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Issue 3: Jul-Aug 2021
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HELPING PATIENTS HELP THEMSELVES Yishun Health’s Integrated Medical Clinics take an asset-based approach to build the capability of their patients to self-care
FROM CORRECTIONS TO CONNECTIONS
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HEAR’S TO LISTENING, CONNECTING 20 & LIVING YOUR BEST LIFE
SLEEP, ELUSIVE SLEEP
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ontents
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COVER STORY Helping Patients Help Themselves Our Integrated Medical Clinics empower patients with the support and tools to be active participants in their own care
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WHAT’S UP Community events, outreach efforts, and more
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LIVE WELL From Corrections to Connections Two former prison officers transfer vital skills from their former roles to their current positions in the PHCT team
16 EVERYDAY HEROES A Mother’s Selfless Love Mdm Neo Bee Then remains cheerful despite having to be caregiver to her daughter and late husband 18 Q&A Health and wellness questions asked and answered!
16 20 SPOTLIGHT Hear’s to Listening, Connecting & Living Your Best Life Hearing loss should be treated early to maintain independence and healthy interpersonal relationships 24 DAILY DOSE Sleep, Elusive Sleep Tips to get Singapore out of the ‘sleep-deprived nations’ list
Part 3 of 3
A MODEL FOR UNIFIED CARE 2 |
Patients and caregivers play just as important a role as medical teams — after all, for a majority of the time, patients are at home and in their communities outside the purview and control of clinics and wards. To this end, Yishun Health’s Integrated Medicine Clinics (IMC) not only streamline care, but focus on empowering patients to become more active participants in their own chronic disease management.
PUBLISHER Yishun Health is a network of medical institutions and health facilities in the north of Singapore, under the National Healthcare Group. It comprises Admiralty Medical Centre, Khoo Teck Puat Hospital and Yishun Community Hospital. It also includes community extensions such as Wellness Kampung.
28 26 5 THINGS ABOUT… Mask Hygiene Are your bad habits negating the benefits of wearing a mask? Find out how to ensure you and your loved ones stay safe in this pandemic 28 MAKAN TIME Chicken Rendang Check out this spicy chicken dish that is sure to be a family favourite! 30 FIT & FAB I Have a Hunch… That You Have Shoulder Pain Stretches to relieve neck and shoulder pain, the bane of many office workers 32 NURSES’ DAY 2021 Recognising and celebrating the efforts of our healthcare heroes! Maskless photos in this issue were taken before COVID-19 or with safe management measures in place
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Issue 3: Jul-Aug 2021
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EDITORIAL TEAM Hannah Wong Sabrina Ng Sharon Ng Albert Foo
EDITORIAL COMMITTEE
The editorial committee — made up of clinical, nursing, allied health, population health & community transformation, and administrative heads of department — advises aha’s direction. A/Prof Tan Kok Yang Bastari Irwan Chia Kwee Lee Fatimah Moideen Kutty Shirley Heng Teresa Foong
www.ktph.com.sg/ about-us/media/publications aha@ktph.com.sg
PUBLISHING AGENT THINKFARM PTE LTD www.thinkfarm.sg M A N AG I N G D I R E C T O R
Christopher Tay
H E A D, E D I TO R I A L
Chua Kim Beng
C O N T R I B U T I N G E D I TO R
Sheralyn Tay
MCI (P) 047/07/2021
E D I TO R
Dang Hui Ling
HELPING PATIENTS HELP THEMSELVES
H E A D, C R E AT I V E
Yishun Health’s Integrated Medicine Clinics take an asset-based approach to build the capability of their patients to self-care
FROM CORRECTIONS TO CONNECTIONS
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HEAR’S TO LISTENING, CONNECTING 20 & LIVING YOUR BEST LIFE
SLEEP, ELUSIVE SLEEP
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hy aha? The name aha holds much significance for us at Yishun Health. In part, it is a nod to our history; it also stands for ‘Advocates for Health in Action’. Through these pages, we hope to empower you to take charge of your own health and discover those ‘aha!’ moments that lead to a healthier, happier you.
Sean Lee
H E A D, C L I E N T R E L AT I O N S H I P
Jessie Kek
C O N T R I B U TO R S
Justin Loh Lee Lily
aha is the official bi-monthly publication of Khoo Teck Puat Hospital (Co. Reg. No. 200717564H) and is produced by ThinkFarm Pte Ltd. All rights to this publication are reserved and no part may be reproduced without the expressed written consent of the publishers. While every effort has been made to ensure that the information in this newsletter is accurate and up to date, the editorial team will not be responsible for errors due to information received. Opinions expressed are that of the writers and do not necessarily represent the views and opinions of the publishers. Printed by Mainland Press Pte Ltd. MCI (P) 047/07/2021
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hat’s Up
Tackling a Weighty Issue
O
besity affects about one in nine people in Singapore; it poses a significant burden to health and quality of life, as it increases the risk of many chronic conditions. To mark World Obesity Day and share ways to lose weight in a healthy and practical way, KTPH’s Integrated Care for Obesity & Diabetes (ICOD) team held a Zoom webinar for more than 80 participants on 6 March 2021. During the session, the multidisciplinary team — comprising physicians, surgeons, psychologists and allied health professionals — shared how participants could maintain a healthy weight.
One of the healthy yet yummy dishes that participants could learn how to make during the webinar was Oyakodon!
A morning of working out and burning calories together! Our ICOD team led participants in simple exercises to get their hearts pumping and excited for the day’s programme!
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It began with an easy-to-follow workout, and included a cooking demonstration and engaging talks on healthy living and good weight management.
Refreshing our Commitment to Patient Safety
Y
ishun Health held its first Patient Safety Time Out on 19 March 2021 to reinvigorate our commitment to patient safety. The well-attended event recorded 50 physical attendees and another 450 over Zoom. During the session, Chairman of the Medical Board, A/Prof Pek Wee Yang, reiterated our organisational priority of putting patients, including their safety, first. This culture of safety and zero harm goes beyond rules and protocols, and encompasses a mindset and attitude of professionalism and dedication. A five-member panel then discussed five areas to work on: 1. A proactive and preventative approach to enable us to be more aware of the interplay between systems and human factors. It also allows us to proactively look out for risk factors and implement more checks and balances. 2. Greater openness to facilitate communication beyond
hierarchies and disciplines to enable all staff to be able to speak up regardless of seniority or experience to point out risks, flaws and dangers. 3. Reducing groupthink and being open to playing the devil’s advocate to avoid unconscious and implicit bias. 4. Embracing honest self- and team-examination to acknowledge weaknesses and manage expectations for greater communication. This challenges us to step up and take ownership of situations instead of looking at what the system can do for us. 5. Supporting staff who are stressed out using creative and innovative work design that optimises human performance while avoiding burnout. Wrapping up the event was Chief Executive Officer, Prof Chua Hong Choon, who emphasised that good and safe patient care stems from not just systems and processes, but mental resilience that is supported on a foundation of good emotional well-being at work.
