despite objections from his friends and family, who felt nursing system for central asset management, he is currently working on was for females, he successfully applied for a Public Service more innovations to benefit nurses in the future. For him, the sky’s Commission nursing scholarship. “I wanted to show that I can be as the limit: “There are so many opportunities to use technology to help good as a female nurse. Being a man does not make me any less of a nurses do their jobs well!”
88 89 CHAMPIONING CHANGE, ADVANCING CARE
Angie products that the soft-spoken creative solutions to help them.” nurses’ station for health check-ups, she mother of two has invented; the Angie She added that the impact on her entertains them with her 43-year-old Cargo Pants (comes with special pockets patients has been immense: “One instrument. Be an to hide urine drainage bags), the Angie elderly gentleman was so overjoyed Given her inquisitive nature, Hai Moy Headband (to keep nasogastric feeding when he bought the Angie Cargo obviously has more ideas up her sleeve tubes tucked neatly along the hairline), Pants because he was no longer and is working on some new ideas the Angie Potty (a level up of the existing self-conscious about his catheter and that could boost the Angie range of Witches Hat model to make collection could visit friends and relatives over products… all to help her patients. Angie of urine specimens even easier for Chinese New Year.” As for the nickname, she thinks the patients) and the Angie Nasogastric In addition to tinkering with patient probably thought it was easier Feeding Set (a toolkit to help caregivers patient-related gadgets and gizmos, to call her by that name but has now feed patients through the same feeding Hai Moy also spends some time adopted it to mean something: “I always TOH HAI MOY tubes). perfecting her harmonica skills which encourage my nurses to be an ‘Angie’… Advanced Practice Nurse Hai Moy, 61, said: “As nurses, we are come in handy when she goes on her learn to observe what goes on around the eyes and ears of our patients, we annual medical humanitarian trips to them and see if they can come up with Khoo Teck Puat Hospital know what their needs and challenges neighbouring countries with fellow innovative solutions to help are. When we spot something that nurses, doctors and dentists. patients in their daily lives.” NECESSITY, as the saying goes, is the needs fixing, our challenge is to think Besides providing clinical care More likely, Angie is short mother of invention. About eight years out of the box and come up with to the locals who come to their for angel. ago, Advanced Practice Nurse Toh Hai Moy at Khoo Teck Puat Hospital had a As nurses, we are the eyes flash of inspiration: she wanted to give and ears of our patients, we her patients, who all required a feeding tube or urine drainage bag, the dignity “know what their needs and of going about their daily activities challenges are. When we spot without inviting uncomfortable stares or something that needs fixing, questions. And voila, the nursing veteran of 40 our challenge is to think out years invented a range of products that of the box and come up with did just that. She named them under the creative solutions to help brand Angie, a nickname a patient had bestowed on her. them. To date, there are a total of four
90 91 CHAMPIONING CHANGE, ADVANCING CARE
Innovation is a must to meet the needs of an ageing Tech-ing “population. Innovation with the use of IT and job re-design will care in the enable us to do better.
make the transition back to home after being discharged from hospital and even includes a training programme for community caregivers. Pointing to the difficulty in recruiting manpower for the community care sector, Mui Lang said: “Innovation is a must to meet the needs of an ageing population. Innovation with the LOW MUI LANG use of IT and job re-design will enable us to do better.” Executive Director No wonder she turns to jigsaw puzzles whenever she is stuck for an answer to a work-related problem or challenge. Peacehaven “It helps you to find the answers to some of the things you do in life,” said the enthusiastic lady whose largest jigsaw puzzle to date was 4,000 pieces. LOW Mui Lang is 61 and has been a nurse for 43 years, the Peacehaven team use technology and innovation to enhance lifting hoist introduced in 2015 helps residents with mobility last 19 of them at Peacehaven, The Salvation Army’s nursing the care they deliver to their residents. issues attend their rehabilitation and exercise sessions home in Changi, where she is the Executive Director. The For instance, to help residents who have dementia, the without needing a wheelchair or a walking aid. The hoist also length of service is no surprise when she tells you that from nursing home is modelled on a common HDB flat but with saves on manpower time, which allows nurses to focus more the tender age of 10, nursing was her dream job. open-concept kitchens and cupboards without doors. This on their core work with the residents. “I lost my younger brother to encephalitis when I was 10, is to help residents see the things they need at one glance Another initiative, the IngoT system, by the Lien Foundation maybe this could be part of my motivation to join nursing,” before they forget what they want to do. was introduced in 2013 and moved the home from a manual recalls the 2010 recipient of the President’s Award for Nurses, Residents are also encouraged to take care of each other, medical health record system to a digital one that is more who graduated from the former School of Nursing in the late where higher functioning residents help the rest. “Seeing the secure and agile. 1970s and has a master’s degree in Healthcare Management. others do the activities, the lower-functioning ones will be Peacehaven, which has two day centres for seniors in She is now using the vast experience garnered at various prompted to do them too,” Mui Lang explained. Bedok and Changi, uses an exercise programme called Gym public and private healthcare institutions, a community Technology has also been harnessed to help the nurses Tonic to keep residents mobile and independent. It also has hospital and nursing homes to improve the way she and her focus on their primary job of caring. For instance, the patient a short-term rehabilitation programme which helps patients
92 93 CHAMPIONING CHANGE, ADVANCING CARE Harnessing research for better patient care
HERE is a little-known fact about in the West are not catered for the local This study was later developed into Florence Nightingale: In 1854, while at setting. This is where research findings a tool called the Surgical Pressure Ulcer a British military camp in Turkey during help to adapt our current care model, Risk Score (SPURS) used in SGH to the Crimean War, she observed the which focuses largely on the patient, to identify and assess all high-risk patients devastating effect the dirty environment a care model that looks after the entire undergoing surgery. They receive a had on the soldiers. She recorded family,” explained Ee Yuee. SPURS wrist tag, a prophylactic foam the mortality rate in the hospital and Having worked at TTSH for 29 years, dressing over bony prominences and found that for every 1,000 injured the self-proclaimed fan of Florence an alternating pressure-relieving air soldiers, 600 were dying because Nightingale got into research work in mattress before the operation. of communicable and infectious 2005 when she was a Nurse Educator “Research helps to identify areas diseases. at the hospital. She believes it is where we can channel resources,” said Florence’s interventions were simple; important to push boundaries to find the 40-year-old who has logged in 18 she and her team provided a clean new solutions in patient care: “Nursing years at SGH. environment, medical equipment, clean needs to be at the frontier of new Thanks to her familiarity with analytics water and fruits. The result? A significant SITI ZUBAIDAH CHAN EE YUEE FAZILA ALOWENI clinical developments. If we never want and computer languages – she picked drop in the mortality rate. Florence’s use Assistant Director of Nursing Assistant Director of Nursing Nurse Clinician to do something different, we will never up those during a brief stint in a of evidence-based practice saved lives. improve.” computer science diploma programme National University Hospital Tan Tock Seng Hospital Singapore General Hospital Today, the three nurse-researchers Nurse Clinician Fazila Aloweni was before she switched to nursing at featured in this article are embarking juggling research work and her nursing Nanyang Polytechnic as she wanted on the same mission: Using research to ask me if my research work was like a which does a large part of the impact of stress on caregivers of elderly duties at the Singapore General Hospital more “human contact” – research was a data to improve clinical practices and ‘CCA’ (co-curricular activity) and why assessment, and hopes it will take some patients. Realising that one in three (SGH) for four years until she switched to natural progression for Fazila. standards of patient care. And they I would want to do research.” pressure off the nurses’ workload. family caregivers is stressed and at full-time research two years ago. Among The three nurses hope to see more have to constantly explain what they do The 57-year-old, who has been a If successful, this will help identify risk of falling into depression, the her research interests are informal colleagues take on research work as the and why they do it, even to their own nurse for over 36 years, added that and assess patients with a higher risk of 52-year-old Assistant Director of Nursing caregiving and wound care, particularly time spent at a patient’s bedside and the colleagues. translating the research findings into falls. This will allow the nurses to provide and her team are developing tools to pressure injuries. She and her team desire for new knowledge and solutions Dr Siti Zubaidah, Assistant Director solutions for better patient care is timely interventions for the patients. help nurses screen the caregivers and developed and published a study in make nurses good researchers. As of Nursing at the National University exciting. She is currently researching Over at Tan Tock Seng Hospital develop psychoeducational programmes 2018 on how to reduce the incidence Siti put it: “It is empowering to use Hospital, said: “During my time as a fall risks in patients, using an artificial (TTSH), Adjunct Assistant Professor Chan to provide them with better support. of pressure injuries and identified eight our clinical experience to find better Operating Theatre Nurse, nurses used intelligence (AI) predictive software Ee Yuee is currently researching the “We realised many tools developed significant risk factors. solutions for our patients.”
