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NOVEMBER/DECEMBER 2012 MICA (P) 158/04/2012
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At a moment’s notice Preparing for mass casualty incidents
Shoulders to stand on Associate Dean targets body, mind and soul
Loving and living the good life
Meet Ng Puey Kwan, our longest serving staff
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at a moment’s notice
Preparing for mass casualty incidents
bench press
Cancer study finds local trend
class act
Shoulders to stand on – Associate Dean targets body, mind and soul
nursing research Evidence-based procurement and nursing
03 05 07 08 12 14 16
no accidental leader
Prof Fong Kok Yong on his new role as Chairman of Medical Board, SGH
a leader who creates more leaders Thank you, Prof Ng Han Seong
loving and living the good life
Meet Ng Puey Kwan, our longest serving staff
in every issue 20 22 23 26 27 24
quality pulse spree in action campus buzz time out your take the last page
contents
LIFE at SGH Campus | Nov/Dec 2012
e r u feat
No accidental leader Prof Fong Kok Yong takes the helm as Chairman Medical Board (CMB) at SGH on 1 November 2012. Prior to this, he was Chairman of the Division of Medicine and was the pioneer head of the department of Rheumatology and Immunology. He tells us his views and the challenges of his new role. Shoring up our values
Advisor Tan-Huang Shuo Mei Contributors Eileen Lew, Pauline Leong, Ng Deng Peng, Vanessa Peters, Ang Shin Yuh, Chia Kuok Wei, Loo Shin Yi, Amy Tan, Jennifer Wee, Claudia Yeo, Carol Ang, Michelle Scully, Goh Sai Luan On The Cover Ng Puey Kwan, 78, was and still is the life of the party in the SGH plaster room. His love for life and his work bubble over, in Up Close.
Beyond clinical skills and knowledge, senior clinicians like Prof Ng Han Seong and Prof Ong Yong Yau have contributed much in transmitting values. So how do we help our doctors pick up good values from senior clinicians? If we don’t stop the erosion of values, we will risk losing many good doctors who become disillusioned. Taking personal responsibility for our patients is of supreme importance. Medicine is not a nine-to-five job, where you can forget your patients once you hand over to the next shift. For very ill patients, if needed, the least you could do is to call back to check. Yes, it does add stress to your personal life, but we are personally accountable to our patients, who
have entrusted their well-being in our hands.
The “bad guy” CMB
The role of a CMB is predominantly a governance one. It means making decisions relating to expectations and performance of our clinicians and the hospital. I understand what our doctors want, but there will be times when I have to be the bad guy and say “No”. But I intend to make sure they know the reasons behind the “No”, through personal engagement with them.
A passion to start and to shape
I like to start things. I always enjoy the challenge of doing something new, and then passing on to a
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“I always enjoy the challenge of doing something new, and then passing on to a good successor to bring it up to the next level. The opportunity to mould the outcome of a project is a great motivating factor for me.“ At Havard Business School in 2010 for the Advanced Management Program
good successor to bring it up to the next level. The opportunity to mould the outcome of a project is a great motivating factor for me. This is reflected in my career – I started departments in Rheumatology in NUH in 1998 and in SGH when I returned in 2003. At each post, I have not stayed beyond five years. My six years as Chairman of Division of Medicine is the longest yet. Once things get “routine”, I’m game for new challenges.
The willing leader
Someone said, “You must be crazy to want to take on this role!” It is tough to lead a group of extremely talented doctors in a complex organisation like SGH. To do this job well, you must be willing and you must believe you can do it. Why am I willing? If I know I can do it, and I have the necessary support, it would be remiss of me to leave it to someone who may be less ready. I need to play my part, serve to the best of my ability, and psychologically be ready to stand down at the end of my term.
The man at home
My four children – two boys and two girls – are so busy with their teenage activities that at times they have to check their schedules before we can get together for a family outing. Usually, it is just chit-chatting over a meal. I help my wife in the garden – usually just sweeping the leaves, and sometimes give unsolicited advice. This is a way to contribute to domestic harmony. I have always read widely. But now that I have so much material to read at work, I have turned to fiction for relaxation. I would pick up just any book from the library, but often don’t finish them.
With Prof Fong’s appointment as CMB, Assoc Prof Chow Wan Cheng (left) now helms the Division of Medicine as Chairman, while Assoc Prof Wong Kok Seng heads the Department of Internal Medicine.
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LIFE at SGH Campus | Nov/Dec 2012
Prof Ng has inspired and trained many clinicians, many of whom are leaders in their specialties and in medicine today.
A leader who creates more leaders Prof Ng Han Seong stepped down as Chairman of Medical Board (CMB), SGH after six years of sterling contributions at the helm.
Y
oung doctors will be glad to know that the Emeritus Consultant will be devoting more time to his clinical work in the Department of Gastroenterology and Hepatology, to teach and mentor them. Prof Ng will continue to lend his wisdom and experience to SGH and the Group as Special Director in CEO’s Office, as well as SingHealth’s Group Chief Risk Officer.
In summing up his contributions, Prof Ho Lai Yun, Senior Consultant (Neonatal & Developmental Medicine) said it best:
Widely recognized for mentoring generations of clinicians, Prof Ng has also groomed many clinician leaders such as Prof Fong Kok Yong, who succeeds him as CMB. He has also served the larger community and the public healthcare through his appointments with the Singapore Medical Council and the Ministry of Health.
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The great communicator, known for his stories and songs.
National Outstanding Clinician Mentor 2009.
As a young mentor, with an even younger Prof Fong Kok Yong.
Beginning his lifelong dedication to medicine and SGH on this Campus.
Thank you Prof Ng I am personally grateful to Prof Ng for his support as CMB, especially when I first took over as CEO of SGH. He had generously shared his insights, wisdom and supported me in major decisions. Han Seong, thank you for your outstanding stewardship! — PROF ANG CHONG LYE, CEO
Thank you for being a dear friend and great supporter of nurses. We love your "sportingness", wisdom and advice. — DR TRACY CAROL AYRE, Director, Nursing
Thank you for all these years of teaching and guidance – from elementary clinics to HO/MO and your continued support and mentoring in the years as HOD and Div Chair. It was a privilege being your student and an honour to have worked with you. — ASSOC PROF LEE LAI HENG, Chairman, Division Of Research
Thanks for being such a great mentor and guide, Prof! Have learnt much from you clinically as well as in leadership and management. Best wishes for your future! — PROF LUCIEN OOI, Chairman, Division of Surgery
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Dear Han Seong The mountain is beautiful when covered in snow After the snow moss grows For each moss there is a pain But wit h each pain a loss
The journey begins but it also ends For every beginning there is an end But wit h each end comes a new beginning ~ A Shaolin monk With best wishes, Keng Thye — Prof Woo Keng Thye, EMERITUS CONSULTANT, RENAL MEDICINE
LIFE at SGH Campus | Nov/Dec 2012
up close
Skills and experience are needed to re-align fractured bones before applying plaster cast.