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hat’s Up
Planning for our Future Healthcare Preferences
Y
ishun Health’s Advance Care Planning (ACP) Office conducted two Zoom webinars in March 2021 to share the benefits of ACP. The sessions were targeted at those with high blood pressure, high cholesterol and/or diabetes. The main aim of the webinars was to showcase that ACPs are for everyone, at any age, regardless of whether one has a chronic disease. As participants in these webinars would have the chronic diseases listed, the sessions thus highlighted the risks and complications of each condition. The doctors and nurses who spoke at the sessions came from several specialties, including Geriatric Medicine, Family and Community Medicine, General Medicine, and Palliative Care Service. Apart from being well versed in their own clinical roles, most of them also double up as ACP practitioners. They introduced the different types of ACP, using case studies to illustrate the practicalities and advantages of getting an ACP done early. More than 250 participants, including many healthcare professionals, attended the sessions.
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Why do ACP? How would you like to be cared for when you are sick? It is important to plan ahead, should you become seriously ill and unable to make decisions. By discussing with your loved ones your wishes and preferences, there will be a shared understanding of what matters to you. The plan gives them the assurance and peace of mind that they are fulfilling your wishes. It also guides the healthcare team on how best to care for you.
If you’re interested to get your ACP done, visit our website by scanning the QR code, or contact us to book an appointment.
KTPH Mainline: 6555 8000 Email: ktph.advancecareplanning@ktph.com.sg
ive Well
FROM CORRECTIONS TO CONNECTIONS
Former senior prison officers, Mr Woo Yew Kah, 65, and Mr Ng Gim Lee, 66, bring their knack for people and persuasion into the Population Health and Community Transformation team, adding value in the drive towards preventive health and healthy living.
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As part of the Population Health and Community Transformation team, Mr Woo (left) and Mr Ng now see themselves as connectors who spark little seeds of change in the residents they meet
otivating someone to change their self-harming behaviour and negative attitudes to make better choices can be a tough task, but for about three decades, that was what Mr Woo and Mr Ng did as Rehabilitation Officers in the Singapore Prison Service. In their many years with the service, they have encountered the spectrum of human wretchedness, and take great pride to have helped many people find their inner strength, build their self-confidence, and find the path towards redemption. Some years into his retirement, Mr Woo sought to do something else that would be just as meaningful as his previous line of work. “I asked my daughter, who works at KTPH, whether there were community work opportunities, like with seniors, and she told me about the Wellness Kampung,” he recalls. Joining in 2015, he found the work interesting, and the culture supportive, collaborative and open.
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ive Well
Mr Woo at one of the many programmes he oversees at Wellness Kampung @ 115 Chong Pang
A MATTER OF MOTIVATION Today, he oversees the programmes and residents at the Wellness Kampung @ 115 Chong Pang, a role that involves a significant amount of people management. This is where he brings a lot of his experience to the fore. “We rely on our residents to sustain our programmes,” explains Mr Woo. “So my job is to identify the right person for the right programmes and initiatives.” With his understanding of complex human interactions that are inherent in community life, he is able to ascertain people’s strengths and the levers that can activate them. “Everyone is a potential asset,” he insists, noting
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that everyone has something valuable to bring to the table. This can be tapping an aptitude for singing to lead a music class, a home cook’s passion for food to conduct cooking workshops, and active ones with an observant and nurturing side to help in exercise sessions. This ability to spot leadership qualities, collaborative natures, and altruistic tendencies helps him grow residents into assets for the Wellness Kampung. “We cannot possibly run and lead every programme ourselves, or outsource it to vendors all the time,” Mr Woo points out. “We count on our residents to keep our programmes running in a sustainable way and, at the same
time, give them meaning in their silver years.” As for Mr Ng, much of his capacity for seeing the best in people stems from his work in prison rehabilitation. As he stresses, it is important to see the potential in everyone, even those who have made mistakes. “In prison, we take the approach of advising and encouraging first before we try the more disciplinary way. In the community, of course, we focus on the first two steps only!” he adds with a laugh. Knowing how to channel someone’s potential and skill is one part of the equation. The other is understanding how to leverage people’s motivations and use peer influence and interpersonal relationships to nudge them towards a given path, habit or mindset change. Whether it is to develop someone’s leadership potential or help them cultivate better lifestyle habits, it starts with knowing what their ‘push’ factors are and focusing From receiving awards to the camaraderie he has forged in the Singapore Prison Service, Mr Woo remembers them all
on them. This ‘people knowledge’ is also essential for managing interpersonal politics, cliques, disputes, and conflict resolution.
BEING CONNECTORS AND ENABLERS It was Mr Woo’s insight into understanding people’s skill sets that led to him recommend his excolleague and friend, Mr Ng, for the job as a Community Care Associate with the Population Health and Community Transformation (PHCT) team. Mr Ng, who now works with the Community Nursing Posts (CNPs) and takes charge of their telehealth initiative, joined in 2019. This project helps residents with diabetes who have blood sugar trackers do their tracking and monitoring at home. He had previously worked for almost a decade at the prison medical centre with doctors, psychiatrists and nurses — organising the daily work, keeping an eye on the inmate patients, and ensuring the safety of all staff. His organisational skills and highly reliable nature make him greatly suitable for operational tasks and administration. This came in particularly handy during the pandemic, which escalated the push towards telemedicine. Acting as an IT ‘rover’, he went into the homes of residents who needed help to set up equipment for health monitoring and video consultations. He also helps facilitate the consultations so that nurses at the CNPs can run them more efficiently. “Not everyone is IT-savvy, so we go in quickly to set up their video conferencing and maybe even help with blood pressure measurements and so on.” He also does all the administrative
Mr Ng showing a resident how to independently check her vital signs
duties, such as filling out forms, managing inventory of equipment on loan, and more. In addition to the telehealth project, Mr Ng’s other role is that of an unofficial bodyguard. He has been roped in at times to accompany nurses to visit homes that have had a history of some form of aggressive behaviour. With experience in managing violent inmates in the prison medical centre, Mr Ng’s knowledge of self-defence and psychological deescalation adds a layer of security while the nurses deliver care to the residents. He is also highly attuned to pick up signs of social issues, alcoholism, drug abuse, and other potential challenges — this helps with delivering the right form of
help and intervention. Both Mr Woo and Mr Ng agree that deploying their skills to a different arena of work has been a very fulfilling post-retirement job change. “It is all about building rapport with people, to help point them in the right direction,” says Mr Ng. Be it towards better community participation, lifestyle changes or self-care, they see themselves as connectors who spark little seeds of change. The job also gives them a lot of satisfaction because, in addition to helping them age actively, it is purpose-driven work that uses their unique skill sets for the good of society. “We are continuing to give back the community!” says Mr Woo.