94 95 Beyond Hospital Walls, Into the Community BEYOND HOSPITAL WALLS, INTO THE COMMUNITY
SYLVIA LEE nursing students, she joined For me, what matters most her camera. Having picked up Advanced Practice Nurse Singapore General Hospital (SGH) is being able to journey with photography as a hobby in 2014, as a Registered Nurse. the patients till the very end she said: “I recharge by taking solo Dover Park Hospice However, the academic path “ holidays to photograph natural APN 0000001 kept beckoning, and she embarked with dignity. landscapes which allows me to on her degree in nursing at the leave my worldly worries behind.” University of Sydney (Australia) in While APN 0000001 has its own 1997. “After my first work experience at SGH, I was convinced honour, what’s more important to this 45-year-old nurse is that I had to continue learning to provide better patient care,” her patients. The 2009 President’s Award for Nurses recipient she explained. By 1999, she had added a master’s degree said: “For me, what matters most is being able to journey with from the same university to her resume. the patients till the very end with dignity.” After working at Dover Park Hospice for the next five years – where she provides and supports end-of-life care for patients – she got the management’s support to pursue her post-master’s qualifications in palliative care. Recalling that stage of her career, Sylvia said: “At that time, the APN role was just beginning to take root in Singapore and I was glad I could qualify as an APN when I returned. Thankfully, I passed!” She confessed that being a pioneer APN was not easy: “I was charting my own path by casting my job description. As an APN, I saw the need to build and contribute meaningfully to the role.” Today, it is much better defined and while the primary task is to diagnose and manage patients’ medical conditions, APNs like Sylvia also help their patients navigate the healthcare system. She said: “I had a patient who guarded his independence IF IT wasn’t for an excited Singapore Nursing Board (SNB) asked chirpily if I knew I was the first APN to be registered. She and wanted to die at home. To honour his wishes, I engaged employee, Sylvia Lee wouldn’t have known that she was our pointed to the certificate and the number read 0000001!” a caregiver and mobilised community resources to care for nation’s first Advanced Practice Nurse (APN). The unique number aside, it was the culmination of a him at home for as long as possible, till he was ready to be She said: “When I collected my certification at SNB on long journey for Sylvia. Having graduated from Nanyang admitted to an in-patient hospice for terminal care.” 16 October 2006, the person in charge of my registration Polytechnic in 1992 as part of the first cohort of diploma To cope with the intensity of her job, Sylvia turns to
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his reluctance stemmed from his poor have since evolved. From focusing eyesight. on patient education, they now work Loo See recalled: “He couldn’t see alongside doctors in NHGP’s care teams, the syringe markings, so my colleagues also known as teamlets. Under this purchased a pair of spectacles from model, patients with chronic diseases can Daiso for him. I was overjoyed when he see the same team of doctors and Care successfully injected the insulin!” Managers for polyclinic consultations. This is just one of the ways NHGP Besides that, nurses also partner General nurses specialising in Chronic Disease Practitioners (GPs) to care for patients Management – Care Managers as they’re with chronic diseases at GP clinics under known – go the extra mile for patients. the Primary Care Network. They also educate and treat patients Loo See, feels a sense of satisfaction with chronic diseases, understand their because Care Managers “enjoy greater emotional and social wellbeing as well as autonomy today”. In fact, after 34 years YEO LOO SEE create a care plan for them. in the profession, she describes nursing Deputy Director of Nursing Chronic Disease Management gained as an intricate juggling act of being a prominence in 2000 when such medical patient’s friend, coach and counsellor. National Healthcare Group Polyclinics conditions surfaced more frequently in The greatest challenge? “Empowering Singapore. And Loo See was pivotal in patients to change behaviours,” added driving it at NHGP. The 58-year-old said: “Chronic diseases the affable nurse, who was drawn to the profession in her late like diabetes and the recovery from a stroke are lifelong, so teens to fulfil her late mother’s wish to have a nurse in the WHEN an elderly diabetic patient was reluctant to load his nurses must be well trained in managing them.” family. insulin injections himself, the nurses at Ang Mo Kio Polyclinic She and her colleagues introduced a compulsory When work gets stressful, she tunes in to her favourite wondered whether it was the unfamiliarity with the process foundation course in Chronic Disease Management in 2014 Korean and Hong Kong dramas on weekends. Like these A friend, that was stopping him. As the polyclinic is part of the National for NHGP nurses who were specialising in co-managing such dramas, Loo See’s nursing story has its ups and downs, but Healthcare Group Polyclinics (NHGP), the nurse clinician medical conditions. She also earning her patients’ trust informed Yeo Loo See, Deputy Director of Nursing at NHGP, spent two years revising a motivates her. She said: about the issue. competency assessment Chronic diseases like diabetes “Going forward, we need to coach and Loo See first checked with Tan Tock Seng Hospital’s framework that moulds and the recovery from a stroke are train nurses to gain greater Diabetes Centre, which was managing the patient’s case at nurses into competent Care autonomy by working with lifelong, so nurses must be well that time, for the reason. Following her chat with a nurse Managers. “ doctors on more complicated from the Diabetes Centre, she got her polyclinic nurses to Polyclinic nurses’ roles in trained in managing them. cases so that we can continue counsellor counsel the patient further. That was when they realised that Chronic Disease Management to win our patients’ trust.” 100 101 BEYOND HOSPITAL WALLS, INTO THE COMMUNITY
of Technology. I am inspired by the survivors the memory with a teary Care across Through all this, Jelita’s (of natural disasters), their resilience smile. spirit of volunteerism Jelita has also joined a and grit. I want my children to see the remained strong and, with “ local Christian organisation her growing nursing skills, world as I do; that we can help and care – she was one of the few she embarked on more for people who need it the most. Muslims in the group – on the borders medical-humanitarian a mission to a village in missions. Surabaya to build public In 2015, she joined non- toilets. As part of a small government organisation Crisis Relief group of medical professionals who Singapore and Singapore Red Cross on offered health screenings as well, she their relief mission in Nepal, following an found it “interesting to see people of earthquake there. She stayed for eight different professions and religions weeks, much to her husband’s chagrin. coming together to help the locals”. “He didn’t want me to go initially, These days, work and raising her but I insisted. As there were no means young children keep her very busy, of communication, I just told him that putting overseas missions and her love NUR JELITA REMIE no news is good news,” she said with a for running on hold for now. Assistant Nurse Clinician laugh. In the meantime, she volunteers Staying with villagers on the outskirts locally, helping out during health National University Hospital of Nepal’s capital Kathmandu, which screenings at the local mosques. When occasionally experienced after-shocks her children are older, she hopes to that followed the 7.8 magnitude resume medical mission work and even WHEN Nur Jelita Remie was in her too,” she explained. Polytechnic in 2007 and joined the earthquake, Jelita provided care to the take them with her. mid-20s, she joined a humanitarian Now 41, Jelita is an Assistant Nurse emergency department at NUH in 2009. villagers in the mobile clinic, while also “I am inspired by the survivors (of mission to a village in Vietnam. That Clinician at National University Hospital She later completed the Advanced engaging with the local children. natural disasters), their resilience and trip led to the event manager deciding (NUH), and very happy with what she’s Diploma in Nursing (Emergency) from “I remember giving a set of colour grit. I want my children to see the world to change professions. Inspired by doing. But it didn’t come easy. It took the same polytechnic thanks to a pencils to a girl after she won an as I do; that we can help and care for the nurses caring for the villagers, she five tries for her to be accepted into the sponsorship from NUH and, in 2016, impromptu colouring competition. To people who need it the most,” she said. wanted to be a nurse too. “I wanted to Professional Conversion Programme, followed up with a nursing degree my surprise, instead of keeping it all to In recognition of her effort, Jelita do more. Nursing is not just needed in where she took on the accelerated with honours awarded by University of herself, she gave each friend a colour received the Healthcare Humanity hospitals. It takes me to other places Diploma in Nursing at Nanyang Manchester via the Singapore Institute pencil,” said the mother of two, recalling Award in 2014.
