Friday, 1 August 2014

Nurses stepping up to gain recognition

NURSES' work ethics and dedication are better known today within the health-care sector, as stated by Dr Leong Choon Kit ("Nurses deserve more recognition"; Tuesday) and Dr James Low ("Our front-line heroes and heroines, thank you"; Mind Your Body, July 24).

We are grateful for their strong affirmation, and concur with Dr Leong that more can be done to make nurses' contributions better known and appreciated by the public.

Nurses today are well represented on committees, strategic work groups and boards at both the organisational and national levels.

Within the arena of evidence-based practice and publications, many of our nurses in various institutions have been getting their research papers successfully published in notable international journals, as well as in the local academic journal published by the Singapore Nurses Association.

We are heartened that ongoing efforts and consideration have gone into shaping the future development of nursing in Singapore and raising the competency levels of every nurse through comprehensive training, as well as regular recognition.

Like Dr Leong, we look forward to the recommendations by the National Nursing Taskforce.

While the incidence of abuse of nurses by demanding patients and families has been on the rise, this is generally true for all health-care workers. The reporting of abuse cases and deterrent penalties by the courts of law are steps in the right direction.

The professionalism of nurses has won the respect, appreciation and admiration of the public. Their consistent and engaging approach to care is often alluded to in complimentary letters from patients or their families to health-care institutions.

The ongoing work on improving professional and career progression is an indication that our nurses and nursing leaders are committed to improving patients' lives.

On behalf of all nurses in Singapore, I thank members of the public for their faith and trust in nurses. And to all nurses, have a great Nurses Day!

Lim Swee Hia
(Associate Professor)
President Singapore Nurses Association
ST Forum, 1 Aug 2014

President’s Award for Nurses 2014
Four bag Singapore's top award for nurses
By Aw Cheng Wei, The Straits Times, 31 Jul 2014

TWO days after a woman died in hospital following a heart attack, her children waited at a ward to thank Ms Karen Koh for the help she had given.

Until that point, Ms Koh, 38, had "never felt the higher calling to be a nurse". She had taken up a career in nursing as it married her interests in biomedical science and hospitality.

Yesterday, the advanced practice nurse at National University Hospital received the President's Award for Nurses from President Tony Tan Keng Yam at the Istana. Her achievements include setting up a clinical service that slashed the time that heart patients have to wait for an appointment from three months to one.

She was one of four recipients of the award, along with Madam Sim Lai Kiow, Madam Ng Wai May and Mr Yong Keng Kwang.

Madam Sim developed guidelines at Khoo Teck Puat Hospital to help other nurses advise patients on resuscitation efforts.

The 57-year-old clinician nurse, who also specialises in palliative care, visits elderly patients at their homes in her spare time. "This award is a huge encouragement and I'll continue to be a pillar of emotional support for my patients in the last lap of their journey," she said.

Madam Ng, 39, an advanced practice nurse, set up the stroke clinic at National Neuroscience Institute. Mr Yong, 43, introduced a system of co-governance at Tan Tock Seng Hospital, in which nurses can elect council members to partake in policymaking processes that involve nursing education, practice and work-life balance.

"This award represents my colleagues' affirmation," said the nursing director. "They all helped by giving testimonials."

The 15th annual award ceremony was attended by about 650 people, mostly from the nursing community, as well as Health Minister Gan Kim Yong and MPs Lily Neo and Chia Shi-Lu.

'Navigators' steer patients through health-care system
They help with medicine, referrals, home support
By Linette Lai, The Straits Times, 2 Aug 2014

MORE than 30 new "patient navigators" have been appointed by the SingHealth group to steer patients through the complex health-care system - from admission to discharge and beyond.

They serve as a bridge between patients with complex conditions and other health-care staff, such as doctors, therapists and medical social workers.

They also keep tabs on patients after they are discharged, and will make home visits if necessary.

"Our health-care system is complex, and we need someone to actually hand-hold (patients) through the journey," said Dr Tracy Carol Ayre, group director of nursing for SingHealth.