Loving and living the good life A s Mr Ng Puey Kwan walks down the corridor, you immediately sense something special about this man. The staff greets him warmly. Nurses pat his back affectionately and tease him. Doctors fondly call him “Ah Kwan”. This orthopaedic technician is SGH’s longest serving staff – clocking 60 years.
The making of a master
In 1953, a friend recommended 18-year-old Ah Kwan for plaster work at SGH. His supervisor, recognising his skills and "hand artistry", decided to mentor this protégé. By 26, Mr Ng was already training all medical officers in the art of plastering. Mr Ng remains passionate about plastering. When vacationing overseas, he visits hospitals and asks to observe their plaster rooms and practices. He proudly declares, “Of all I have seen, none can beat us!” Mr Ng would also (and still does) observe orthopaedic surgeries, to study the alignment of bones.
Then and now
He recalls how in the old colonial days, healthcare staff were considered "kings". Patients were scolded and made to wait while the staff lunched together. Today, times have changed; patients are more knowledgeable, impatient, and have no qualms about complaining. Yet his greatest joy is the gratitude he gets from patients when he helps relieve their pain. And he has helped countless people. “I have seen all sorts, from a fourday-old baby, to the elderly in their 90s; from local top politicians, to foreign royalty,” he says.
A good catch! Fishing led him to his wife, whose family owned a kelong.
The SGH straight course
When asked what has kept him here for six decades, Mr Ng tells of other hospitals attempting to bait him with hefty pay raises. “In the end, it is the friends. I have many friends here, I like the people I work with and the nurses – they love to hug me all the time!” he laughs.
The charming rascal
We see why everyone loves Ah Kwan. He exudes a zest for life. He declares, “I love playing and living a good life.” The sprightly 78-year-old expands: “I was a rascal in my younger days, going to parties all the time at Pasir Panjang in my red Mini Cooper! Even when I didn’t feel like going, people would keep asking for me.” He recalls being asked to dance with the Caucasian nursing matrons – “They were too tall and big to even put my arms around!” he chuckles. “In my younger days, I loved to hike, spear fish, hunt wild boar, dive and fish! Every few weeks, I would explore parts of Malaysia. Sometimes, I would invite the doctors along on my boat for fishing! Now, I brisk walk every morning, and still go fishing and snorkeling every few months. I travel at least twice a year.” Mr Ng hopes to retire next year. His previous two resignations were rejected – a testament to his priceless worth. Quite the inspiration, one can be certain Mr Ng will never retire from living the good life.
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Preparing for mass casualty incidents
At a moment’s notice W
hat if Singapore Airlines flight 006 had crashed at Changi instead of Taipei? In that incident in 2000, 83 of the 179 people on board died. How would SGH, as Singapore’s largest hospital, have managed the surge in casualties?
Do you know how your area of work can be affected, and what is expected of you? Where do you go to get accurate information? What happens to our usual patient services? How can you support colleagues on the front line? Knowing the Campus emergency response plan is a first step in getting yourself ready for such civil emergencies. At the A&E, casualties are triaged or sorted by the extent of their injuries.
Preparing for mass casualty incidents how does SGH Campus make it work? COMMANDING THE CAMPUS RESPONSE
The SGH Campus Command Centre is the nerve centre that coordinates and manages the medical and operational responses for SGH and the other centres on Campus. “As the Head of the command centre, I lead and direct the implementation and integration of response measures swiftly and consistently, as part of crisis management,” said Ms Eileen Lew, Assistant Director of the SGH Preparedness & Response unit. “In the national civil emergency plan, SGH will take on the largest number of mass casualties. The authorities also consider the fact that we have specialised facilities like the SGH Burns Centre,” said Ms Lew. “Coping with a sudden surge in patients affects the entire Campus, as the medical operations of SGH and the other institutions are closely linked and inter-dependent. On the plus side, responding as a Campus means we have more resources to tap on,” added Ms Lew.
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RAPID RESPONSE AT THE FRONT LINE
The surge in patients will hit our Department of Emergency Medicine (DEM) first, which is likely to have the shortest notice to respond while Dr Puneet Seth, Consultant, Emergency Medicine running one of the busiest Accident & Emergency (A&E) operations in Singapore. On top of the usual tasks of sorting the casualties according to the severity of their injuries, our DEM is also equipped with special facilities and resources to deal with patients contaminated by hazardous materials. "Finding space; managing the traffic flow of casualties; deploying staff; activating more resources; liaising with the wards and the other doctors – these are the many areas that have to be coordinated," said Dr Puneet Seth who coordinated DEM’s response plan. “With so many different units coming together, it all comes down to how well you talk to each other. We also
LIFE at SGH Campus | Nov/Dec 2012
The Operating Theatre (OT) Recovery Room will be quickly converted to temporary Intensive Care Units.
activated doctors from both the surgical and medicine units, and had to make sure everyone knows where to go,” said Dr Seth. “The exact nature of the injuries is not as important as having an efficient process to quickly sort out who needs help and what kind of help. Having a plan and a person clearly in charge makes the difference,” he said.
ACTION IN THE THEATRES The nurse in charge of the Emergency Operating Theatre, which already operates round the clock, leads the Major Operating Theatres’ (MOT) initial response to any mass casualty incidents until the arrival of more staffing support. The team of 20 staff has to decant patients on the existing surgical list, prepare Operating Theatres and set up temporary intensive care units. In such a situation, MOT nurses may be deployed to clinical areas different from their normal ones. With the reassignment, they will be given Action Cards which define their specific roles and responsibilities – OT nurse, anaesthetic nurse, or temporary ICU nurse etc. A team led by Nurse Clinician Teng Chai Lian is responsible for setting up special OT Radiation Isolation Rooms in readiness for ‹persistently contaminated radiation› casualties who require surgery. “Many nurses volunteered for the recent exercise in July. It was a valuable learning experience. We were also very proud that we were able to keep the Emergency Operating Theatre running while taking on the additional roles required by the drill,” said NC Teng.