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patients, whether in a hospital or in the prison. NOOR HAFIZ BIN HASSAN “We perform what we are trained to do – caring Senior Staff Nurse for the patient; it’s only more controlled in the prison environment. We also emphasise the patient’s mental Parkway Pantai well-being and try to divert their attention from their situation as being in jail is a stressful experience,” said Hafiz, who was inspired by an older cousin and role model in nursing, to take up nursing studies in 2003. As for fellow nurses who may be keen to work in the prison, his advice is take time to get used to the Showing environment and don’t give up so fast. He said: “There are many security protocols. We have to surrender our phones and electronic devices, and pass through many security checkpoints whenever we enter. It took me two years to adapt. However, it has care, even been very fulfilling. At the end of the day, inmates deserve the same amount of respect as behind bars any other patient.”
NOOR Hafiz bin Hassan enjoys long rides on his Suzuki ones in army camps with sick bay beds for patients. The There are many security protocols. Hayabusa motorcycle, cruising down the highway with the rest operate from 8am to 5.30pm, just like outpatient We have to surrender our phones and wind caressing his face. It is his way of unwinding from the clinics. Hafiz, who is part of a team of 180 nurses from pressures of his job as a Senior Staff Nurse. Of course, Parkway Pantai which provides medical service to “electronic devices, and pass through many given that he works at Changi Prison, he does care for Singapore’s prisons, has worked in both settings. security checkpoints whenever we enter. It a unique group of patients. The 36-year-old nurse said he feels very safe within the took me two years to adapt. However, it has Asked what it’s like to work within a prison, he said: prison complex: “The inmates are always accompanied by “I didn’t know what to expect when I started but, after prison officers who will manage them, even for basic needs been very fulfilling. At the end of the day, six years of working in prisons, it has been a great and like showering, and we don’t see them alone.” inmates are patients and deserve the same rewarding experience.” That said, the cheerful Nanyang Polytechnic graduate, amount of respect as any other patient. Changi Prison has 14 blocks and each block has a clinic. who also has a nursing degree from the University of Five of these are 24-hour medical centres, similar to the Sunderland, doesn’t differentiate the care he gives his
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WHEN Lai Chooi Ngoh was pondering stimulate the blood cells and We (renal nurses) do more than While this situation is not that her next step in life as a young woman, increase haemoglobin,” she just oversee the patients’ dialysis; common at the dialysis centres, she wanted to have a career that was said. NKF nurses have to stay vigilant Renal nurses do we educate them on vascular fulfilling, noble and stable. She added that since “ and make quick decisions for the Nursing ticked all of those boxes and doctors are not in NKF access care, diet fluid control and well-being of their patients. still does even after close to 40 years of dialysis centres all the administer medication for the In addition, much has more than dialysis service! Chooi Ngoh, 66, is now a Senior time, nurses take the lead changed in the area of renal Clinical Nurse Manager at The National in assessing the patients’ patients. nursing, particularly due to Kidney Foundation (NKF). progress as well as planning the changing demographics Having received her training in their dialysis schedules and of dialysis patients and the the United Kingdom, which included processes. taking him to hospital on their own but evolution of technology. LAI CHOOI NGOH stints in two hospitals, she returned to “The nurses will plan the duration we convinced them that it was urgent “When I started, setting up the Singapore in 1982 where she joined accordingly, such as if the patients and they might not be able to handle dialysis process was manual. Now the Senior Clinical Nurse Manager Mount Elizabeth Hospital as a Staff need a longer or shorter period and the situation by themselves,” said Chooi machines do most of the work and The National Kidney Foundation Nurse. That’s where she got to know make sure they have adequate dialysis Ngoh. I see more advanced machines being more about renal care and eventually sessions,” said Chooi Ngoh. While the patient eventually didn’t developed,” said Chooi Ngoh. made it her speciality. She received the She pointed out that NKF nurses make it and passed on, the family was She believes the NKF nurses of the Post-Basic Certificate in Renal Nursing are also seeing more elderly patients still grateful to the nursing team for future will be able to focus more on from the then School of Nursing. with kidney failure as a result of making the right call for their father. the increasingly complex cases at In 1990, after spending eight years in diabetes, so they have to include the dialysis centres. This means Mount Elizabeth, she moved to NKF. diabetic foot screening and gerontology they would have to ensure they are Said Chooi Ngoh: “We (renal nurses) assessment... and be prepared for always up-to-date on the changes in do more than just oversee the patients’ emergencies. healthcare. dialysis; we educate them on vascular The mother of two While retirement is on the access care, diet fluid control and remembered a 70-year-old who horizon for Chooi Ngoh – she administer medication for the patients.” came in for his dialysis as dances (left, with her husband) The nurses also follow-up on the usual but complained about twice a week to keep her mind patients’ medications and assess the not feeling well. active – she hopes to see the patients. This includes measuring their “I noticed that he was next generation of nurses ‘wet’ (before dialysis) and ‘dry’ (after perspiring profusely and keep up with the training as dialysis) weights. seeing that this was not healthcare needs evolve. “We ensure that they do not get normal for him, we decided She said: “Nurses have complications from fluid overload and to call for an ambulance. to be ready to take on new administer a erythropoietin injection to Initially his family insisted on challenges as they come.”
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As we don’t wear our too, promoting healthy living to can keep them updated on their child’s nurse uniform in the students and collaborating with schools situation. We need parents to be on programmes to encourage healthy more involved in the development of school, the students Healthy “ eating. their children’s health and have better tend to call us ‘teacher’; Added Mages: “As we don’t wear conversations about healthy eating.” it makes me feel that our nurse uniform in the school, the students tend to call us ‘teacher’; we are one of the journey it makes me feel that we are one of the educators too. educators too.” Her challenges are time and apathy. She has to organise the activities career as a nursing aide at Thomson around the students’ busy schedules, starts from Medical Centre in 1993. Two years later, sometimes during recess or Physical encouraged by her nursing officer and Education lessons, and deal with supported by her mother, she signed apathetic parents. She is grateful for up for a programme then offered by the support from the teachers at Ang young the Ministry of Health to become an Mo Kio Primary School who work with Enrolled Nurse. her to encourage their students to be Following her certification in 1997, active and healthy. she joined the Institute of Health’s Another challenge was keeping track MAGESWARI AMADERLINGAM School Health Services and is still with of the children’s immunisations with the the unit – which is now part of Health health booklet. That has since changed. Senior Staff Nurse Promotion Board (HPB) since 2001. Mages, who does yoga in her free Health Promotion Board “I was in the school health screening time, feels technology has helped the team where I administered vaccinations work of the school nurse a great deal and conducted vision checks for school with digital records of immunisations REMEMBER immunisation shots from Mageswari Amaderlingam is part I work, I say we are engaged in the children. I also worked in HPB’s Student and scans on HealthHub. She added: a nurse at school? Most of us do, yet of the special group of nurses who schools. Normally they are surprised, Health Centre where I performed “We can do more data analysis on the many of us are unaware that nurses have kept generations of our students so I explain that we collaborate with clinical duties such as ear syringing health of the student population using are the backbone of Singapore’s School healthy for 99 years, giving them schools and conduct activities with procedures and assisted doctors,” said the information stored online.” Health Services (SHS). In fact, you may life-saving immunisations and providing the students to encourage them to be Mages, who was sponsored by HPB That said, the 44-year-old be pleasantly surprised to also know crucial health check-ups in school healthy.” for her Diploma in Nursing at Nanyang unassuming lady still wants to engage that the SHS has been around since campuses. Mageswari, who is called Mages Polytechnic in 2002. more with the students’ parents 1921. She said: “When people ask where by colleagues, started her nursing Now she is a Student Health Advisor through home visits or via apps: “We
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I am so scared of the pests but had to I remember visiting region as well as the after-hours focus on attending to the patient while a patient whose flat services duty schedule and handles hoping that I won’t have ‘surprises’ from new referrals and complex cases. was infested with Taking care to homes the roaches,” said Renuka who is now “ She also works closely with medical an Assistant Nurse Clinician at HNF. cockroaches. I am so social workers, community service She immediately followed up with a scared of the pests providers and caregivers to help social worker to seek the town council’s patients with social issues that impact assistance with cleaning the flat. but had to focus their health. Having joined the profession in on attending to the To upgrade her skills, the 1996, following her Diploma in Nursing patient while hoping effervescent nurse completed the from Nanyang Polytechnic (NYP), Advanced Diploma in Nursing Renuka spent 12 years at National that I won’t have (Gerontology) at NYP in 2014 – to give University Hospital. During this time, ‘surprises’ from the her an edge in providing better care she always wondered how her patients roaches. for her older patients – and is currently coped at home when they were studying part-time for a degree in discharged from the hospital. nursing from Griffith University “You can teach the patients how to (Australia). care for themselves and the caregivers Her hope is that community care on giving the care, but when they go nurses embrace technology to better home, it could be another story,” care for their patients and more she said. volunteer befrienders can be This concern stayed with incorporated into the HNF network. her even when she took a “I would like to see nurses use short break from nursing tele-monitoring for our patients to focus on raising her two in the future so our follow-ups sons. Not surprisingly, it can be better especially with was HNF that she headed to wound care, diabetic care and when she decided to resume management of medication. LIKE most of us, Renuka Nagalingham Nurse at the Home Nursing Foundation her career in 2009. It will also empower them to RENUKA NAGALINGHAM despises cockroaches. However, when (HNF), she shrugged off an unpleasant When she started at the take better charge of their care. Assistant Nurse Clinician it comes to her job, she has the mental encounter during a visit to a patient’s foundation, Renuka visited Having befrienders for lonely elderly fortitude to focus on her task and home. about five to six patients a day. patients will be good too as they can Home Nursing Foundation ignore the ugly pests. She proved that “I remember visiting a patient whose Now, the 44-year-old manages the be the eyes and ears on the ground,” when, during her time as a Senior Staff flat was infested with cockroaches. home visit schedules for the western added Renuka.