She estimates that 20 per cent of patients have conditions in need of this service.

The 33 patient navigators, who started their new full-time roles in June, are mostly nurses with about 10 years of experience.

They identify the patients who they feel may need more help - such as those who have multiple chronic conditions or get poor support at home.

The navigators will then guide these patients through the various aspects of their health-care journey, from sorting out their medication to putting together referrals for step-down care facilities.

The new role was officially launched yesterday in conjunction with SingHealth's Nurses' Day celebrations.

SingHealth hopes to have 400 patient navigators by 2018, with each one of them looking after around 100 patients.

They will be based at Singapore General Hospital (SGH), KK Women's and Children's Hospital, and the National Heart Centre Singapore.

The group hopes that the navigators will be able to prevent "frequent fliers" from being constantly readmitted, which can happen when a patient's conditions are not optimally managed.

Group chief executive Ivy Ng said: "With the introduction of the patient navigator role, it is expected that there will be a reduction of readmission rates and average length of stay for patients with complex chronic conditions."

One of the new patient navigators is nurse clinician Xu Yi, who works in SGH's medical oncology department.

Formerly, the 34-year-old played a more supervisory role, helping to manage other nurses in the hospital ward.

"This is more patient-focused," she said of her new role. "We follow up with patients very frequently."

At yesterday's event, Health Minister Gan Kim Yong presented awards to outstanding nurses, and congratulated all nurses on their hard work.

He said: "With your commitment, your compassion, as well as your clear sense of mission, you have touched the lives of many."

Nurses deserve more recognition

I LOOK forward to the recommendations by the National Nursing Taskforce, and their possible implementation ("Nursing task force finalising proposals"; July 15).

As a doctor, I have learnt much from my nursing colleagues. Our health-care system will not be able to function without them.

Unfortunately, their work often goes unrecognised. At times, they are also subject to abuse by members of the public.

We need to do more to raise awareness of our nurses' significant contributions.

First, Singaporeans must be educated on the nurses' job scope, and learn to trust and respect them.

It is not uncommon to see patients' family members treating nurses like their servants. They turn abusive when their demands are not met or when the nurses are busy tending to other patients.

Second, the public must understand that hospitals are not in the "traditional" service industry, and that patients are not customers.

Health-care workers do not choose their vocations because of the pay. Creating such a mercenary culture and public image will not help the nurses.

Third, the medical profession bases its practices on evidence-based principles. This protects the public from unsubstantiated and unnecessary treatments.

Nurses have contributed much to evidence-based research in Singapore, and they should be recognised for their efforts.

Perhaps an annual nursing scientific conference could be organised to showcase the fruits of their labour. A local nursing academic journal could also be considered for our nurses to publish their research.

The Ministry of Health could consider funding these, which will allow more nurses to be appreciated, on top of the usual Nurses' Day awards given to just a few of the many nurses who deserve recognition for their contributions.

Finally, more nurses could be invited to serve on think-tanks, and the boards and committees of various organisations. Their contributions will help us shape the medical landscape better.

We will be patients some day and will need the care of nurses. It will benefit us if we pay them the respect they deserve.

Leong Choon Kit (Dr)
ST Forum, 29 Jul 2014

Our frontline heroes and heroines, thank you
By Dr James Low, The Straits Times, Mind Your Body, 24 July 2014

It was the year 2003.

The Sars virus had just found its way into Singapore.

There was a sense of panic in the air. A few of our comrades had fallen to an unseen enemy.

We did not know who was next in line.

The doctors were divided into those who would cover the "clean" wards and the dreaded "fever" wards. We were to be very careful with febrile patients as they could be harbouring the Sars virus.

I remember entering the "fever" ward for the first time, all geared up with my personal protection equipment of gown, gloves and N95 mask, ready for action, albeit a little scared.

It was hot and humid and my breathing was impeded by the mask.

Soon I would be entering a "war zone".