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Cover Story
Helping patients
HELP THEMSELVES 10 |
A MODEL FOR UNIFIED CARE
PART 3 OF 3
When it comes to managing illness, the solution does not just lie in the hands of medical teams. Patients and caregivers play a crucial — if not more important — role in the equation. Yishun Health’s Integrated Medical Clinics (IMCs) ensure that their ‘patient first’ approach applies not only in the way care is designed and delivered, but in empowering patients with the support and tools to be more active participants in their own care.
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At home, Mr Bari educates and empowers his mother, Mdm Markona, to take her own medication every day
ach morning, Mdm Markona goes about her day with independence and energy that belie her 92 years. She does her own laundry before readying herself for the ride that will take her to a Day Care Centre near her home in Yishun. According to her son, Mr Bari, she enjoys these daily sessions, especially the crafting activities and interactions with other seniors. “She wants to join in the exercises, too,” he adds, but is unable to because of her existing heart condition. In fact, it was this condition that caused Mdm Markona a lot of problems in the past. Many years ago, she had to undergo bypass surgery and, a few years back, she began to experience bouts of chest pain that would land her in hospital through the Acute & Emergency Care Centre (A&E). Mr Bari shares that this would happen once every three to four months, with each stay lasting about four days. “It was very worrying,” he recalls.
FEWER APPOINTMENTS, BUT BETTER OUTCOMES Things have since been better after Mdm Markona was enrolled in one of Yishun Health’s Geriatric Medicine IMCs in 2019. She was recommended to the clinic after one of her chest pain incidents led to her admission at Khoo Teck Puat Hospital. Now, as part of her team-based care at the Geriatric IMC, Mdm Markona is under the watchful eye of her Geriatric Medicine doctors, Senior Consultant A/Prof Terence Tang and Senior Staff Physician Dr Foong Yi-Lin, alongside care coordinators, nurses, pharmacists, and more. The Geriatric Medicine IMC — like its counterparts for renal disease, diabetes and heart conditions — is designed to ‘bundle’ care management for patients living with multiple chronic medical conditions and/ or frailty and declining function. In many cases, these patients tend
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Cover Story
to see multiple specialists and are often admitted to the A&E. The goal of the IMCs is to consolidate care as much as possible under a primary physician, while also ensuring patients get the support they need at home. These days, despite fewer medical appointments, Mdm Markona is doing well, reports Mr Bari. In the past year, she has been stable and has not needed a trip to the A&E — much less, getting hospitalised. Being able to determine what caused Mdm Markona’s chest pain has been a long process as the team worked slowly to monitor her condition, titrate her
“We suggested that she try eating earlier and tweaking her day’s prayer schedule. Looking back, we realised that while there were justified initial concerns, the final solution was not a medical one at all.” A/PROF TERENCE TANG SENIOR CONSULTANT GERIATRIC MEDICINE
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medications, and understand more about her daily habits and routines. A/Prof Tang shares with a wry smile that “it took a while to figure out”. It turned out that there was a pattern to Mdm Markona’s pain, which tended to happen in the evenings after her dinner and prayers. A/Prof Tang, who is also the Deputy Chairman, Medical Board (Clinical Informatics, Innovation and Patient Engagement), realised that something about the timing of her meal and the posture used during prayers would bring on discomfort. “We suggested that she try eating earlier and tweaking her day’s prayer schedule,” he explains.
A MODEL FOR UNIFIED CARE
PART 3 OF 3
“Looking back, we realised that while there were justified initial concerns, the final solution was not a medical one at all.” This was something that could not have come about without the relationship and conversations over time. And it is this relationship-based care that the IMCs strive to foster as part of their person-centred design. This approach is also underscored in the way the IMCs try to make sure that care is more convenient for patients. In the past, when she was with a different hospital for her heart issues, Mdm Markona had to attend many different
“Now, it is much better. We see the doctor about once every three months. They check the medications to see what is needed and what can be cut.” MR BARI SON AND CAREGIVER TO IMC PATIENT MDM MARKONA
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Cover Story
Yao Yan, a care coordinator at the Diabetes IMC, is just a quick phone call away should patients or caregivers need to ask about a medical issue
appointments at different hospitals at least once a month. “It was far and not very convenient because I needed to take leave each time,” Mr Bari says. “Now, it is much better. We see the doctor about once every three months.” Most of her conditions are managed in a more consolidated way by the IMC team, with only one or two specialist appointments. Mr Bari also highlights the care that the team takes to review his mother’s condition, her medications, and her overall well-being. “They check the medications to see what is needed and what can be cut,” he shares. This not only makes the regime easier to manage, but lowers the risk of side effects, and is cheaper, too. Having the expert backup of a care coordinator helps as
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well. “Sometimes, when there are problems, like if my mother’s blood sugar is a bit high, I will call to check,” Mr Bari explains. “Usually, the care coordinator will ask me to monitor it and see if it comes down the next day. Like this, we don’t feel so worried or want to call for an ambulance immediately.” Having someone to pre-empt and explain symptoms and warning signs to look out for is also reassuring — and helps Mdm Markona keep well at home. The team even works with her to ensure she can fast safely over the Ramadan period.
EMPOWERED TO SELF-CARE Mdm Markona is not the only patient who benefits from the empowering support of Yishun Health’s IMCs.
Mr Goh, 52, is another one of them. He has diabetes and mobility issues, which require him to use a mobility scooter. In the past, his HbA1c — a measure of blood sugar control over time — was not ideal. He would also frequent the A&E whenever he felt weak or ill, as he feared that he was having a stroke. These days, under the guidance of care coordinator Yao Yan at the Diabetes IMC, Mr Goh no longer panics when he feels unwell. He has a helpline to call — and someone to advise him on what to do and what to look out for. “With support, Mr Goh has been able to manage his HbA1C well, and it has come down from 12 to 8, which is an indicator of good control,” reports Yao Yan. Importantly, he has gone from multiple hospital admissions every year to none at all since enrolling in the IMC in 2019.
A MODEL FOR UNIFIED CARE
PART 3 OF 3
Mr Goh also used to have follow-ups at National University Hospital and other polyclinics for other conditions such as issues with his heart, but they have now been streamlined to a single location: Admiralty Medical Centre. At the same time, the IMC team makes sure he is scheduled for critical follow-ups, such as eye tests, foot screening, and flu shots. “He is more confident in taking care of himself,” Yao Yan points out. For example, over festive periods, he is more aware of his diet, and knows exactly what to change should his blood sugar levels rise. “As his results get better, he is also more motivated to continue with his good habits.” Dr Lim Eng Kuang, who leads the Renal IMC, tells a similar story about an end-stage kidney failure patient who would frequent the A&E for every problem because she was highly anxious about her condition. “With a little more support through the IMC’s care
“With a little more support through the IMC’s care coordinators, she began to tap on us for advice rather than go through the A&E.” DR LIM ENG KUANG HEAD RENAL IMC
“He is more confident in taking care of himself. As his results get better, he is also more motivated to continue with his good habits.” YAO YAN CARE COORDINATOR DIABETES IMC
coordinators, she began to tap on us for advice rather than go through the A&E,” Dr Lim recounts. “We managed to transition her safely onto dialysis and reduce her A&E visits.” Importantly, the IMC teams work not only to meet their patients’ medical needs, but also give them and their caregivers the skills to self-manage at home. Slowly, through engagement, education and empowerment, patients are encouraged to take greater ownership of their care and
become more active participants in their own chronic disease management. “We work with them to understand their conditions better, and to recognise and act on red flags,” Dr Foong says. A/Prof Tang emphasises that this is the crux of the IMC. “Usually, there are early symptoms in the days leading up to an A&E visit. If patients know what to do and who to call at certain warning signs, we have an opportunity to provide appropriate types of care and help, and avert an admission.”