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Nursing at HSA has progressed quite a bit and we are currently training the nurses to be able to “handle screenings prior to blood donations (a role Banking presently handled by doctors). I hope to see nurses on blood handling the whole process, from start to finish. is how she prefers to enjoy her free a bit and we are currently training the time – to help out at other blood bank nurses to be able to handle screenings national emergencies like the collapse branches if they are shorthanded. prior to blood donations (a role ANG YI LIN of Hotel New World in 1986 and the She has one unfulfilled aspiration presently handled by doctors). I hope to Senior Staff Nurse Spyros accident in 1978 which saw many though: To see nurses handle the entire see nurses handling the whole process, casualties following an explosion on the blood donation process. from start to finish.” Bloodbank@HSA Greek oil tanker docked in Singapore “Before, we didn’t have sophisticated waters. Nurses worked around the clock, machines, so nurses had to keep WHEN Senior Staff Nurse Ang Yi Lin collecting blood from donors to ensure monitoring the (blood collection) looks at a bag of blood, she is constantly there was sufficient supply for the process. It was a manual reminded that it can save three lives. injured. hook-on mechanism That statistic has been drilled into her The 38-year-old nurse, who was even though they live closer to the master’s degree in aged care in 2006. and so they had to as part of her work at the blood bank at drawn to the profession thanks to her satellite blood banks around the island, The next eight years were spent working make sure the anti- Health Sciences Authority (HSA) or as it aunt who was a nurse, says her team attributing it to the friendships the HSA in a community hospital in Sydney, coagulator and blood is known, Bloodbank@HSA. works hard to ensure the blood bank nurses have developed with them. “The before she returned to Singapore in in the bag were “Many people don’t know that there maintains a six-day blood stock at all donors’ appreciation and their smiles 2013 when she was expecting her first mixed well,” she said. are nurses at HSA,” said Yi Lin, adding times. To ensure they do not drop under mean a lot to us,” added the mother of child. She joined HSA in 2014. Today’s machines that it included members of her family. required stock levels, Yi Lin and her two who started her nursing career at Now, Yi Lin’s passion for her job sees are more advanced, Having been with HSA for five years, fellow nurses do their best to ensure the National Heart Centre, Singapore her literally going the extra mile when letting the nurses do she always takes time to explain that the donors have a positive experience after completing her nursing diploma at the occasion demands it. Although their jobs better and she and her team collect and maintain at blood donation drives and at the four Nanyang Polytechnic in 2002. stationed at Bloodbank@HSA, she is helping them focus on the nation’s blood supply for patients, blood banks. In 2003, she headed to the University part of the mobile team that handles the donor experience. especially in times of crisis. She revealed that her regular donors of Wollongong (Australia) for her degree blood donation drives and is always Yi Lin added: “Nursing HSA nurses have been there for keep coming back to Bloodbank@HSA in nursing and followed it up with a ready to put down her book – reading at HSA has progressed quite
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the Mayo Clinic and Cleveland Clinic, To nursing leaders, she has this to TRACY CAROL AYRE Over the last 30 top medical facilities in the United years, nursing has say: “It’s very important to know your Group Chief Nurse States), citing its clinical research and nurses, engage and always be there SingHealth “outstanding nursing”. The magazine already moved up for them. If they feel happy, they will do Chief Nurse “ also noted that SGH was the first many notches. We good work; patients will be happy and Singapore General Hospital hospital in Asia to be awarded the used to be, for lack outcomes will be good.” Magnet designation in 2010 – the When she is not strategising on nurse IT WAS a single moment of tragedy in highest accolade for nursing excellence of a better word, staffing challenges, talent retention Adjunct Associate Professor Tracy Carol – by the American Nurses Credentialing doctors’ handmaidens. and development across SingHealth, Ayre’s life at age 14 that determined Centre. Now, we have greater Tracy relaxes by reading, gardening, her life’s path as a nurse. Her beloved Yet, like her SingHealth colleagues, baking and cooking for her daughter. maternal grandmother died due to she remained humble about it. “I think autonomy and “My 11-year-old daughter has a varied pulmonary edema – a condition caused we must keep aspiring to be better. I’ve independence, new palate, so I have to vary my cooking by excess fluid in the lungs. always told my nurses I am very proud technology, robotics style. I am adept at cooking Malay, Tracy, now 53, can still vividly recall of them and of their dedication and Indian, Chinese and Western food!” the that moment: “She collapsed at night commitment. SGH is very complex and and automation that cheerful lady revealed with a laugh. and we took her to a hospital. Mum they are busy every hour, every day, yet relieve us of mundane and I were left waiting in the corridor. their love for their patients and work is tasks and add value to Nobody came out to update us and we evident,” added Tracy. didn’t know what was going on. And then The 2007 President’s Award for what we do. this person came out and told us ‘your Nurses recipient, who completed her grandmother has passed away’.” PhD in 2009, would like nurses to be Striving Five years later, she enrolled in the nimble and adaptable change makers, Tracy observed. then School of Nursing and worked at challenging the current way of doing Her aspiration is for future nurses the Singapore General Hospital (SGH) things to deliver the best patient to be “intelligent, resilient and equal for after graduation, eventually specialising experience and quality care. players at the policy table, while in critical care nursing. Now, after “Over the last 30 years, nursing has maintaining compassion and humanity 34 years with SGH, Tracy has 12,000 already moved up many notches. We for patients”. nurses under her care as Group Chief used to be, for lack of a better word, “I hope they will go the extra mile, excellence Nurse, SingHealth and has been Chief doctors’ handmaidens. Now, we have whether it’s for a new process, a new Nurse of SGH since 2012. greater autonomy and independence, skill or a new way of doing things,” she It gave her great pride when new technology, robotics and added. “We always have to be one Newsweek ranked SGH the world’s automation that relieve us of mundane step ahead, otherwise we will lose our third best hospital in March 2019 (after tasks and add value to what we do,” relevance in this changing world.”