But as I walked into the ward, and to my surprise, I was met with a strange calm and quietness.

It was the sight of the nurses going about their work perfectly composed and unperturbed.

They were attending to the patients without a semblance of fear or worry. It was a reassuring sight, seeing them don their hot and humid gowns and suffocating masks and going about their duties as always.

They were truly at the front, in the direct line of fire. It must have taken courage and altruism to do this.

Fast-forward to 2014 and we are in the midst of another kind of epidemic, a new war zone - the greying of a population.

I took a peek into the day of the nurses in one of the aged care wards.

It was just past 7am in the morning. The ward was already a hive of activity.

One nurse was pushing her medication cart around administering medications to the patients.

Other nurses were scurrying around tending to patients, who were being wheeled one by one into the bathrooms.

Some were assisted as they walked to their morning shower while others were sponged in bed.

Beds were made while the patients were bathed. Soon after, the old "aunties and uncles", as they are affectionately called, were helped to their armchairs while others were tucked back into bed.

It got busier as the day wore on and the doctors started their rounds.

The multitude of tasks and duties seemed daunting.

The nurses were on their feet most of the time.

A patient was calling to be brought to the toilet. Another, a "fall risk" patient, was trying to clamber out of bed by himself, alarming the nurses in the process.

At another end of the ward, a patient with dementia was calling out for her dinner when she had just finished her breakfast.

Yet another patient had put on her home clothes and was walking out of the ward with plastic bags of her worldly possessions. She was only half way from completing her treatment.

Then there were the patients who required daily wound dressing change, turning every two hours, tube feeding every three hours and blood glucose measurement every six hours.

Many patients had to be patiently fed by spoon and required regular toilet care after wetting or soiling their diapers.

Cleaning up after a helpless person who has soiled himself is not only humbling but, more importantly, it is also an act of true compassion.

In the midst of these, a heartwarming story unfolds.

A patient was living alone but was admitted to hospital with a large oozing wound on her scalp.

It was a sorry sight. Unkempt and reeking of urine, her clothes looked worn out, stained with stale blood and covered in grime.

As she changed into the hospital garb, her dirty clothes stood in a pile on the floor.

The attending nurse picked them up and put them in a plastic bag.

What the nurse did next was unexpected. She took the clothes home to wash them. But before she could bring the clothes back, the patient died. Moments after her death, the nurse got someone to drive her home to iron the clothes so that she could have them ready for the patient's funeral.

While we were experiencing sympathy and pity, this nurse demonstrated what compassion in action meant.

These are just a few stories of the women and men who, daily, walk in the footsteps of the Lady with the Lamp, Florence Nightingale, who, during her late-night rounds, carried a lamp bringing warmth and comfort to many sick and wounded soldiers during the Crimean war.

Nurses work tirelessly to keep the hospital going 24 hours a day, 365 days a year. Through thick and thin, come rain or shine, whether battling thick haze or viral epidemics, one can be sure that nurses will be standing there right at the forefront of patient care.

As Nurses' Day is just around the corner, it would be a most opportune time to highlight the importance of the nursing profession and to thank our nurses for what they have been doing for us.

I will leave this message for all the nurses, on behalf of my elderly patients and I:

"We are sorry that life can be tough and that your work may go unappreciated. We know that you bring kindness and warmth into the wards.

"You brighten the lives of many a suffering soul. Your hands are the instruments of angels that bring comfort and healing to our patients for no treatment would ever work if not for the work of your hands and heart.

"No pain or suffering would ever be relieved if you were not there to administer the balm. No miracles could ever happen if not for your assistance and intervention.

"Because of these and more, we would really like to thank you from the bottom of our hearts. And we would like to express our deep appreciation with the wish that you will one day be blessed in a special way for the love and sacrifice you put into your life's work.

"Happy Nurses' Day!"

Dr Low is a senior consultant and palliative care physician at the department of geriatric medicine at Khoo Teck Puat Hospital. He is a member of the specialist training committee for geriatric medicine.

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