Exercise that changes the mindset Could SGH Campus treat 260 patients injured in an “explosion” involving radioactive materials? That was the test we were put through in Exercise Kingfisher on 7 July 2012, when more than 3,500 Campus staff took part in full gear. “The exercise changed their mindset. That’s the feedback from the junior doctors. They had not anticipated the complexity, and said they could not imagine how the hospital could cope if there were no preparations. They were impressed that we have plans and that we exercise them,” said Emergency Medicine Consultant, Dr Puneet Seth. The emotional impact also caught some staff by surprise, even though the "casualties" they encountered were in the form of folders containing description of their injuries. The experience was enough to make the staff aware that they needed to be ready, emotionally and operationally, for the unexpected. “Overwhelmed and shocked. These were some of the reaction reported by junior nurses. Before the exercise, they had seen only fairly stable patients admitted for elective orthopaedic surgery. All of a sudden, we were confronted with ‘casualties’ with severe burns and multiple injuries. The nurses had to perform the procedures of last office, made more real by the porters who turned up to bring the ‘bodies’ to the mortuary,” said Nurse Clinician Wong Yuk Meng who was in charge of a team in Ward 76.
Nurse Clinician Teng Chai Lian, Major Operating Theatres.
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Preparing for mass casualty incidents how does SGH Campus make it work? learnt that there are procedures and resources in place to support them. We also worked with nurses deployed from the other wards, and it was good to see the new team very quickly working as one. Holding an exercise also helps everyone to remember the procedures better than any written policy,” said NC Wong.
BACKROOM SUPPORT
In the Materials Management Dept (MMD), Assistant Manager Rosli Boedjang’s team maintains the inventory of emergency supplies and makes sure these are deployed timely to various users.
Working in decontamination suits was exhausting and posed other challenges such as effective communication.
MAKING ROOM IN THE WARDS
“Ward 76 is one of the four disaster wards designated to receive the casualties and I NC Wong Yuk Meng heads a team tasked to convert rooms in was in charge of the rooms Ward 76 to treat casualties. set aside for them. A key part of our initial response is to quickly discharge or transfer existing patients suitable to be moved, to make room for the influx of casualties,” said Nurse Clinician Wong Yuk Meng.
“We support the needs of both the Ministry of Health and SGH. For MOH, we maintain medical field kits stocked to their specific needs, packed in mobile backpacks for easy deployment to the scene of disaster. For SGH, we maintain sets of supplies for different disciplines, such as trauma and burns sets, ready for deployment to locations like A&E, the temporary intensive care units and the disaster wards. “Over the years, we have worked with the users to standardise the contents of these sets so that they
“The atmosphere during the exercise was very tense. Hurry, hurry, hurry - we were racing against time, to decant the ward. It was part of the experience, to have to perform under such pressure. But it was certainly a culture shock for the new, junior nurses who have never managed severe multiple injuries as they normally see patients admitted for elective orthopaedic surgery. “Going through the drill gave us a clearer picture of what it can be like. It made staff more confident, as they
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Mr Rosli Boedjang shows the special kits (red backpacks and grey plastic boxes) stocked and maintained by MMD for civil emergencies.
LIFE at SGH Campus | Nov/Dec 2012
Assisting members of public looking for loved ones injured in the incident is the role of Ms Karen Shiu (in orange vest) and our Medical Social Workers (in purple vests).
can easily be shared, thereby optimising resources. The drills give the users a clearer idea of what, how and when MMD can provide them with in terms of supplies, which puts their minds at ease in responding to an emergency. “As we in MMD gained experience and with our own procedures in place, we are now able to look beyond our own needs to identify issues in the coordination with the other departments, or even give them suggestions.” Indeed, while the exercise may be over, preparedness work continues as Mr Rosli holds follow up meetings with users to iron out issues for improvement.
ON THE PUBLIC FRONT
What if members of the public turn up at SGH looking for their loved ones who may have been injured in the incident? Our Hospital Information Bureau helps by matching details of the casualties in our records with descriptions provided by their relatives. SGH has developed a customised information system to track the individual casualties treated here. We will also upload photos of those most severely injured (categories P1 and P2) into the system. Members of public are attended to at the Relatives Holding Area where our Medical Social Workers are on hand to provide support to them. The Bureau is also manned by teams from Communications, Service Quality and IMS, working closely with external agencies such as the police. The team from Communications also provides situation updates to everyone, including hospital staff in general. Heading the Relatives Holding Area is Ms Karen Shiu, Manager of IMS, who has personally experienced large scale devastation caused by natural disasters.
to lead your team and family through such incidents, it changes your mindset and behaviour permanently. “We had to constantly remind everyone involved to think 'real mass casualty incident' and not 'exercise.' Things never go as planned when you are in the middle of a real incident. “Thus when preparing for this exercise, it was necessary to put forth questions to the team, to keep thinking outside the box, looking at the worst case scenario and coming up with possible solutions. We went through many likely scenarios, thought through, agreed on solutions and wrote up detailed procedures. This definitely helped everyone to think on their feet and perform with confidence on the day of exercise,” said Ms Shiu.
What you can do Take an interest. Being informed of the hospital response plan is one way of helping the hospital and the community to be ready. Go to the SGH Emergency & Preparedness website http://mysinghealth/sgh/EPR. Find out what could happen to you. If
the hospital is dealing with a sudden surge of casualties and discharging patients to make room in the ward, how would your area be affected? Would you be recalled?
Update your personal information.
Always keep the hospital and your supervisor updated on your contact information, using the HR portal on our intranet.
Stay informed. During any incident, the SGH Hospital Information Bureau will issue updates to staff on the situation via email and intranet etc. This would be a reliable source of accurate and consistent information.
“I’ve lived and more importantly, worked through many typhoons and earthquakes in Guam. When you have
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bench press
Cancer study finds local trend Yet local data on this aggressive form of cancer is lacking. The researchers decided to look at the profile of 256 ovarian patients seen at SGH in the last five years.
What was found?
The number of such patients diagnosed with this condition has more than doubled in the last 20 years, rising from 5.2 per cent to 13.4 per cent of all ovarian cancers reported. The incidence in Singapore is also higher than that in Western countries such as the US, Norway and Australia.
Who are at risk?
Women who suffer from endometriosis, which is a widespread disorder in Singapore, may likely be at risk of getting the cancer. Of the 81 patients in the study who had clear cell ovarian cancer, almost half of them had endometriosis. Assoc Prof Tay Sun Kuie
S
GH clinicians have shed new light on an aggressive form of ovarian cancer that is more common among Singaporean women than those in the West. The study has added valuable local data which was previously lacking. It was led by Assoc Prof Tay Sun Kuie, Senior Consultant, Department of Obstetrics & Gynaecology.