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spearheaded training modules at As a leader, you must the handicraft lover, who enjoys making SingHealth in 2003 to give nurses empower and support paper lanterns. opportunities to expand their roles. The quietly confident woman the nurses. I am not She also introduced skills upgrading “ received the Her World Woman of the Nurses… programmes in 2005 for Enrolled afraid to speak up for Year award (2012-2013). The award Nurses, giving them a chance to assist them, because if we recognises women with outstanding doctors and take on jobs such as achievements, but Swee Hia is quick to conducting bladder scans. don’t, who will? downplay her accomplishments. “No at the heart Together with Dr Della Lee, Chairman lah, there are many other nurses who of the DS Lee Foundation, Swee Hia stems from her childhood. Growing up deserve the award,” she said bashfully. co-founded the Tan Chin Tuan Nursing in austere living conditions and being One thing she is immensely Award, a national award for outstanding the eldest of five siblings meant she had proud of is SNA successfully hosting of everything Enrolled Nurses. She also helped to make many sacrifices, such as leaving the International Council of Nurses establish the SingHealth Alice Lee school after her O levels to earn a living Congress 2019 in Singapore. Institute of Advanced Nursing (IAN) and help finance their education. The biennial event is an opportunity in 2015, which offers affordable “I only got my nursing degree when for nurses from all over the world, she does nursing specialisation programmes I was 48 due to financial constraints. international healthcare policy makers and practice-based training for nurses I treat nurses like my children, and this and professionals to congregate and in Singapore. is why I want to help them pursue their exchange healthcare knowledge. Swee “About 14,000 nurses across dreams and receive a proper education Hia said: “We are so proud to have Singapore are trained at the IAN yearly,” without worrying about the cost,” said hosted more than 5,000 delegates from said Swee Hia, a 2002 President’s over 140 countries and put our nursing Award for Nurses winner, who is Senior profession in the spotlight!” Director of SingHealth Alice Lee IAN She is also heartened by how and President of the Singapore Nurses perceptions towards nursing have Association (SNA). improved over the years. She said: The institute is the first in Asia “Today, I see nurses embracing their LIM SWEE HIA NOT all heroes wear capes. Some wear she spent the past 49 years fighting to be accredited by the American profession with pride.” Senior Director batik, like Associate Professor (Dr) Lim tirelessly to strengthen the nursing Nurses Credentialing Centre Then she added with conviction: SingHealth Alice Lee Institute Swee Hia who loves the prints for their fabric and raise the profile of the nursing which, she added, is a great “As a leader, you must empower of Advanced Nursing versatility. In sync with the intricate profession in Singapore. morale booster as it benchmarks and support the nurses. I am not President batik prints of her favourite tops, Swee The 70-year-old, who was drawn Singapore nurses to international afraid to speak up for them, because Singapore Nurses Association Hia’s nursing career is colourful and to nursing after volunteering with the standards. if we don’t, who will?” (April 2012 – June 2020) varied, which is no surprise given how Red Cross during her teenage years, Her interest in nursing education Truly, this is a nursing hero.
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the Sigma Theta Tau International Honor management,” said the affable lady, innovating nursing practices. Society of Nursing in 2007, a non-profit whose two older sisters are nurses as “Nurses are cognisant of the Nurse, leader, scholar, international organisation that supports well. unprecedented challenges in healthcare. the professional development of nurses While she was with MOH, working With their strong clinical and operational globally. with the then Chief Nursing Officer Ang expertise, they can be the catalyst to PREMARANI KANNUSAMY She had a hand in establishing the Beng Choo, Prema was instrumental facilitate innovation and digitalisation… teacher, mentor Principal Lecturer (Industry) JBI-IMH (Singapore) Centre for Evidence- in developing the degree and master’s nurses need to take up the challenge Based Practices in Mental Health Care programmes at the NUS Alice Lee to be clinician-innovators to improve Republic Polytechnic when she was the Director of Nursing at Centre for Nursing Studies. The Master nursing practices,” explained Prema. the Institute of Mental Health in 2010. of Nursing programme started in At the age of 61, retirement is not AFTER 10 years as an Intensive Care 2003, allowing senior nurses to skill-up Unit nurse, Dr Premarani Kannusamy Nursing gave me a academically to take on the APN role, made a life-changing decision: She solid foundation; I had which offered them a clinical career path accepted a scholarship from the World and prepared them to serve an ageing the skills and the tools Health Organization in 1990 to further “ population with greater healthcare her nursing studies at the La Trobe to work in areas like needs. University in Melbourne (Australia). education, research, It is no surprise then that Prema has This led the way to more academic received many awards and accolades achievements like completing her strategic planning, over her 42-year career, most notably Masters and PhD in the early 2000s. administration and the Nurses’ Merit Award (1993) and the Her stellar resume lists appointments management. President’s Award for Nurses (2004). like Deputy Chief Nursing Officer at the “I didn’t achieve all these alone. Ministry of Health (MOH), Associate It was a lot of teamwork and Professor at the National University of A collaboration with the Joanna collaboration with local as well as Singapore (NUS) and Chief Executive Briggs Institute (JBI), an internationally international nursing leaders,” recalled on the cards for this bookworm. She Officer of Assisi Hospice. recognised leader in evidence-based Prema, currently a Principal Lecturer said with a laugh: “I have a Type A In 1999, she established the healthcare practices, this initiative (Industry) at Republic Polytechnic. personality; always full of beans and Singapore Nursing Board as a allowed clinical, nursing and allied health She is convinced that innovation ideas. And I never want to stop learning, Statutory Board which oversees the professionals research and develop is key to providing better care to the teaching and innovating.” registration and enrolment of nurses, evidence-based mental healthcare for community, which is why she stays That said, the go-getter confesses she the registration of midwives as well as better patient outcomes. up-to-date with the latest trends in is not all about her academic journals: the certification of Advanced Practice “Nursing gave me a solid foundation; society by delving into topics such as “I also know some BlackPink (Korean girl Nurses (APN). I had the skills and the tools to work augmented and virtual reality as well band) songs… my god-daughter taught Prema was also the founding in areas like education, research, as artificial intelligence. In fact, she has me those lah. She rejuvenates me and president of the Upsilon Eta Chapter of strategic planning, administration and issued a challenge for all nurses: Start makes me feel young.” 120 121 CELEBRATING ACHIEVEMENTS, INSPIRING FUTURE GENERATIONS
be immensely proud of Educator, “teaching and learning with his granddaughter’s many nurses every day”. achievements. In fact, the outspoken lady who A nurse’s A Nurse Educator since 2001 enjoys whipping up dishes such after completing her Master as braised duck, mee hoon kueh of Nursing (Education) at the and pig’s trotters for her family and University of Sydney, she was colleagues, said: “The President’s the Deputy Director of Nursing Award is a constant reminder of my teacher (Education and Practice) at Tan duty to inspire and teach younger Tock Seng Hospital (TTSH) where nurses. I tell myself that I need to be she set up the Department where I was or better, and fulfil my PUA LAY HOON of Clinical Instructors in 2006 responsibility as a role model.” Chief Nurse to promote clinical education To this end, she continues to standards in TTSH. work alongside fellow nurses, caring Woodlands Health Campus She also developed a for patients in the wards of Yishun structured pre-registration clinical Community Hospital (where her office education training programme for is located for now). WHENEVER Pua Lay Hoon faces a challenge at work, she nursing students. Six years later, with a group of passionate Lay Hoon hopes to see the profession grow from strength glances at a small black-and-white photo that sits in a frame educators from the medical, nursing, allied health and to strength with nurses finding meaning in what they do, on her desk. It is a photograph of her paternal grandfather pharmacy teams, the Pre-professional Education Office was contributing and impacting healthcare and health beyond the who passed away 33 years ago, and it obviously has a special set up to promote and enhance hospital, and excelling and starting place in the Woodlands Health Campus (WHC) Chief Nurse’s excellence in clinical education at The President’s Award more nurse-led services. heart. TTSH. She also looks forward to more Lay Hoon, who received the President’s Award for Nurses In 2017, after 25 years at TTSH, is a constant reminder nurses being celebrated and in 2015 primarily for her contributions to nursing education, Lay Hoon took on the Chief Nurse of my duty to inspire and recognised, and making their families has a reason for that habit: “One of his last pieces of advice for role for WHC, which is slated to “ proud. teach younger nurses. me was to choose something to do and do it well; that turned open progressively from 2022. “It takes courage, perseverance out to be nursing.” Though her work now centres I tell myself that I need and heart to help people at their The President’s Award for Nurses is a national recognition on infrastructure planning, clinical to be where I was or most vulnerable and deal with life of nurses who have made a significant contribution to the services development, manpower better, and fulfil my and death,” Lay Hoon, 50, said with profession and the community, while demonstrating planning, staff training and a smile. outstanding leadership, innovation and competence. It is development, and nursing service responsibility as a role “The work that nurses do Singapore’s pinnacle award in nursing. organisation for WHC, she insists model. goes beyond, and should be If Grandpa Pua was still around today, he would she is still very much a Nurse acknowledged. I love my nurses.”