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veryday Heroes
A MOTHER’S
SELFLESS LOVE
Mdm Neo Bee Then personifies the depths of parental love. For nearly 40 years, she has been caring for her daughter, who was diagnosed with focal seizures as a five-month-old. Even after her late husband developed cancer in 2017, Mdm Neo has remained cheerful in her resolve to be the best caregiver she can be.
A
s a new mother in her early 20s, Mdm Neo Bee Then was devastated when she learnt that her baby girl had focal seizures, a type of epileptic fit. She worried about how she would cope with looking after a child with this lifelong condition. “Of course, I did wonder why my child was different from others,” admits the now 63-yearold Mdm Neo. However, the plucky lady took the challenge in her stride. 16 |
“She needed me,” she says simply. “I just had to do what was necessary.” Today, that daughter, Ms Yeo, is 39 — and has led a comparatively normal life: going to school, joining the workforce after she finished her ‘O’ levels, and taking care of herself to a large extent. But, through the years, Mdm Neo has always been close at hand to support Ms Yeo. However, when Ms Yeo was diagnosed with Systemic Lupus
Erythematous (SLE) in 2014, her care needs increased as the auto-immune disease began to affect her health. She suffers from muscle pain and skin sensitivity, as well as weakness that affects her mobility, increasing her risk of falls. Her epilepsy also got worse, and she frequently experienced seizures, which were often triggered by stress, loud noises, and crowded places. This meant that she had to quit her job. Mdm Neo also had to take
“If you control your emotions and responses, then you can control everything else. My daughter relies on me and I have to be the strong person she needs.” Mdm Neo (left) strives to be the best caregiver she can be to her daughter through the highs and lows
more precautions to reduce the risk of fits while helping Ms Yeo manage her illness when it flared up.
A FULL-TIME COMMITMENT In 2017, things took a turn for the worse when Mdm Neo’s husband was diagnosed with bladder cancer. The devoted wife and mother thus not only became full-time caregiver to both her husband and daughter, but also ended up being the sole breadwinner of the family. Then, in May 2019, Ms Yeo fell during a seizure, which resulted in speech and movement impairment. This meant Mdm Neo had to keep an even closer eye on her daughter, including helping with activities of daily living, such as bathing and brushing her teeth. Mdm Neo’s life revolves around the heavy responsibilities of following care regimens for husband and daughter, accompanying them to medical appointments, all while juggling two part-time jobs as a school bus attendant from Mondays to Fridays. There have been many times when she struggled to cope, especially when both husband and daughter were hospitalised simultaneously, sometimes in separate institutions that were miles apart. Working three shifts (5am–9am, 12.30pm–2.30pm, and 3.30pm– 4.30pm), Mdm Neo diligently packs in caregiving duties in the pockets of time when she is not working.
The time after her first shift is dedicated to meal preparation, while the short afternoon break is for seeing to toileting needs. All her other chores are tackled after her work day ends. This includes accompanying her daughter for walks, preparing fresh juices, and doing housework. The last task, though tedious to undertake each day, is particularly important to Mdm Neo due to the weakened immunity of her family. Mdm Neo’s duties extend into the wee hours, as she regularly wakes up in the middle of the night to give her daughter massages to relieve her physical discomfort. Then, at 4am, Mdm Neo wakes up to start the cycle all over again.
OTHERS BEFORE SELF In October 2020, Mdm Neo’s husband passed away. However, her caregiving responsibilities still take up most of her time, as her daughter’s condition has not improved since her fall. In fact, she by now requires even more frequent hospital stays. “I had to give up the morning shift at work,” shares Mdm Neo, as her daughter’s needs have increased. Thankfully, Mdm Neo is able to get support from her siblings whenever her duties become too onerous. The gestures of thanks from Ms Yeo — asking her if she has eaten, buying her favourite snacks — bring a smile to Mdm Neo’s face and make her feel appreciated and loved, even if this is often not explicitly mentioned. The deep bond between mother and daughter is clear as they rely on each other for strength and assurance.
According to Jovina Cheng, Medical Social Worker, from the Medical Social Services with the Population Health and Community Transformation team, Mdm Neo’s perseverance has been nothing short of inspirational. All through her husband’s illness and her daughter’s relapses, the frequent disruptions to her work schedule and long hours of caregiving, she has always remained positive. In fact, when Ms Yeo acts out in frustration due to her ill health, Mdm Neo is always there to soothe things over and offer gentle words of encouragement. “She is a very competent caregiver who actively listens to advice from the doctor and medical teams,” observes Jovina. “Importantly, she knows where to seek help when it is needed.” Although Mdm Neo has had to give up pursuing her own interests and social activities, she has found other ways to decompress. “In between visits to the hospital, I take a walk and relax,” she shares. “Sometimes, I also take a nap.” These simple steps are enough for her to let go of the stress and pressure she is under. “I just tell myself not to think so much.” By not holding on to frustrations and other negative emotions, Mdm Neo moderates her own feelings and lightens her psychological weight. “If you control your emotions and responses, then you can control everything else,” she asserts. It is this attitude that helps her take each day at a time, and gives her the strength to continue to do her best. “My daughter relies on me and I have to be the strong person she needs.” | 17
&A
OBSERVE YOUR HEALTH Yishun Health experts answer your frequently asked questions about health, well-being and medical conditions. In this issue, the questions raised are related to asthma, smoking cessation, and cataract awareness. My eight-year old is asthmatic but has been stable for a while now. I am considering stopping his medications as I’ve read that long-term use of steroids is addictive and will impair his growth. Anyway, as a backup, I have the blue inhaler, which can be used in case of an attack. Asthma is a chronic inflammatory condition that requires good control of symptoms and long-term management to prevent suboptimal lung development and loss of lung function over time. Do not stop asthma medication without first talking it over with your doctor. Poorly controlled asthma can lead to fatal asthmatic attacks.
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It is only natural to be worried about the effects of steroids on young children. Inhaled corticosteroids that help to maintain good asthma control is safe for use in children — they have minimal effects on bone growth. In fact, inhaled corticosteroids prevent exacerbations, which require oral steroids — these can affect a
child’s physical growth when taken frequently. Children with poorly controlled asthma are shorter compared to those whose asthma is well controlled.
