Saturday, 16 February 2013

Singapore faces nurse shortfall for years to come

By Salma Khalik, The Straits Times, 15 Feb 2013

SINGAPORE will not be able to produce enough nurses for its own needs for years to come, despite plans to increase the number of locally trained nurses from 1,700 a year at present to 2,700 a year.

Figures for the past decade from the Singapore Nursing Board (SNB) suggest that the country's health system will have to recruit between 1,000 and 2,000 foreign nurses each year to meet the rising demand for health care that comes with a growing and rapidly ageing population.

This is because the steady expansion of medical services in Singapore will see hospitals, nursing homes and clinics fighting for a limited pool of local nurses.

First, there is the opening of the new community hospital in Yishun later this year.

Add to that the opening of the 700-bed Ng Teng Fong Hospital and a new building with 250 beds at Changi General Hospital next year, and the demand for trained nurses is expected to be fierce.

Two more community hospitals and several nursing homes will also be opening within the next few years.

In the two years leading up to the opening of the 580-bed Khoo Teck Puat Hospital in 2010, about 7,400 nurses were added to the pool - of which more than 4,000 were foreign.

Several hospitals told The Straits Times that they see themselves recruiting substantial numbers of foreigners - as they have been doing in the past few years.

Eastern Health Alliance, which includes Changi General Hospital, needs to hire about 200 nurses this year, said its head of personnel Lilian Chew. Singaporeans are the preferred choice, but she added: "Due to the limited pool and our urgent needs, we are expanding recruitment globally."

And KK Women's and Children's Hospital director of nursing Tan Soh Chin said she anticipates having to hire another 100 nurses and will consider recruiting from overseas.

Other health institutions too will be looking for more nurses. The National University Hospital will need up to 200 more this year. The new Ng Teng Fong Hospital will need to add another 400 nurses to the 1,100 it now has at Alexandra Hospital.

Once its staff moves out by next year, a new team - the one that will be running the new hospital to open in Sengkang in 2018 - will take over Alexandra Hospital. This means it will need to recruit the 1,000 nurses that Alexandra would then require.

Private hospitals too will need more, though Parkway Group, which runs four hospitals here, trains its own nurses who are mostly Malaysians.

The latest SNB annual report shows that the bulk of foreign nurses are from the Philippines, with close to 4,000 of them working here.

Generally, qualified nurses have no problems getting the approval to work here. All in, Singapore has 34,200 trained nurses.

All hospitals, both public and private, are also working hard to retain their older and more experienced nurses. At the end of 2011, Singapore had 2,280 nurses who were 60 years old or older.

More nurses are now better qualified
Three in 10 are degree holders; 88 have at least a master's degree
By Melissa Pang, The Straits Times, 21 Feb 2013

NURSES here are becoming more qualified to better perform their jobs - flying in the face of a perception that the profession does not require much skill.

Nurses say training of a higher level is translating into an improved understanding of patient needs and more staff specialising in certain areas.

Earlier this month, a furore ensued over a footnote in the Population White Paper which labelled nursing a low-skilled job. Prime Minister Lee Hsien Loong, Deputy Prime Minister Teo Chee Hean and Health Minister Gan Kim Yong all issued apologies over the "factual error".

Three out of 10 of about 34,500 nurses here last year held at least a bachelor's degree, double the proportion that did so in 2005. The degree holders are all registered nurses. To qualify for this title, a nurse is required to have at least a diploma.

There are also enrolled nurses, who have certificates from the Institute of Technical Education.

As of December, there were about 26,000 registered nurses and about 8,500 enrolled nurses here.

The number of highly skilled registered nurses who have at least a master's degree, called advanced practice nurses, has also risen from nine in 2007, to 88 last year.

These experts in specialised fields such as mental health and community health are qualified to do physical examinations, diagnose and treat common ailments.

More nurses have also gone for further job training at the SingHealth Alice Lee Institute of Advanced Nursing - 9,400 nurses graduated last year, up from 7,672 in 2008.

The growing number of better qualified nurses is a result of better support from health-care organisations for their staff seeking higher education, said the Ministry of Health.

With changing health-care needs and demands, continuing education and skills upgrading are critical to help nurses stay relevant, said a spokesman for public health-care group SingHealth. It ensures that nurses are equipped with new knowledge to improve patient care, he added.

About 40 per cent of the group's nurses have degrees. Of these, 4 per cent hold master's degrees and doctorates. Research has shown that a highly educated nursing workforce not only improves patient safety and quality of care but saves lives, said Professor Sally Chan of the National University of Singapore's Alice Lee Centre for Nursing Studies.

For this reason, in recent years, many countries have called for registered nurses to be educated to degree level, said Singapore Nurses Association president Lim Swee Hia. For instance, since two years ago, Australia has required all registered nurses to be degree holders at entry.

But while academic qualifications are important, "equally essential in the demanding area of health care is having experience and the human touch", said Ms Elaine Ng, group director of nursing at private health-care provider Parkway Pantai Group. Three in 10 of its nurses hold degrees.

Ms Serene Tan, 42, an advanced practice nurse specialising in neuroscience, said the in-depth education has made her a more critical thinker and boosted her confidence in caring for patients and dealing with family members.

Ms Tan, who began her nursing career with a diploma in 1999 and is among half of the 2,445 registered nurses in Tan Tock Seng Hospital who hold degrees, said: "With more advanced training, I'm able to understand the deeper science behind what is happening to the patients and contribute to clinical decisions.

"When family members of patients have questions, I'm also better able to answer them."

Highly trained
- Three out of 10 of about 34,500 nurses here last year held at least a bachelor's degree.
- There were about 26,000 registered nurses, who have at least a diploma, as of last December, and about 8,500 enrolled nurses, who have Institute of Technical Education certificates.
- There are 88 advanced practice nurses, or nurses with at least a master's degree.

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