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It is a recognition of your hard work, dedication and “perseverance... It means a lot to Community care champion any nurse to receive the Nurses’ Merit Award.
NELSON Coronado Rosales did not professional development and made outstanding performance as a nurse. choose nursing. It was chosen for him… contributions to promote the nursing For Nelson, the awards are an by his older sister. profession. acknowledgement of his commitment Nelson, now a Nurse Manager at “It is a recognition of your hard work, to the community care sector. He Ren Ci @ Bukit Batok St. 52, recalls dedication and perseverance. Not hopes that it will help to dispel the how it happened. When he was just 17, every nurse can be nominated for the misconception that nursing in care his 20-year-old sister told him to be a award. I am lucky that my supervisors homes only involves assisting elderly nurse and told his twin brother to be recognise my work. It means a lot to residents and changing their diapers. an accountant. Being filial brothers – any nurse to receive the Nurses’ Merit “Nurses in community care need to she was their main caregiver as their Award,” he said. be able to make a good assessment mother worked in another town to The cheerful 49-year-old man of the elderly residents and initiate support the family after their father credits Ren Ci’s Chief Executive Officer, activities to provide them with the died – they agreed. his nursing leaders and his colleagues quality of life. It is providing It turned out to be the right path for their guidance and support as patient-centred care,” he added. for Nelson, a Singapore permanent well as appreciating his hard work: The energetic man, who resident who has been working at “In 2015, I was Acting Nurse Manager plays table tennis, jogs the Ren Ci nursing homes for the and in 2017, they promoted me to and watches movies or past 14 years, since moving here Nurse Manager – the same time I was documentaries in his free from the Philippines to seek better nominated for the merit award. I felt time, isn’t done yet. His wish opportunities for himself to support his so blessed and, since then, my luck has for the future is that nurses in four daughters. been good.” the community care sector get more NELSON CORONADO ROSALES In 2017, his diligent work earned The awards didn’t stop. In 2018 and recognition for the good work they do. him the Nurses’ Merit Award, given 2019, he received the Singapore Health He said: “Nurses in community care Nurse Manager to nurses who have demonstrated Quality Service Award, presented are well-trained and knowledgeable. Ren Ci @ Bukit Batok St. 52 consistent and outstanding annually by the SingHealth Duke-NUS They should be seen as experts in their performance, participated in Academic Medical Centre, for his area of practice.”
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lead my juniors well,” said the I was very honoured to receive experience at SGH better and vivacious mother of three these awards. It made a difference more efficient. who recognised her calling to Her passion for nursing is to me as it gave me the opportunity the profession 45 years ago “ so infectious that her eldest when her father was warded to grow and move forward. I was daughter Nur Ramah Fatin at the Singapore General inspired to keep performing at my (facing page, with Nasah) and Hat trick of awards Hospital’s (SGH) Bowyer niece Nozean Mohd Ali have Block. best and lead my juniors well. become nurses too. Other Seeing him hooked up family members also work in NASAH SOHOR to machines and not being able to the patients come for screening and SGH, in non-healthcare areas. take care of him made the 11-year-old triaging, they do not know where to Fatin is a Staff Nurse in SGH’s Principal Enrolled Nurse Nasah realise the value of nurses. go. The main thing is to tell the patient diagnostic radiology department and Singapore General Hospital Coincidentally, when she went through about the estimated waiting time to see Nozean is a Nurse Clinician in SGH. her training at SGH in 1982, it was at the doctor and help them find their way Fatin, 31, calls her mum her role Bowyer Block. Much to her sadness, around the hospital.” model: “How she makes an impact in IF YOU think getting one award is a part of it was later demolished to make She is very proud of the work others’ lives inspired me to become big deal, Principal Enrolled Nurse (PEN) way for the new SGH buildings. she did with the map and the many a nurse. I wanted to save lives like Nasah Sohor, 54, experienced triple Nasah was also part of a team of improvements since it was launched her.” They enjoy a close relationship joy in 2016. She received three awards nurses and doctors who provided 10 years ago as it made the patient and share a passion for reading – that year: The Nurses’ Merit Award, the medical assistance on-site when the Jane Austen’s Pride and Prejudice is National Day Award and the Tan Chin Hotel New World collapsed in 1986. a favourite – and watching Korean Tuan Nursing Award, of which Nasah While her job was to relay updates dramas. was the overall champion. about casualties to the command Nasah hopes that Enrolled Nurses Organised by the Singapore Nurses centre post, she described it as an can embrace technology to improve Association, the Tan Chin Tuan Nursing intense experience, which taught their patients’ healthcare experiences, Award recognises promising and her how to react in a national particularly in accident and emergency talented enrolled nurses who have emergency situation. situations, as well as be ready to take exhibited excellence and dedication in She joined the Department on different roles in healthcare when the nursing profession. of Emergency Medicine (DEM) the opportunities arise. “I was very honoured to receive after she became a PEN in 1984. She said: “We are comforters, these awards. It made a difference to She and her team also developed advocates and caregivers to our me as it gave me the opportunity to the Patient Journey Map to help patients. We should keep abreast of grow and move forward. I was inspired patients navigate the DEM. medical and nursing advances… and to keep performing at my best and Said Nasah: “Sometimes after always try to do more for our patients.”
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I will continue to do my best to SARS, and Pingat Bakti Setia (Long Service Award) for his time inspire the younger nurses. All they in healthcare. A glittering have to do in return is to teach this Now 79, this veteran, who has been bitten by the travel “ bug, hopes to continue working as long as he is physically and lao ren (old man) new computer mentally fit. As he says: “I will continue to do my best to inspire tricks; I learnt how to create the younger nurses. All they have to do in return is teach this lao ren PowerPoint presentations and Word (old man) new computer tricks; I learnt how to create career PowerPoint presentations and Word documents from them!” documents from them!