Dr Wu Qiumei Consultant, General Medicine, KTPH In conjunction with World Asthma Day: 4 May
I’ve been smoking for over 20 years. Since the damage is already done, there’s no point in quitting the habit, right? It is never too late to quit smoking. It is beneficial to stop smoking even after development of smokingrelated heart or lung disease. Smoking cessation slows the progress of smoking-related heart and lung disease. Smokers who stop smoking can be expected to live longer and are less likely to develop tobacco-related diseases. The risk of developing cancers due to smoking will also be reduced markedly. The first week is the hardest. But as nicotine is flushed out of your system, cravings become less intense and lung function starts to improve. Between the second and 15th week, cravings cease and that smoker’s cough should disappear. By now, your lung capacity would have increased by about 30%. Give quitting smoking a shot. You will definitely see an improvement in your overall health. There are also
medical therapies to help curb the craving for a smoke. Speak to your doctor if you need help. Remember, if you succumb to a smoke, it’s not ‘game over’ — just try again. TIMELINE After 1 day: Nicotine and carbon monoxide levels in the bloodstream drop significantly, while oxygen levels return to normal. Already, your risk of a heart attack begins to drop. After 2 days: Nerve endings in your tongue regrow, heightening your sense of taste and smell.
After 1 year: Risk of heart attack and stroke is cut by half. After 5 years: Risk of stroke is comparable to that of a non-smoker. After 10 years: Risk of smokingrelated cancers goes down by 50%. After 15 years: Risk of heart disease is comparable to that of a non-smoker.
Dr Wu Qiumei Consultant, General Medicine, KTPH In conjunction with World No Tobacco Day: 31 May
I think my elderly father needs cataract surgery, but he is convinced it is useless as they will “grow back”. Is this true? A cataract is said to occur when your eye’s natural lens becomes cloudy. This is a degenerative process when normal proteins in the lens start to break down. During a cataract surgery, the natural lens is removed and replaced with an artificial lens. Cataract surgery is a convenient day surgery that is simple and safe. People who have had cataract surgery may get hazy vision again months or years later. This is usually because the eye’s capsule that holds the artificial intraocular lens in place has become cloudy. This is known
as ‘posterior capsular opacification’, and is not the return of cataracts. This can be treated by a quick and simple laser procedure known as ‘laser capsulotomy’, which opens the cloudy capsule and restores clear vision for your father.
Dr Hah Yan Yee Associate Consultant, Ophthalmology & Visual Sciences, KTPH In conjunction with Cataract Awareness Month: June
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potlight
HEAR’S TO LISTENING, CONNECTING & LIVING
YOUR BEST LIFE
Meet our team of audiologists. They are (from left) Jenny Lau (Audiologist), Lim Sin Ern (Audiology Technician), Heng Yih Meei (Principal Audiologist), Aaron Tay (Audiologist) and Chew Zhiwei (Senior Audiologist)
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Hearing is not — as is commonly believed — just one of those inevitable ‘old age’ issues. In fact, it can and should be treated early to maintain independence, healthy interpersonal relationships, and even stave off dementia. Heng Yih Meei, Principal Audiologist, speaks up for the importance of addressing hearing loss early, and what to expect from treatment.
A
ctive ager Mr Arokiam Emmanuel Xavier is always busy with all manner of hobbies and activities: he reads, exercises, attends church, and meets up with friends at least twice a week. However, he began to notice that he had trouble following conversations when the environment was noisy or if people were speaking to him from a distance. He also needed to turn up the volume when watching television. Taking a proactive approach, he sought a referral to Yishun Health’s otolaryngology (ear, nose and throat, or ENT) specialist clinic in early January this year. After some assessments, he was fitted with two hearing aids in February 2021. Today, Mr Arokiam has adapted well and has no more trouble keeping up with chats, sermons, and his favourite TV programmes.
AN AID IN TIME IMPROVES LIVES According to Heng Yih Meei, Principal Audiologist, ENT, many seniors such as Mr Arokiam face similar initial symptoms of hearing loss; but, unlike him, they do not seek help early. In fact, she says hearing awareness in Singapore is very low. “By the time we see
patients at the ENT Clinic, many will have already had the issue for some time, and have significant hearing loss,” she shares. “A large number of them only come to the clinic after family members complain about the problem.” She notes that, even though hearing loss affects the quality of life, it is one of the senses taken for granted. But she emphasises that it is more than the ability to take in sound; instead, it is an essential component of how we process information, communicate, and interact with the world around us. Hearing loss is thus not just a matter of not being able to hear well. She adds that hearing loss is an impairment that affects
interpersonal relationships and psychological wellness. “It can cause a lot of frustration in the people affected and among their family members.” Untreated hearing loss can cause people to withdraw from or avoid social situations, and is associated with higher levels of depression, anxiety and low self-esteem. Most significantly, there is growing evidence that hearing loss and dementia are linked. A Johns Hopkins study indicates that mild hearing loss doubled the dementia risk, while those with moderate loss had three times the risk. In people with severe hearing impairment, the risk of developing dementia was five times more likely. One theory is that Alzheimer’s disease — which leads to dementia — narrows the blood vessels in the brain, speeding up cognitive decline; hearing loss could be an early symptom of this. Another theory is that, when hearing loss occurs, the brain diverts resources towards understanding what one is hearing, leaving less cognitive reserve for memory and other mental functions. A third theory is that hearing loss leads to social isolation, which is a risk factor for dementia.
“My role is to help people adapt to their hearing aids not only as a technology, but to re-educate patients on hearing and being able to listen well.” HENG YIH MEEI PRINCIPAL AUDIOLOGIST OTOLARYNGOLOGY (EAR, NOSE, THROAT)
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potlight MORE THAN A SOUND ISSUE As an audiologist, Yih Meei works with ENT specialists to diagnose, treat and manage hearing impairment. The clinicians assess for other conditions that impact hearing, such as an infection or surgical issues. If patients are deemed suitable for a hearing aid, she steps in to help. Hearing aids are electronic devices that amplify sounds, including speech, to help improve the reception of sound. But there is more to her job than simply deploying technology. “Audiology is a combination of using technology to improve lives as well as patient engagement and education,” Yih Meei points out. Selecting the right hearing aids is
Principal Audiologist Heng Yih Meei getting ready for a hearing test in the audio booth
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only the first step. Typically, it takes anywhere between three to six months of follow-up consultations as the hearing aids are adjusted and calibrated to suit each patient’s needs. “We need to help patients use it well in tandem with other skill sets.” This includes educating patients and even caregivers and family members on taking care of the device and its batteries. At the same time, other skills such as the subtleties of body language, active listening, and clear speech are also important. One key lesson is to manage expectations. “Often, patients think that simply wearing a hearing aid is sufficient to ‘cure’ them immediately. However, the brain needs to learn how to adapt to the hearing aids,” Yih Meei explains.