Why study this condition?
The number of patients diagnosed with clear cell ovarian cancer in Singapore has been increasing. They generally fare worse than those with other forms of ovarian cancer. Its outcome of treatment is also poorer. Even with standard chemotherapy, up to 86 per cent of these patients will experience worsening of the disease over time.
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Ovarian cancer patients who were never pregnant or have never given birth are also more likely to have clear cell ovarian cancer, compared to other ovarian cancer patients who had at least been pregnant or given birth once.
How will the new knowledge help?
We now have a better idea of the patients at risk, which can translate into earlier diagnosis. We also know we need to find better ways of diagnosing the cancer, as our study also showed that the current standard scoring system to assess risk of malignancy is an unreliable predictor for this form of cancer. With the new understanding, we hope to find better ways of diagnosing and treating the cancer. The team presented their study at the Singapore International Congress of Obstetrics and Gynaecology in 2011.
LIFE at SGH Campus | Nov/Dec 2012
100 papers
A
ssociate Professor Tay Sun Kuie likens research to running a full marathon and thinks that researchers should adopt a runner’s never-give-up mindset. “The only difference is,” he pointed out, “there is no finish line in medical research.” The clinician scientist has been doing this "marathon" for 30 years, with 100 peer reviewed publications to his name. Yet the Senior Consultant from the SGH’s Department of Obstetrics and Gynaecology has no plan to quit the quest to improve patient care through research.
Q. Do you remember the first paper you had published? A. Yes, of course! Shortly after I graduated from the
University College of London in 1981, I joined my mentor, Professor Albert Singer, at his colposcopy clinic. In 1983, we did a study on the impact of colposcopy in a general hospital and got my first paper published in the British Medical Journal, one of the top journals.
Q. What drives you in research? A. To do clinical research, you must also be a fully
30 years
“The only failure in research is when you give up.”
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goal
Q. What is the life of a researcher like? A. It is definitely not easy. To be a researcher, you must be
able to accept failure. If the results are not what you had anticipated, you learn from it. The only failure in research is when you give up. A researcher also needs lots of support from his colleagues and family who share his vision. Being a clinician is a full time job, which means research can only be done after office hours. I’m very lucky to be married to a former nurse who understands what I’m doing. After the arrival of our third child, she stopped work to look after the family.
Q. What is your advice for younger doctors who want to venture into research? A. The desire to do research must come from your inner
self or a drive to push the (medical) frontier. It cannot be a directive from your boss, and certainly having a mentor who can inspire you is also important.
committed clinician. Only when you deal with patients, you will know what the patients’ problems are; where the knowledge gaps are; and try to narrow these gaps through research. You are driven not just by motivation but also outcomes. There is great satisfaction when you get new and interesting findings that contribute to the knowledge for better patient care. The added bonus, of course, is when your paper gets published in good journals.
Ovarian tumours can grow to significant size.
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class act
Shoulders to sta “I always tell the students, ‘I want you to be better than me. You start your learning journey standing on my shoulders.“ With over 70% of the school’s students coming through our doors each year for clinical posting, the team at the Associate Dean’s Office is kept busy with Prof Tay’s holistic approach of “body, mind, and spirit”.
Care for the Body
“The physical needs are the easiest to address. We’ve started initiatives such as ensuring that the students on night shift have snacks such as hot Milo and biscuits; and working with the Facilities department to provide sofas for sleeping and Housekeeping for fresh bed linen, so that they are comfortable and can focus on attending to patients well.”
Broaden the Mind
E
nergetic Teacher 2009. Most Motivational Teacher 2010. Associate Professor Tay Sook Muay also has a Master’s degree in Education. Appointed in April 2012 as Associate Dean at SGH Campus for the NUS Yong Loo Lin School of Medicine (YLL-SOM), the anaesthesiologist has been on a mission to better the learning environment here for faculty and students alike.
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“We put up winning posters showcasing work done by students and faculty, including those done in collaboration with the Duke-NUS Graduate Medical School; provide reading materials like research publications and magazines, and information on talks and conferences. All in a bid to remind students that they need to continuously think about how they can do things better and keep their minds open to new knowledge so
Team f left) Me Keok L Tay Soo Li-Li, Le and Ch
that we can advance and improve patient care. “I remind them that they are not just students, but young doctors in training, and therefore need to be mindful of their emotional language and to use the right medical lingo. They have privileged access to renowned doctors who are their faculty members and must remember to treat them well. In time to come, these very teachers will be their professional colleagues so the relationships built now are important.”
Nurture the Spirit
“We need to remember that they are young and still learning. I
LIFE at SGH Campus | Nov/Dec 2012
and on
share my own experiences to help build their internal ‘compass’, and teach them situational awareness to better handle their personal approaches to faculty, colleagues, patients and their family members. It is crucial to build up their communication and interpersonal skills as they pursue their medical education. “It is also crucial that they are aware of the need for regeneration from ADO. (From or rejuvenation. We elissa Tang, Tan Lan, Assoc Prof all have different ways ok Muay, Chang eung Tak Yam to de-stress and relax, heng Kam Fei. and it’s vital that we allow time to recharge and refresh emotionally and spiritually to achieve balance in life. “We also work with them on community projects to build and encourage the spirit of altruism, and the importance of giving back to the community. With this approach, it’s easier for the students to also understand how it applies to patients and faculty, and to empathise with them. I hope this helps to ‘humanise’ healthcare delivery and education. “I’m also an advocate for the students to teach-to-learn. Because when they teach, the learning multiplies and our techniques can be refined.”
Much ADO about everything Tucked away in their office on the rooftop of Block 1, the executives at the Associate Dean’s Office (ADO) act as the vital middlemen, liaising between the students and various departments for their postings, evaluations and exams. They plan programmes for orientation, tutorials as well as ward and ambulatory attachments. Leung Tak Yam, Chang Li-Li and Cheng Kam Fei enjoy the people aspect of their job. This is most felt when the students return to express their appreciation with cards and gifts. Some even become friends on Facebook.
Q. What is a typical need that you deal with? A. “Parking! During their posting, we
Kam Fei travels at least once a year.
try to arrange free parking for students who drive. As many of them do drive, it can be difficult but we try,” said Kam Fei. This former teacher enjoys frequenting board games cafes and places around the world.
Q. Tell us about an unusual student request A. “It is quite common for them to ask
Tak Yam is a hospital volunteer in his spare time.
me who are the handsome or prettiest doctors around,” said Tak Yam matterof-factly. An avid fan of television programmes like How I Met your Mother and Grey’s Anatomy, Tak Yam has real aspirations of going to medical school in the future.