HARBHAJAN SINGH
Emeritus Fellow and further studies, my priority was to get a job and support Senior Nurse Manager my family. I chanced upon the Public Service Commission’s Tan Tock Seng Hospital circular of available jobs at the ministries. My first choice was to be a teacher, but they asked me if I would like to consider nursing. And here I am today!” Harbhajan, who was one of the nominees for The Straits Times Singaporean of the Year 2018 titIe, can still recall his early days in a female-dominated workforce. “I had to always bring my A-game to gain the trust of my supervisors, female colleagues as well as patients and their families,” he said, adding that the gender gap in the profession started narrowing by the 1970s, thanks to efforts by the Health Ministry. The Emeritus Fellow and Senior Nurse Manager has seen the nursing profession evolve, noting with pride that the pay is better and younger colleagues are entrusted with managerial MOST people consider their 60th birthday a momentous has celebrated his 60th work anniversary. And every one of and leadership roles. He is especially proud to see nurses occasion. But what about a 60th work anniversary? Now, that’s those 60 years was as a nurse! receiving awards in recognition of their work. His personal tally something really special, given that careers usually span 45 to He joined the profession way back in 1959. Here’s how he includes the Pingat Bakti Masyarakat (Public Service Medal) 50 years at best. remembers that time: “I was fresh out of school after my for his active grassroots and community work, Pingat Kepujian Harbhajan Singh is one of the few people in Singapore who O levels. As my family did not have the means to pay for (Commendation Medal) for staying strong in the battle against
128 129 ON DISPLAY ON AIR MRT platform screen doors (below), TV commercials (right), a nursing drama buses and brochures are used to series with Mediacorp (far right), a nursing showcase the CTGB messages and help anthem with local music duo Jack & Rai the public understand more about the (below) and a National Day music video diversity of the nursing profession. by eight nurses (below, right) have been produced to help spread the campaign’s messages. The nursing anthem has crossed 2.7 million views as of end April CARE TO GO BEYOND 2020 while the National Day music video was screened at the pre-show segment of Boosting the the National Day Parade in 2019. nursing population
ALMOST a decade ago, spurred by the desire to provide better healthcare to Singapore’s rapidly ageing population, the Ministry of Health (MOH) decided it was time to boost the number of nurses here. While the ministry worked on enhancing the professional aspects of the job, the corporate communications team at MOH Holdings was given the task of launching a branding campaign to enhance the image of the profession and draw more locals into the workforce. Taking guidance from the relevant divisions at ONLINE MOH – Chief Nursing Officer’s Office, Social media Manpower Planning & Strategy and is a big part Corporate Communications – the team of CTGB’s launched the Care To Go Beyond (CTGB) connection campaign in early 2013. to the target Initially, the campaign took a double-barrelled audience. ON THE Regular posts view of the target audience: Students, who could form GROUND comprising the next wave of local nurses; and influencers (parents, The Healthcare Bus (above articles, videos family members, teachers etc) who could nudge a and left) and the Health and GIFs on the youngster on career choices. The platforms used And Life-skills Outreach CTGB website, comprised a mix of online and traditional media, with (below, left) exhibition Facebook, print advertising and a television commercial to spread engage secondary Instagram and YouTube the message about nursing. Over time, adapting to students with interactive pages have evolving communication patterns, the campaign zeroed game stations and career talks. The CTGB team also garnered more in on social media platforms such as Facebook and participates in outreach than 39,000 Instagram as the primary channels to reach the target events at the community followers. level (far left). 130 131 audience. One thing stays, though – the campaign takes great pride in using real nurses, every time. As the campaign matured, retention became a major focus too. Buoyed by the great efforts of the Chief Celebrating Nurses’ Day Nursing Officer and her team to improve the profession from within, the CTGB team dived into work that appreciated the diligent professionalism by our existing DID you know that Singapore is the cohort of nurses. The celebration of Nurses’ Day on a only country to celebrate Nurses’ Day national level was one such mega effort (see right). Other on 1 August? The rest of the world efforts included year-end parties to boost the morale of uses Florence Nightingale’s birthday nurses who were working over the festive period. – 12 May – as their special date for Star power was recruited too, in the bid to better the profession. embed the profession in the public’s mind. The CTGB The decision to use 1 August team linked up with Mediacorp’s Channel 8 to produce here harks way back to that very day a nursing drama series titled “You Can Be An Angel in 1885 when some French nuns Too”. Starring big names like Zoe Tay, Bryan Wong and stationed in Singapore left their Rebecca Lim, it drew enough viewers to merit three convent to nurse the sick at the 20-episode seasons. A fourth season focusing on General Hospital at the Sepoy Lines. nursing and allied health in the community is in the While their employers celebrate pipeline. the nurses’ special day at the There was also on-the-ground engagement respective healthcare institutions, to reach out to secondary school students and the Care To Go Beyond team to get them to think about nursing and allied has been coordinating a national health as a career as early as possible. The celebration of Nurses’ Day since campaign therefore introduced the HALO (Health 2013. Our President and Prime And Life-skills Outreach) exhibition and the Healthcare Minister join fellow Singapore Bus – both featuring interactive elements that engage residents in acknowledging the hard students and teach them about nursing and allied health work by nurses throughout the year. professions. This annual effort includes a The ministry’s drive to attract more students to double-spread advertisement in The join nursing is gradually showing results. In 2019, 332 Straits Times (some are displayed students joined the Bachelor of Science (Nursing) on the right) and other local media programme at the Alice Lee Centre for Nursing Studies platforms. Nurses are also given a in the National University of Singapore, more than simple CTGB gift every year – flowers, double its intake of 155 students in 2016. At Ngee Ann paper windmills, balloons, tote bags, Polytechnic and Nanyang Polytechnic, intake numbers coffee mugs so far – while generous for the Diploma in Nursing course climbed by 13% sponsors have stepped up to offer between 2016 and 2018. At the same time, enrolment special deals for nurses. figures for nursing studies at the Institute of Technical It is our nation’s way of saying Education increased by 6%. thank you to our nurses. The work continues.
132 133 OUR NURSE CONTRIBUTORS SIM PEIZHEN NURAIDAH M.NASIR FARIDAH FADILAH 1 LEA E. TANDOC-NUÑEZ 2 YANG LI PING 1 2 3 CHOCK HUAY CHING 4 WANG JIAXIN 5 ABU BAKAR Staff Nurse at Ng Teng Fong General Hospital Nurse Clinician at National Advanced Practice Nurse at Senior Enrolled Nurse at Senior Staff Nurse at Senior Staff Nurse at Lecturer at Nanyang Polytechnic Medium: Acrylic paint and String gel Heart Centre Singapore National University Hospital Health Promotion Board Ng Teng Fong General Hospital Changi General Hospital (School of Health and Social Sciences) Medium: Oil paint I am proud to be part of this book. For Chapter 8, I visualised a nurse Camera: Canon D60 Camera: Olympus Camera: iPhoneXS Camera: Sony A7II Camera: Sony a6000 saving thousands of lives. The hearts represent the people healed by It was challenging yet exciting Working on this book gave me E-M10 Mark II I’m really grateful to be part of I feel so proud to be part of this I feel honoured to have the caring hands of nurses. But the artwork became more personal to do the artwork for Chapter 6. the opportunity to interact with It was an honour to be one of this book. Of course, we faced book, and enjoyed the great participated in this project because of COVID-19: I was caring for a COVID-19 patient when I Working closely with the book’s several nursing leaders. It is the photographers who bring time challenges (we nurses do team-work with the project which is a gift to my fellow too became a patient in NCID as a suspected case. Luckily I tested designer, I produced this diffused an honour indeed, and I am this book to life with images that shift work, remember?) but team. The three interviewees nursing comrades. Many of negative but this painting has a deeper meaning for me now. It is oil painting of hot air balloons inspired by their candidness capture a moment in nursing we made it happen. There is I photographed reminded me the nurses I photographed more than just helping sick people. It shows that a nurse has all kinds that signal pushing boundaries and professionalism despite history for future generations. so much captured in a single that nurses can do more than have a wealth of knowledge of hearts to give. A heart of courage and bravery; a responsible heart; and exploration. I really enjoyed their huge responsibilities at It made me realise that there is photograph – the emotions of a just clinical work to contribute and experiences. They are all a heart full of passion; a heart of selflessness and sacrifice; and a this assignment and hope you will the workplace. more to photography than just person, the stories they tell and to patient care. I was also truly inspirational. heart of inspiration and unsung heroes. enjoy the book as well. taking pictures. the moments that stand still inspired by their passion for against the passing of time. their nursing careers. 