Because hearing aids amplify sounds in general, it can seem very ‘noisy’ in the initial period. Many patients have spent years with hearing loss, so their brains are no longer able to distinguish background noise from speech. In fact, what most people hear in the initial stages is simply ambient noise that the brain has not learnt to filter out appropriately, making everything seem very loud and overwhelming all at once. “We have to help manage patient’s expectations about the process of adapting to a hearing aid and complying with the regime of wearing them sufficiently so the brain can adapt.” Another important part of adaptation is to remind patients and their families that communication
ALL SHAPES AND SIZES Hearing aids typically consist of three parts: the microphone, amplifier and speaker
Microphone
Sounds are picked up by the microphone and converted into electrical signals.
PLAY YOUR PART! Communicating with someone who wears a hearing aid requires more consideration on our part. Effective communication is, after all, a two-way process!
Speak where there is
Amplifier
good lighting, move closer to one another, and face each other so that visual cues can be conveyed.
These signals are sent to the amplifier, which increases their loudness.
Try using physical cues
Speaker
The speaker sends the signals to the ear, which processes them via the brain.
Hearing aids come in a variety of models, and can be worn inside or behind the ear.
to get the hearing aid user’s attention; for example, tap their shoulder or nod to them before speaking.
When chatting in crowds or social gatherings, move away from noisy areas; similarly, reduce background noise, such as that from the television or radio, when having a conversation.
Use hand gestures or is not just about sound. Body language and other visual cues are just as important. “When we listen, it is an active process that requires not just hearing, but also all our other senses.” This is especially obvious now that we all wear masks, highlights Yih Meei. “We can no longer read lips and expressions well, so we need to be more observant and patient,” she says. “My role is to help people adapt to their hearing aids not only as a technology, but to re-educate patients on hearing and
being able to listen well; these are two different things!” Yih Meei practises her own advice for each and every patient she sees. Audiology is more than about the science of hearing technology to her. “Every patient I see is someone I have to truly listen to — and understand their needs and concerns, their challenges and their goals. It’s satisfying to know that, through listening and helping them hear better, I can make an impact.”
facial expressions to improve understanding.
You don’t need to speak louder — only a little more slowly, clearly, and naturally without shouting or exaggerated mouth movement.
Use short and simple sentences.
If you need to repeat yourself, rephrase or use different words instead of repeating the original statement.
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aily Dose
SLEEP, ELUSIVE SLEEP Polls have long shown Singapore to be one of the most sleep-deprived nations globally. Blame it on long working hours, demands of school, and the allure of the digital world. The pandemic has not helped, disrupting work and home life, thus affecting both quantity and quality of sleep. In consultation with Dr Surej John, Senior Consultant, Psychological Medicine, KTPH
G
etting good-quality sleep is one of the best things we can do for ourselves to keep healthy — physically and mentally. Unfortunately, insomnia is all too common, and is often attributed to both external factors (long working hours) and internal ones (poor sleep hygiene). The COVID-19 pandemic has created new challenges to our peace of mind and sleeping patterns. Feeling frustrated by insomnia? Here are some good sleep hygiene practices.
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BUILD A SLEEP SCHEDULE AND STICK TO IT A routine offers a sense of normalcy even in abnormal times, and makes it easier for your body and mind to acclimatise to a sleep schedule. This is also why experts recommend consistency in daily sleep times. • Set a fixed time to wake up and kick the ‘snooze’ habit • Set a fixed wind-down window when you get ready for bed • Pick a consistent time to turn out the lights and try to fall asleep
JAZZED UP ON CAFFEINE? Caffeine (found in tea, coffee, and some soft and energy drinks) lingers in the body longer than you realise. If you have trouble sleeping, avoid caffeine within six hours of bed.
DEVELOP YOUR OWN RELAXING ROUTINE AND GOOD SLEEP HABITS • Plan a routine that helps you relax before sleep: clean up, stretch, meditate, or do some quiet (non-screen) reading • A warm shower an hour before going to bed can help
MAKE YOUR BEDROOM A SLEEP-FRIENDLY ZONE
DON’T TOSS AND TURN FOR TOO LONG
• Turn down the lights and digital devices as you prepare to sleep; this helps the body’s circadian rhythm to adjust to ‘night mode’ • Create an association between your bed and sleep; avoid working in bed or binging on that popular new drama in bed; use your bed only for sleep, sex and convalescence • Avoid using screens close to bedtime; the blue light produced by electronic devices interferes with the body’s natural sleep-promoting processes. Otherwise, turn on the blue light filter for your devices
Still can’t sleep after 20 minutes? Get out of bed, do something relaxing in low light, then head back to bed. You could try: • meditating • listening to relaxing music • gentle stretching Sleep is an essential part of health. If you find yourself still unable to sleep, or if you snore, wake up feeling tired, and fall asleep easily during the day, consider getting checked for sleep apnoea, which is a significant sleep problem.
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5
Things About...
Mask Hygiene
Things About...
Mask wearing is likely to continue to be an important part of keeping ourselves, loved ones, and the community safe. But are our bad habits defeating the purpose of keeping germs and viruses at bay? In consultation with Benjamin Tan, Nurse Clinician, Infection Control, Yishun Community Hospital 26 |
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BE MINDFUL WHEN WEARING AND TAKING OFF MASKS
Masks are only effective if we use them correctly and dispose of them properly. Wash or sanitise your hands before putting one on. Ensure the mask covers your mouth and nose, and that there are no gaps between your face and mask. When wearing your mask, avoid touching the surface. If you use a disposable mask, replace it when it becomes damp and do not reuse it. Do not touch the front of the mask when you remove it, and wash your hands afterwards. The same guidelines apply if you’re using a reusable mask.
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MASKS PROTECT US, BUT WE HAVE TO KEEP IN MIND THAT THEY ALSO HARBOUR GERMS
Masks form a barrier between us and respiratory droplets, but this very function also means that microbes collect on the protective outside and inner surfaces. Used masks that become moist with respiratory and saliva droplets are an especially conducive environment compared to a drier surface. This is important to bear in mind — and is why we should be careful about how we handle them, as viral and bacterial particles can accumulate on these surfaces.
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WEAR YOUR MASK ONLY ON YOUR FACE — NOT YOUR CHIN OR ARM
Pulling your mask down under the chin or temporarily transferring it to your arm are bad habits that defeat the purpose of wearing a mask. The surfaces of masks collect bacteria, viruses and dirt from the external environment. Pulling the mask over your mouth onto the chin may transfer these onto the face and lower lip, spreading pathogens directly to the mouth and face. Wearing it on the arm is no better as it spreads microbes from the arms (which have a high chance of touching a lot of surfaces) back into the nose and mouth.
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STORE YOUR MASK IN A CLEAN AND DRY PLACE, AWAY FROM EXTERNAL CONTAMINATION
The best way to store a mask temporarily is to place it in a clean carrier that can protect it from the external environment. A clean plastic bag or case that can be sanitised with soap and water or alcohol wipes is the best option, as it protects the mask from exposure to external surfaces, dirt and pathogens. It is not a good idea to place masks on top of table surfaces, your mobile phone, or in your pocket, wallet or bag. Wallets and phones are some of the dirtiest objects as they are handled frequently, and their surfaces are often riddled with germs.