Q. What do you enjoy most about what you do? A. "The medical students take away
Li-Li scours Singapore for food gems with fellow foodie friends.
valuable lessons from their tutors, and if they enjoy themselves, they may come back to join SGH in future," said Li-Li, who is aware of how the smooth running of the programmes contribute to SGH and the Campus. Li-Li likes baking, crafting and decorating her cakes as beautifully as her mum's.
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nursingrch resea
Brought to you by the Nursing Research Council
A good buy
Applying research in evidence-based procurement
H
ow do we decide on the brand of medical products to be used in our wards? In nursing, procurement and evaluation of products are based on evidence and informed by latest practice guidelines.
A case study
In the last issue of Nursing Research, we highlighted a change in practice in relation to how the placement of nasogastric tube is checked. Nurses in SGH now use pH paper, rather than litmus paper, to ascertain the pH level of aspirate obtained from nasogastric tubes. To ensure that we use the most accurate brand of pH paper, we conducted a product evaluation trial. A group of nurses was provided with bottles of colourless and odourless liquid of different pH levels to test three brands of pH paper. Although we used only three types of solutions, of pH levels 5, 6 and 7, each nurse was given nine bottles of solutions in different order. And here is what we found: % of correct readings BRAND A
BRAND B
BRAND C
Solution 1
78
81
4
Solution 2
76
89
40
Solution 3
8
59
51
Using Brand C, nurses tend to rate a liquid to be of pH 5 when in fact it was a pH 7. Guess which brand we bought? Brand B of course!
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The resource guide was launched by Minister for Health Gan Kim Yong at our Nurses Day 2012 celebration.
A HANDY GUIDE for nurses For the first time in SingHealth, we have our very own nursing research resource guide.
It is a handy reference for the various aspects of nursing research. You can find outlines of various study designs such as experiments, surveys and qualitative research methods. It also provides answers on how to frame a research question, search the literature and obtain approval for studies. “Our nurses are already trained to carry out research. The resource guide serves as a refresher and a ‘quick-go-to’ for nurses who would like to embark on a research project in the clinical setting,” said Nurse Clinician Ang Shin Yuh. Can’t wait to start your own project now that you have this aid? Download the resource guide at http://mysinghealth/ SGH/Nursing-Intranet/QINResearch/ Nursing-Research/
LIFE at SGH Campus | Nov/Dec 2012
Appraising Validity Following the earlier issues of our newsletter, you have completed the first four steps of:
This is the fifth of an eight-part series on Evidence-Based Nursing. Look out for the rest of the articles in subsequent issues.
1. Formulating a focused question 2. Searching the databases 3. Retrieving relevant articles 4. Appraising the articles’ relevance to your question (For details on the first four steps, access the previous issues at: http://mysinghealth/SGH/Nursing-Intranet/ QINResearch/Nursing-Research/Newsletter/) It is now time to appraise the articles in detail for two other aspects - validity and results. In this issue of the newsletter, we will focus on validity.
Validity
Validity refers to the likelihood that results of the studies are true, believable and free from bias. Validity of a study can be inferred from the Methodology section of the article. Your assessment should be in accordance to the article’s study design.
Example Evidence-Based Nursing is a systematic approach to the acquisition, appraisal and application of research evidence to guide nursing care decisions. The three main skills are: Acquire, Appraise and Apply.
ACQUIRE
APPRAISE
FORMULATE FOCUSED QUESTION
RELEVANCE?
SEARCH THE LITERATURE
VALIDITY?
RETRIEVE INFORMATION
RESULTS?
APPLY CLINICAL APPLICABILITY INDIVIDUALISED CARE
You found a randomised controlled trial, which answered your clinical question and it was stated in the article that:
Participants were chosen at random, using a computergenerated table of random numbers.
The randomisation sequence was unknown to the clinicians and researchers.
Allocation of placebos was unknown to the participants (i.e., participants were blinded).
Participants’ results were analysed in the groups to which they were first allocated. The research methodology appears to be sound and the results, valid; hence this article should be included in your review.
REFERENCE Duke University Medical Centre Library (2010) Introduction to Evidence-based Practice. Available at: http://www.hsl.unc.edu/ services/tutorials/ebm/index.htm. Accessed on 12th August 2012 Scottish Intercollegiate Guidelines Network (2012) Critical Appraisal: notes and checklists. Available at: http://www.sign. ac.uk/methodology/checklists.html. Accessed on 12th August 2012.
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nursingrch resea
Winning papers
SGH nurses presented 18 papers at the SingHealth Duke-NUS Scientific Congress 2012 in August. We share two winning entries here.
Best Evidence-Based Oral Paper (Nursing) Effectiveness of Nurse-Led Services in the Acute Care Setting — A Systematic Review of Randomised Controlled Trials [RAJASHULAKSHANA D/O RAJARAM] INTRODUCTION Given the expansion of nurses’ roles in Singapore, it is timely and useful to gather and appraise the evidence on nurse-led services/programmes’ impact on patients’ outcomes and health care costs. OBJECTIVE To evaluate the clinical effectiveness of nurse-led services in the acute-care setting. POPULATION
Patients who access inpatient and out-patient services in the acute care settings
INTERVENTION
Nurse-led services based in the acute-care setting
COMPARISON
Services/Programmes led by medical doctors
OUTCOMES
Patients’ outcomes
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Prof Jane Barnsteiner (Nursing Expert from University of Pennsylvania) and SSN Rajashulakshana d/o Rajaram
METHODOLOGY A systematic review was performed in June 2011 using the databases of MEDLINE(OVID), CINAHL, EMBASE, PUBMED, Centre for Reviews and Dissemination and The Cochrane Library with the following terms: nurse-led or nursing-led or advanced practice nursing or advanced practice nurse or specialist nurse or clinical nurse specialist AND acute care or hospital or inpatient or tertiary care or acute clinic or specialist clinic. Studies were limited to those published in the last 10 years. Papers were assessed by two independent reviewers using standardised critical appraisal tools. Any disagreements were resolved through discussion with a third reviewer. RESULTS 20 Randomized Controlled Trials (RCTs) were found, covering a range of medical conditions and settings (emergency care, 1; intensive care, 1; mental health, 1; diabetes, 2; respiratory, 4; rheumatology, 3; cardiac, 3; oncology, 5). The five studies on oncology patients demonstrated that nurse-led services led to improvements in quality of life and patient satisfaction but less so in the domains of clinical outcomes. Similarly, the four studies on respiratory patients showed that nurse-led services were not inferior to doctor-led care. Most of the studies failed to provide details of how randomisation was done and what doctor-led care entails. There were vast variations in the interventions carried out by the nurses; hence pooling of results was not possible. CONCLUSION Preliminary evidence demonstrated that nurse-led services was in general as safe as doctor-led care but not superior.