3 MA ISABELLE KAGAWAN MANLAPIG 6 LIM VOON HOOI Staff Nurse at KK Women’s Deputy Director of Nursing and Children’s Hospital at the National Healthcare Medium: Copic Markers and Multiliner ARTISTS Group Polyclinics For someone who has always worked in the Camera: Canon EOS 7D Mark II hospital setting, it was enlightening to see This assignment allowed me to the profession from a different perspective. meet some of my amazing fellow My inspiration for Chapter 7’s artwork is nurses. Hearing what they have the multi-faceted nature of community 2 5 1 3 achieved is inspirational. It may nursing, which is colourful in its diversity 2 have taken a while to get them to and uniqueness. smile and be comfortable in front 3 1 4 of the camera, but it has been a rewarding experience. 4 NOORLEEYAHTI BINTE RAMJUDI CHARLY MAGNE Senior Staff Nurse at 4 10 7 National University Hospital PANAGUITON TRONCO Medium: Acrylic paint Senior Staff Nurse at 6 Changi General Hospital I was excited and nervous at the same time when chosen to be part of this project. For Camera: Nikon D750 Chapter 5, I used splatter painting which 5 Although I was hesitant at first, is a lot harder than it looks… and very I am really thankful to be part messy! I wanted to show a person with 6 7 8 of this project. It wasn’t really many hidden talents on the move, using 9 difficult to convey the nurses’ colours to represent our various healthcare 12 11 7 stories and emotions through institutions. I had the added privilege of my photos as these nurses doing the caricatures on these pages. 8 were just so natural and real in their comfort zones. All caricatures by Noorleeyahti Binte Ramjudi PHOTOGRAPHERS 5 MOHAMMED KAMAL LIM MARK ANTHONY Staff Nurse at Tan Tock Seng Hospital 8 PAMINTUAN Medium: Oil paint 6 BIBI WONG 7 CHEAH MEE WEN 8 NICOLE SIM MARIA BAGUITA WONG YU RUI SUHAIMI BIN KASMON PHOON KUM KIN Enrolled Nurse at 12 BOEY SOH QI 11 10 9 Tan Tock Seng Hospital My artwork for Chapter 1 gives an Senior Staff Nurse Senior Nurse Educator Staff Nurse at Sengkang Camera: Canon EOS R ideation of the struggles faced by at Tan Tock Seng Hospital at Sengkang General Hospital General Hospital Senior Staff Nurse at Senior Staff Nurse at National Senior Staff Nurse at Senior Staff Nurse at our nursing pioneers. The vessel KK Women’s and Children’s Hospital Heart Centre Singapore Singapore General Hospital Sengkang General Hospital Even though I had to sacrifice represents their perseverance and Medium: Procreate (iPad) Medium: Acrylic paint Medium: Pencil Camera: Sony A6300 Camera: Canon 800D Camera: Nikon D750 Camera: Canon 5D Mark 3 some personal time for photo guidance, the waves show new What an honour to join this project This project has renewed my interest in Working on an artwork for this shoots, I am truly excited to heights and opportunities while the and work with other nurses! It was a art. Juggling work and this art assignment book was a novel and challenging It was exciting to be part of this It was an honour to contribute It was a rare opportunity to I enjoyed this assignment. see everyone’s hard work in dolphins are the new generations memorable experience. My artwork was challenging, fun and de-stressing experience. My pencil sketch for project, which has definitely my little strength to this big capture photos of a prison Not only did I have fun doing this nursing book. Not only of healthcare providers. It all blends for Chapter 4 shows that nursing is at the same time. I used acrylic paint to Chapter 3 showcases plants like the expanded my photography project. I enjoyed working with nurse in his element, to the photoshoots with nurses, did I learn a lot by helping to complete a scene depicting a journey. Every step you take and capture the theme of Chapter 2, books Birds of Paradise which symbolise skills. I appreciate Edmund for the editorial team and even see the depth of meaning I also got the opportunity with this book, I was reminded teamwork. everything you see, be it success or to signify education, progressing to the success and overcoming obstacles being very patient and sharing learnt some photography skills behind his every expression. to visit various healthcare that nursing is truly a noble failure, will be the milestone for a electronic pad, with caring from the heart. while the small plants and spade different ideas and concepts. in the process. Also, it was very It reminded me that every institutions. profession and I will always be better tomorrow. reflect breaking new ground. It gave me the chance to motivating to have some of photo tells a story. Nursing proud of it. explore different photography my super seniors in nursing and photography will remain 134 angles, while retaining my own encouraging me. my lifelong passions. 135 photography style. ACKNOWLEDGEMENTS
This book was made possible with the guidance, assistance INSTITUTIONS and support of the following people and institutions: Agency for Integrated Care Nanyang Polytechnic The National Kidney Foundation Alexandra Hospital National Centre for Infectious Diseases Sengkang General Hospital Ang Mo Kio Primary School National Healthcare Group Singapore General Hospital SPECIAL ADVISORS Changi General Hospital National Healthcare Group Polyclinics Singapore Prison Service A/Prof Benjamin Ong Dover Park Hospice National Heart Centre Singapore Singapore Medical Council A/Prof Kenneth Mak Health Promotion Board National Skin Centre Singapore National Eye Centre A/Prof Chew Suok Kai Health Sciences Authority National University Health System SingHealth Ms Elizabeth Quah Home Nursing Foundation National University Hospital SingHealth Polyclinics Institute of Mental Health National University Polyclinics St. Andrew’s Community Hospital ADVISORY COMMITTEE Institute of Technical Education National University of Singapore – St. Joseph’s Home Ms Tan Soh Chin Khoo Teck Puat Hospital Alice Lee Centre for Nursing Studies St Luke’s Hospital Chief Nursing Officer’s Office, Ministry of Health KK Women’s and Children’s Hospital Ng Teng Fong General Hospital Tan Tock Seng Hospital (2015-2020) Ministry of Communications and Information Parkway Pantai Thomson Medical Centre Dr Tracy Carol Ayre Ministry of Health Peacehaven Woodlands Health Campus SingHealth MOH Holdings Ren Ci Nursing Home Ms Low Beng Hoi Mount Alvernia Hospital Republic Polytechnic Yishun Health Campus Prof Emily Ang National University of Singapore Alice Lee Centre for Nursing Studies EDITORIAL TEAM
RESOURCE COMMITTEE Editor Ms Jancy Mathews Sheela Narayanan National University Polyclinics Designer A/Prof Edward Poon Edmund Goh St Luke’s Eldercare Writers Ms Kwek Puay Ee Jeslyn Goh, Kimberly Yap, Lum Wen Qing, Singapore Nursing Board Nathaniel Wong, Siti Humaira, Wong Jin Xian Mr Tan Lai Hong Woodlands Health Campus Editorial coordinator Tan San San Ms Poh Chee Lien National Healthcare Group Production coordinator Shery Zhan Ms Pauline Wee KK Women’s and Children’s Hospital Editorial support Ms Joann Pang Clareen Goh, Grace Tan, Lincoln Sim, National University Hospital Nurkhadijah Bamadhaj, Rose Soong Ms Mylene Koh Editorial advisor Ministry of Health Pradeep Paul The true backbones of I would like to thank all nurses, They are the garb that shields every large healthcare setup especially during the period of us and provides comfort during COVID-19, for their effort and our healing. They are made of and organisation...Thank support of the patients who Kevlar in attitude in times of Hey nurses, your jobs aren’t easy Hello nurses! You Nurses for all you are ill and having the courage adversity. They are our Mother and this is why I have so much have done! Thank you for keeping to care for them despite being Teresa, they are the NURSES. respect for each and every one vulnerable to the virus. Primary school student, 8 of you. Keep up the good work us safe and putting our Seishen Gerard and know that many of us health & wellbeing as your Jeevaneesh Soundararajah Ashari bin Ali Exercise Physiologist, 33 Social enterprise owner, 58 appreciate what you do and greatest priority. Engineer, 27 are silently cheering you on! Joelle Teo Nicolas Goh Polytechnic student, 18 University student, 22 Thank you nurses, for your selfless dedication and Thank you all so much for Thank you nurses Dear Nurses round-the-clock care for taking care of the patients for the help and The nurses who took care I really appreciate nurses. Their jobs are Thank you for your in the hospital. You are all very good because they are saving lives. those who need it the most. kindness of my grandmother at the Nurses gave me tips on how to take care of dedication in caring heroes in each and every one hospital were very kind and the elderly, for example my husband, when for us in times of your unique ways. meticulous. he had dialysis and heart attack. I’m really of need. Philip Thomas Kanianthara Brayden Khoo very thankful to them. They are the top in Full-time national serviceman, 20 Primary school student, 8 Singapore; their work is very good. They Marcus Ong are serving the country, the people and Sufia Alesya Najib Polytechnic student, 17 saving lives. Sharon Michelle Anne Primary school student,10 ITE student, 17 Aisah bte A Wahid Retiree, 68
I want to let you know how Dear nurses, thank you Hello nurses of Singapore, To all the nurses, thank We appreciate you for all your Thank you, Nurses, grateful we are during for all your hard work! thank you for your continued for your strength you for the dedication trying periods. You make us Your selflessness is an hard work and dedication in and hard work that each hard work & serving the and dedication in the feel confident that we are inspiration to us all! caring for Singaporeans. You one of you put in to in good hands. country well. Without you, Keep up the good work! have such noble jobs! profession you have ensure the recovery of we’d be nothing! chosen. our patients. Marilyn Patricia David Lum Fook Lim Warrant Officer, 37 Love Nayli Qistina Part-timer, 66 Leonard Lee Crystaline Poh Farah Syazana Polytechnic student, 18 Engineer, 42 Respiratory Therapist, 26 Education Executive, 25