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A CLEAN MASK IS A SAFE MASK
It is only natural that particles, germs and other microbial life find their way onto masks. Microbes are part of the environment and are present even on our skin and in our gut. Furthermore, not all microbes are necessarily harmful. However, we should do our part to keep the more dangerous ones at bay. Whether you opt for single-use or reusable masks, it is important to keep them clean. This means changing disposable masks regularly, washing reusable ones daily, and avoid touching your masks with your hands, which are the biggest transmitters of disease. It is helpful to carry spare masks and hand sanitisers with you at all times — these could come in handy to protect yourself and others, too!
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akan Time
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cut & keep
CHICKEN RENDANG Aromatic and rich, this dry curry made with chicken and spices is sure to be a family favourite. Recipe provided by Sous Chef Muazzin Shah Bin Mohd Shah, Food Services, KTPH, in consultation with Nutrition & Dietetics, KTPH
INGREDIENTS SERVES 4
• 450g skinless, boneless chicken thigh, cubed into chunks • 1½ tbsp canola oil • 2 kaffir lime leaves • 100ml reduced-fat coconut milk • 1 tbsp sugar • 1½ tsp low-sodium salt • 1 medium eggplant, cut into 1-inch thick semi-circles
Rempah paste (125g) • • • • • • • • • • •
10 shallots 2 garlic cloves 1-inch fresh turmeric 1-inch ginger 1-inch galangal 1 stalk lemongrass 10 dried chilli, soaked ½ tsp fennel powder ½ tsp coriander powder ½ tsp peppercorns ½ tsp cumin seeds
METHOD 1. Prepare rempah by blending all ingredients together, adding water if needed. 2. Heat canola oil in a non-stick pan. 3. Add rempah and kaffir lime leaves, then stir-fry until fragrant. 4. Add cubed chicken thigh and stir-fry for 5 minutes, mixing chicken and paste thoroughly. 5. Add coconut milk with ¾ cup water and simmer for 10 minutes. 6. Add sugar, salt and eggplant. 7. Simmer, stirring frequently, for another 20 minutes or until the chicken is tender and gravy thickens and dries. 8. Serve hot with mixed brown rice and vegetables to complete the meal.
NUTRITIONAL INFORMATION (PER SERVING) Energy
295kcal
Carbohydrates
10g
Protein
23g
Fat
17g
• Saturated
5.5g
• Polyunsaturated
3.0g
• Monounsaturated
7.1g
Cholesterol
89mg
Dietary Fibre
5.1g
Sodium
451mg
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it & Fab
I have a hunch…
that you have shoulder pain Pain in the shoulder or neck is the bane of many office workers — and experts are seeing an increase in cases as more of us continue to work from home. In consultation with Dr Benjamin Soh, Registrar, Sports and Exercise Medicine Centre
A
s you read this, take a moment to check in with yourself. Are you hunched over? Do you feel your shoulders creeping up towards your ears? Is your neck straining forward? Many of us spend most of the day hovering over keyboards, peering into computer monitors, or looking down at our smartphones. All these make us prone to poor posture, especially around the neck and
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shoulders. It is no wonder that, anecdotally, more and more people are seeking help for such aches and pains. It is important to take a break every hour or so to adjust your posture, stretch and move. Beyond stretching, it is also helpful to address overall wellness holistically, as long-term tension and stress can contribute to bodily aches and pains.
SOME HELPFUL STRETCHES INCLUDE: NECK MOVEMENTS: Look up/down/left/right as far as possible, hold for one to two seconds. Repeat 10 times.
GET A GOOD NIGHT’S SLEEP
Everyone requires somewhere from seven to nine hours of sleep a day. The lack of sleep can increase the chance of feeling pain, and increase the intensity and duration of existing pain. Learn how to tackle insomnia on page 24.
MANAGE YOUR STRESS LEVELS Chronic stress can cause real physical damage, and is associated with increased aches and pains. It is also linked to conditions such as high blood pressure.
GET REGULAR EXERCISE
A little activity a day improves mood, reduces stress, improves sleep quality, and can even reduce the chance of developing chronic pain. Try to get 150 minutes of moderately intense, heart-pounding aerobic activity a week. On top of that, include some resistance training about twice a week. If you are just starting out, work up to this slowly over several weeks.
Y RAISES: Stand against a wall or lie down in a Y position as shown. Raise hands off the wall or floor as far as possible, hold for one to two seconds. Repeat 10 times.
MIND YOUR WORKPLACE ERGONOMICS
Keep your arms, legs and line of vision in as neutral a position as possible — such that there is no strain on the joints. Your monitor should be at eye level, and your elbows and knees at a 90-degree angle. Support your wrists, if needed, to keep them straight while you use the keyboard and mouse.
UNUSUAL PAIN IN THE NECK? SHOULDER BLADE RETRACTIONS: Hands behind head as shown, pull shoulder blades backward. Hold position for one to two seconds. Repeat 10 times.
Neck and shoulder discomfort is commonly due to prolonged strain and poor ergonomics. However, you should see a doctor if the pain is accompanied by: • Loss of strength or feeling in the arms or legs • Difficulty balancing • Loss of toileting control • Loss of appetite/weight • Severe pain radiating down the arms or legs
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urses’ Day 2021
SPECIAL
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Why ‘Courage to Care’? W
e have been embattled by COVID-19 in the past year. As frontline workers, nurses have had to deal with fear, uncertainty and fatigue on multiple fronts. Fear of contracting the virus, and possibly bringing it back to the family. Uncertainty of the evolving situation, changing instructions and re-deployments. Fatigue from prolonged use of personal protective equipment (PPE). Anguish and frustration over pandemic restrictions, in particular the protracted separation from loved ones beyond our borders. Yet, despite the ravages of COVID-19, our nurses have shown the courage and tenacity to face these challenges head-on, and continue to deliver unwavering care and compassion to our patients. Hence, ‘Courage to Care’ was chosen to specifically highlight our nurses’ fortitude. The resilience they have shown is amazing, and is testament to the solid foundation upon which Nursing has been making big strides forward as leaders in healthcare. This theme underscores the pride we have for them. So, to all our nurses — wear this badge of courage, DR BIN WERN HSIEN stand tall, and feel proud to be a nurse of Yishun Health! CHAIRMAN, NURSES’ DAY COMMITTEE Happy Nurses’ Day!