LIFE at SGH Campus | Nov/Dec 2012
Best Nursing Oral Paper Coping and well-being in caregivers of Singaporeans with Parkinson’s Disease [DR TAN SIOK BEE] AIMS The need to provide care for people with Parkinson’s Disease (PD) will increase with the extended life expectancy of Singaporeans. Caring for people with PD in their own homes for as long as possible is argued to provide care recipients with psychosocial benefits as well as benefitting the community by delaying institutionalisation. The aims of this study are to investigate the PD caregiving experience and to identify the types of coping strategies used by caregivers. Factors that affect caregiver well-being were also explored. METHODS A cross-sectional survey of caregivers of people with PD were recruited from a PD clinic at an acute tertiary hospital in Singapore and members of the Singapore Parkinson’s Disease Society from 2009-2010. Guided by the theoretical framework of Lazarus’s cognitive theory of stress and coping, this study was the quantitative part of a mixed method sequential explanatory design. RESULTS A sample of 94 caregivers completed the face-to-face survey with a response rate of 57.3%. There were 74 females (78.7%) whose ages ranged from >21 years old to >71 years old. Most caregivers used adaptive
APN Dr Tan Siok Bee
coping strategies. However, the use of either adaptive or maladaptive coping strategies was associated with an increase in caregiver burden. There was a moderately strong negative correlation between caregiver burden in six out of eight health domains of the SF36, rs=-0.36 to -0.53, n=94, p<0.001. Strongest negative correlations were obtained between the mental component score (MCS) and caregiver burden; rs=-0.58, n=94, p<0.001, 95% CI (-0.70,-0.42). CONCLUSION Caregivers used predominately adaptive coping strategies and the use of maladaptive coping strategies was negatively associated with caregiver well-being. Caregiver burden had the highest impact on emotional well-being. The findings from this study inform future research on the caregiver experience and in planning appropriate and effective multi-disciplinary interventions that support caregivers throughout the stages of PD.
Our other winners! SSN REKA RAMAKRISHNAN
Best Nursing Oral Paper (2nd Runner Up)
Evaluation of the Inter-rater reliability of two fall risk assessment tools in the inpatient setting of a tertiary hospital in Singapore
SSN NURSHIFA SHAIK HUSSAIN
Best Nursing Poster (Runner-Up)
The effectiveness of glucosamine sulfate in the management of osteoarthritis symptoms: A systematic review
APN RACHEL MARIE TOWLE
Best Nursing Poster (2nd Runner Up)
Evaluation of the effectiveness of BOOST – a programme to improve the transition process from hospital to home
Want to know more about their work? Please contact NC Ang Shin Yuh at ang.shin.yuh@sgh.com.sg
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quality pulse
Brought to you by Service Operations, a unit of Operations and Performance Management
Shh... the babies are sleeping
Relocating supplies cabinets.
Reducing noise in the Neonatal Intensive Care Unit [TEAM SGH-NICU]
T
he SGH Neonatal ICU (NICU) was sometimes too noisy for the infants, 70% of whom were born premature. With their still developing ears, loud noises make them cry excessively, disturb their sleep and may affect their development. There is a need to ensure that the sound levels in NICU consistently follow internationally recommended levels. Team SGH-NICU, led by Dr Imelda Ereno and consisting of doctors from Neonatal and Developmental Medicine, nurses from NICU and staff from Biological Safety department decided to look into the problem. THE SOLUTION The team adopted a multi-pronged approach, introducing a new intervention every week for seven weeks. The measures included:
Briefings for staff on the importance of keeping voice levels down.
A noise-activated warning device that gives a visual alarm to staff when noise level in the ward goes above a pre-set level.
Not conducting handover procedures at the bedside.
Replacing metal bins and tap valves that cause loud noises.
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Using a separate room to prepare for new admissions, as the process tends to be noisy.
Using low-level lighting and incubator covers to provide a more soothing environment. THE RESULTS The average daily sound levels were reduced by approximately four decibels, a 23% improvement to the operational noise level. The resultant environment is calmer and quieter, providing a more peaceful area for the babies. The project won QI Project of the Year 2012. Will your project be the next winner in 2013? Keep your eyes peeled for the call for nominations soon!
Effective Signage
Signs are commonly used as reinforcements for safety regulations or process guidelines. However, too many signs in one given location may reduce their effectiveness.
LIFE at SGH Campus | Nov/Dec 2012
QI Chat
More than 10 quality improvement (QI) projects in 12 years – that is the track record that earned Mr Yeo Han Seng the crown of QI Champion 2012. The Assistant Director of Specialist Outpatient Clinic shares his thoughts about QI in SGH. 1. You have been in SGH for 12 years. How has the QI culture changed over the years?
Staff today take the initiative to get together to look into problems they encountered. In the past, QI teams were formed only because they were “ordered” to do so. So I see greater awareness, understanding and acceptance.
2. “This is our practice all along and it is working fine. Why change?” What is your response?
I will usually agree with them that the practice is fine, and then challenge them to try to make it even better, faster and safer for themselves, their staff and the patients.
You are not allowed to smoke here! Can’t you read the sign?
3. “It’s not worthwhile to put in 20 hours for the QI project, just to save 10 minutes daily.” What do you say to that? I will illustrate how, in the long run, they would benefit. In 120 days, they would have “recouped” the 20 hours “invested” and the rest would be more quality time for themselves or their staff.
4. What motivated you to drive the many QI initiatives?
The SOC teams simply wanted to improve processes and experience for both patients and staff. Eager to share our approaches to problem solving, I encouraged them to take
part in QI conventions. It was also a way to showcase their hard work. The bonus was that our people picked up presentation skills, and bonded through these projects. I must thank my team for believing in me and supporting the QI initiatives through the years. Check out the full interview at QI Net - http://mysinghealth/SGH/ Quality/QI-net/
Oh sorry! I didn’t see it!
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spree in action
Service champion “You are our model and icon for the spirit of SGH,” said Prof Ng Han Seong of Prof Tan.
F
or her key role in raising the level of service in SGH, Assoc Prof Agnes Tan was given the new SGH Service Excellence Honorary Award, meant for members of the Senior Management.
Chairman of the Division of Ambulatory & Clinical Support Services, Prof Tan has been co-chairing the Service Quality Committee for the past four years, leading its efforts to recognise staff who deliver excellent care and service to our patients. She also initiated the Energiser programme in 2011, to rekindle our passion for service.
“I would like to see Service Excellence as part of our culture in SGH, becoming so natural that we do it unconsciously, for every patient that we meet and for every colleague that we interact with.”
AN SGH MOMENT
Making SGH safe Quick thinking and action by Nurse Clinician Irene Goh helped a patient at the Same Day Admission Centre recover her missing mobile phone before the culprit could get away. As soon as she was alerted, Irene swung into action. Together with our security, Senior Operations Assistant Hisham Bin Abdullah from the Security Department, they ran through the closed-circuit camera recording, and were able to identify the suspect. Security officers called to the scene then retrieved the phone and returned it to the rightful owner. The duo’s handling of the incident on 7 June 2012 demonstrated the SPREE Qualities of Safety, Professionalism and Efficiency. Thank you Irene and Hisham, for making SGH safe for our patients.
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Teams UP!
Every six months, we select a Ward and a Clinic/Centre that have shown teamwork excellence and outstanding performance in patient care for the Teams Up! award. WINNERS FOR OCTOBER 2011 – MARCH 2012 Clinic G
MOST IMPROVED CLINIC/CENTRE OCTOBER 2011 – MARCH 2012 Clinic J
campus buzz
LIFE at SGH Campus | Nov/Dec 2012
A toast to teachers
T
eaching has moved into higher gear on Campus. The Academic Medicine Education Institute, launched in September, offers training and resources to help educators become better at teaching. The completion of The Academia next year will also add new facilities dedicated for education. At the same time, the Campus paid tribute to individual teachers and mentors with a series of Teachers Day activities.
TRIBUTES TO MENTORS
“Teaching is in my blood, I am always excited by it,” said Esther Lim.
Colleagues and medical students submitted dedications to mentors who have helped them in their learning journey on this campus. The September session of Grapevine, SGH’s monthly townhall session with staff, was used to honour the mentors. Here are a sampling of the tributes:
A/Prof Ng Beng Yeong, HEAD AND SENIOR CONSULTANT, DEPT OF PSYCHIATRY, SGH The moment he meets you, you will be instantly delighted by his laughter and sense of humour. He uses his wonderful personality to inspire and teach students to the best that he can. Many students attend his clinics and his ward rounds repeatedly because every moment with him is a rewarding learning experience. He will always ask his patients to talk to his students and yet ensure that the care for his patients is never compromised. What we learn from him is not just the knowledge in psychiatry, but more importantly, the care for his patients and the passion for his work. — CHUANG DING FANG, Yong Loo Lin School of Medicine, NUS
Jennifer and Ruby
Jennifer Liaw, SENIOR PRINCIPAL PHYSIOTHERAPIST, SGH
She has taught me what resilience is, what mental strength means and what integrity represents. To me, the best mentor is someone who guides you to achieve heights you have never dreamt about and also pulls you along when the going gets tough. Jennifer is that person to me. — RUBY POH, Physiotherapist
Secrets of a
creative teacher Medical Social Worker Esther Lim has been named Outstanding Creative Educator by SingHealth Academy and Duke-NUS Graduate Medical School. The head of department specialises in Family and Marital Therapy. A pioneer in the suicide prevention programme ASIST, Esther shares her know-how in this area by training fellow healthcare professionals, community social workers, police officers and even teachers. I am always thinking “What is the best way to get my message across?” So I get ideas from the courses I attend, by learning from the presenters. I always take notes in two columns – Content and Presentation. This is something that I have always done, without being told or taught to do so. Movies and videos. I like to use these as material, drawing inspirations from them. One such movie is Good Will Hunting, where the main character deals with the issue of abandonment. Midway through the show in the cinema, I found myself groping for my notebook in the dark, so that I could take down notes! Teaching gives me room to be free to explore, and test new ideas. The ability to innovate through teaching, to be spontaneous – that’s why I enjoy teaching.
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campus buzz The SGH website is managed by the Communications Department.
External drive
Endorsement from experts has given a boost to our efforts to use information and communication technology (ICT) to connect with the public. App winner Health Buddy, the SingHealth mobile app, could be the app that every adult Singaporean should have to help them manage their health. The judges agreed with this proposition when they chose Health Buddy as one of only two winners in the mobile apps category at the Singapore Infocomm Technology Federation (SITF) awards. It beat nine other finalists to the honours, meant for ICT applications developed locally.
in Singapore – health tips, GP clinic listings, Doctor Q&A, etc,” said Kathryn Ng, Director of Marketing Communications and Partnership Development. Her team developed the app with our IT partner IHiS. The judges also gave suggestions on ways to enhance the application. Health Buddy is available on all iPhone, Blackberry and Android platforms. Go check it out and tell your patients and friends about it!
“The judges were impressed with the comprehensiveness of information offered, and the fact that we included not just 'our own company info’, but generally things useful to everybody
Download Health Buddy to your smart phone now!
Web award The next time you access the SGH corporate website, know that you are looking at one that is highly rated among those from the healthcare industry. It was bestowed the “Healthcare Provider Standard of Excellence” title at the recent 2012 WebAwards. The annual awards from the Web Marketing Association in the US recognise the best websites in 96 industries as benchmarks of excellence for website development, internationally. The judges loved our “clean site and simple navigation structure”, leading it to garner high scores in the Design, Use of Technology and Innovation criteria. SGH now keeps company with past winners Johns Hopkins and Boston Medical Center, among others.
outstanding clinician scientist
K
udos goes to Prof Pierce Chow for winning the Ministry of Health’s annual National Medical Excellence Award for National Outstanding Clinician Scientist 2012.
The Senior Consultant at the Department of General Surgery at SGH has done outstanding work in the area of hepatocellular carcinoma to advance patient therapies. His vital research work has contributed towards a deeper understanding of the condition. Prof Chow’s work is widely known internationally and he has more than 160 publications to his name. Prof Pierce Chow (right) is on the faculty of the Duke-NUS Graduate Medical School.
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Within the SingHealth group, Prof George Yeo from the KK Women’s and Children’s Hospital won the National Outstanding Clinician Mentor Award.
LIFE at SGH Campus | Nov/Dec 2012
Live on
The transplant message was carried to the heartlands by patients, volunteers and staff from various SingHealth institutions during the SingHealth Transplant Awareness Walk on 1 September.
Not the usual workout in the gym but great for team building.
Well-wishers stopped to cheer on the elite riders.
They fanned out at selected MRT stations - Ang Mo Kio, Toa Payoh, Hougang, Serangoon, Tampines and Bedok – to engage the pubic and give out education materials. The walk marked the end of five days of public outreach effort which included activities held at SGH, KK Women’s and Children Hospital and the Singapore National Eye Centre.
Our doctors and nurses pounded the pavement to get the transplant message out to the public.
champions for charity More than 40 staff went the distance at the SGH Cyclefor-a-Cause event held in conjunction with the annual President’s Challenge. For every $10 donated in their name, participants rode a kilometre on stationary bikes at our Work-Life Booth on the ground floor of SGH on 18 September. A group of 12 elite riders raced to clock 1,600 km while maintaining top speeds for hours. Novice riders rode more than 100 additional kilometres to raise more than $17,000 for needy beneficiaries. SGH’s annual Charity Bazaar on the same day brought in a record breaking $9,000 for the President’s Challenge.
The sky bridge spans Hospital Drive.
Skybridge on campus
A sky bridge across Hospital Drive shall link the new National Heart Centre Singapore to SGH at Block 4 level 2. This is to facilitate the safe and prompt transfer of heart patients who need admission to the wards or intensive care unit after procedures at the new centre, to be completed in 2014. Work has started on the skybridge. During the construction, the food outlets at Block 4 will remain open although barriers will be put up around the Urology Centre.
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time out
Cross Culture “We Burmese don’t use surnames or family names. So you should call me by using my name in full.”
10 TIPS for a fit body
[FROM PRINCIPAL PHYSIOTHERAPIST PAULINE LEONG AND SENIOR PHYSIOTHERAPIST NG DENG PENG] 1. M ake SMART goals. Your fitness goals must be Specific, Measurable, Achievable, Realistic and Timed. 2. W alk more than 10, 000 steps a day to improve your activity level. 3. T ake the stairs instead of the lift or escalators. 4. E xercise with a buddy, who will motivate you and keep you on track. 5. M ake it fun. Learn a new sport. 6. W alk an extra stop - get off one bus/MRT stop earlier. 7. M ake it social. Walk with your spouse or friend. 8. C hoose activities you like to do. You are more likely to stick to it. Schedule it and stick to it. 9. D o 10-minute bouts of exercise a day to make it 45-60 minutes daily, or exercise at a moderate intensity for 150 minutes each week for health benefits. 10. B reak up long periods of sitting with some light exercises, such as marching on the spot. Always seek a professional’s advice if you are unsure of how to start an exercise programme or if you have pre-existing medical conditions.
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Besides this useful gem of information, SGH research coordinator Ei Mon Soe (say it as “ee mon soh.”) has generously agreed to share her home cooking with us. True to her researcher profession, she tested her own recipe to measure the items and time the steps! Remember to thank her after you’ve tried this out.
Burmese Prawn Curry INGREDIENTS
500g medium prawns, peeled and deveined 3 garlic cloves, coarsely chopped 2 teaspoons fish sauce 1/2 teaspoon turmeric powder 4 tablespoons vegetable oil 1 tablespoon freshly grated ginger (from a 1-inch piece) 1 medium onion, coarsely chopped 1 teaspoon chilli powder 1 branch of coriander leaves ( chopped medium size) METHODS 1. Combine prawns, half the garlic, the fish sauce and turmeric powder in a large bowl and set aside to marinate for 10 minutes. 2. Heat the oil in a medium nonstick skillet over medium heat and cook the remaining garlic and the ginger till fragrant (about 45 seconds). 3. Add the onion and cook till soft and translucent (about 3 to 4 minutes). Stir in the chilli powder. 4. Add the prawns and arrange them in one layer and cook until just opaque (about 3 minutes), turning the shrimp over halfway through. Then stir until the shrimp are fully cooked. Sprinkle with chopped coriander leaves and serve.
LIFE at SGH Campus | Nov/Dec 2012
y o ur t a k e
The most important person in my department
OUR PICK!
Foong May, please contact us to collect your $20 prize voucher.
“Without Madame Ho, the toilets would be dirty, the dustbins would be overflowing, the floor would not be clean and the pantry would be messy. That is why I think she is the most important person where I work.”
— Leong Foong May, Lab attendant, SingHealth Office of Research
It has to be Staff Nurse Jovin Ang, who acts as my IT “consultant” whenever I need her help. — HO AUN
NAH, Senior Staff Nurse, Ward 53 (Obstetrics & Gynaecology)
NEXT:
Ho Kah Hoon from ISS
Kristine Tay is the go-to girl in the team when it comes to managing the Friends of SGH volunteers. She checks on the volunteers (in their signature green T-shirt) daily and provides them with sound advice when they have questions or have problems on the ground. She is also like a mother hen to the student volunteers who run the arts workshop during the school holidays, Kristine Tay, Senior constantly exhorting them to Administrative have their meals, drink water, Assistant and wash their hands! She is certainly a mother figure to students who have never worked with patients before!
— MUMTAJ IBRAHIM, Manager, Community Relations
A SPECIAL CORNER ON CAMPUS
Send in a photo of the location, and tell us why it holds special meaning for you. A good photo is one that helps to tell your story. The most interesting entry wins a prize! Send it to mysgh@sgh.com.sg. Closing date: 30 November 2012.
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st a l theage p
If I have all the money and time in the world, I would like to learn….
“Acting! This could be for movies or TV. My secret dream is to be a K-pop superstar!” — KONG XIU LAI, Staff Nurse, ward 75
“Digital painting! I have been doing this as a pastime for a few years, but I would like to go overseas to study this art form.” — LIN JIA HUI, Administrative Assistant, Post Graduate Allied Health Institute
“Motivational speaking! I have always wanted to be able to guide people in need through motivation!”
“Skydiving! Just because it is not available in Singapore and I would have to go overseas to do it.”
(Starts singing) “In particular, opera singing! I love to sing and I enjoy listening to classical music.”
— ANANTHI PERIMALU, Deputy Shift Leader, Security
— JASON LING, Executive, Allied Health Division
— PAMELA KHOO, Occupational Therapist
“I would like to learn organic agriculture, to help revitalise barren land in my country (Myanmar).” — JOHN KYAW LIN, Guest Relations Officer, Visitors Services
“About finance and property trends. Observing property market patterns has been my hobby for over 10 years! I would also love to be a fashion designer and open my own fashion boutique.” — JASMINE LEE, Senior Staff Nurse, Nursing Administration
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