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urses’ Day 2021
THE COURAGE TO CARE
I
f there ever was a time for all of us in the nursing profession to dig deep into ourselves and ignite our purpose, it has been the past year. The COVID-19 pandemic has truly been one of the more impactful global challenges in recent memory. For healthcare workers, it has been a particularly hard journey — and one that is not yet over. The road ahead of us will continue to be difficult as we keep pace with the evolving nature of the pandemic while juggling day-to-day responsibilities. I know that this ongoing battle often leaves many of us tired and disheartened. But take heart — I believe we have what it takes to overcome this crisis together. While the pandemic has made an impact on almost every aspect of our lives and changed the way we live, work, learn and play, one thing will stay the same: our commitment to our patients. This is why, this Nurses’ Day, I wish to emphasise the strength that is within all of us. For all of us who have followed the calling to be a nurse, we can draw on our innate fortitude to have the Courage to Care. This bravery has been carried out in many ways, even in the actions, thoughts and feelings that we do not realise. Courage is: 1. In the simple act of turning up at work each day, despite our own doubts and exhaustion. In times of crisis, it is natural to question why we
MS SHIRLEY HENG CHIEF NURSE, YISHUN HEALTH
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continue to do what we do. Certainly, we have many other priorities — our family responsibilities, their safety, and our own sense of preservation. Suffering this dilemma does not detract from our dedication to nursing; it underscores it. The sense of feeling torn between obligations shows that we care for our chosen profession just as much as we do for our other roles. Every time we show up to care for our patients, we become the closest thing to family that patients have. Diverting our energies from our fears towards understanding the needs of others strengthens our commitment to patient safety and care outcomes. 2. Stepping away from victimhood to take ownership of problems. It is easy to feel downtrodden by circumstances. Instead of saying events “happen to us”, we should instead look to the actionable things we can do to overcome them. By holding positive views and coming up with solutions together, we can reframe our views about our struggles. 3. The acknowledgement — not absence — of negative emotions. By allowing ourselves to be open and honest about our struggles, we can process our feelings, set boundaries for our own mental health, seek help, and take breaks when we need to. We cannot pour from an empty cup. Accepting our own moments of need allows us to take the time and space to regroup and reflect — and come back re-energised. 4. Stepping up to defend ourselves and our profession with grace and dignity when the need arises. In times of crisis, emotions are heightened and unpleasant behaviour can, unfortunately, surface. However, just as we stand up as advocates for our patients, so we must stand up to defend our peers and colleagues, and speak up against discrimination. 5. The ability to communicate with honesty and respect — even when our views differ from others. Sharing our misgivings, alternative ideas, and varying perspectives, including with our seniors, is useful to prevent groupthink. Respectful and open discussions are a healthy part of growing our profession to make space for a multiplicity of views. 6. Sharing our stories, hopes and dreams. We may
not see our experiences or interactions as inspirational, but they may be to others. All stories come from a rich tapestry of nursing experiences. What we may see as an insignificant act may mean the world to another. Be brave in sharing your stories with others — they are an encouragement. 7. Embracing change. The future is even more uncertain than ever as we redesign our lives around the pandemic. It is unlikely that we can ever go back to pre-pandemic times, so we will need to continue adapting, making adjustments, and planning for an
upcoming generation of future-ready nurses who are trained for unpredictable times. We have already showcased our ability to be courageous in many of these ways, especially in taking on a variety of roles in the past year as part of our crisis response. And we will continue to transform and grow, expanding our professional learning and developing our digital skills. The Courage to Care in all these areas will enable and embolden us in time to come as we evolve and shape a bright and promising future for all of us in the nursing profession.
EMBRACING THE NEW NORMAL WITH FORTITUDE & L.O.V.E. MDM CHUA GEK CHOO
DIRECTOR, NURSING, YISHUN COMMUNITY HOSPITAL
N
MS LOW BENG HOI
DIRECTOR, NURSING, POPULATION HEALTH & COMMUNITY TRANSFORMATION
o one knows what will come next as we navigate the new normal ahead of us. What we do know is that the COVID-19 pandemic has disrupted life for many. For nurses across the care spectrum, it has been a challenging experience both in terms of their work life and personal life. Everyone has had to cope with anxiety over the safety of their own families and, for many others, a painful separation from their loved ones. Despite all this, our nurses have continued to serve with dedication, compassion, adaptability and collaboration. Take the hard work done last year at YCH to convert the subacute and rehabilitative wards to acute COVID-19 wards
— an effort that has meant developing and learning new work processes and safety protocols. Many have had to toil in non-airconditioned environments wearing PPE. Within community nursing, it has meant moving swiftly to develop ways to connect digitally with residents, especially the vulnerable and at-risk, so that care is not disrupted and they do not fall through the cracks. We have done well to keep up with the evolving landscape, and there will be many more ways we must adapt in the days ahead. This will mean building our fortitude — a strength of mindset that we forge through professional mastery and personal faith. It is something we can build through mutual trust and support, as well as interpersonal connections. At the same time, we should continue to L.O.V.E.: Listen, Offer help, give Value, and Engage. By seeing the best in ourselves and each other, practising patience, learning and teaching with open minds, and sharing responsibility, we can develop a growth mindset that is nimble and resilient. In the days and months to come, we urge all nurses to continue to find strength and courage in yourself and one other. Together, we can overcome whatever comes our way. As it stands, change and transformation have always been integral aspects of nursing and healthcare. The pandemic has accelerated the pace but, together, with fortitude and L.O.V.E., we can embrace and triumph over what lies ahead. Please take care, stay safe, and Happy Nurses’ Day! | 35
urses’ Day 2021
Nurses’ Merit award 2021 The MOH Nurses’ Merit Award recognises nurses who have made noteworthy contributions to the nursing profession and have performed exceptionally in their duties. This year, we are proud to congratulate seven winners from Yishun Health for their outstanding care and dedication. Here, they share what drives them to constantly heed the call of nursing.
LU QIAOXIAN
NURSE CLINICIAN, PERI-OPS, KTPH
As a perioperative nurse, my journey has been challenging, yet rewarding. Beyond skill, nurses have a keen awareness that every patient is different and going through different challenges. Together with empathy, we are equipped to support our patients and their families through the recovery process.
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ZHENG DEXIN
NURSE CLINICIAN, WARD B66, KTPH
The defining moment for me was when I donned my nursing uniform and put myself on the frontlines of patient care. I constantly remind myself to always stay vigilant as I have been entrusted to ensure the safety and comfort of each of my patients, serving with passion and purpose.
RAMANATHAN S/O PERUMAL
SENIOR STAFF NURSE, WARD B65, KTPH
I enjoy my work as a nurse because of my passion for it and the fulfilment from caring for my patients. Getting a ‘goodbye and thank you’ from my patients when they get discharged, and seeing my junior nurses become well-trained, compassionate professionals make it all worthwhile!
urses’ Day 2021 NURAINI BINTE MAMON NURSE MANAGER, WARD B66, KTPH
In our role, we learn to see the person beyond the condition. While we have the clinical knowledge to offer the best treatment possible, we are also mindful that every patient’s background, culture, needs, values and beliefs are different — and respecting this diversity is crucial in providing care.
TAN SI HUI
NURSE CLINICIAN, RENAL CENTRE, KTPH
At the start of my nursing career, I had difficulty coping as I was soft-spoken in nature. However, I am thankful for the many excellent mentors and nursing leaders who guided and inspired me to become the confident nurse that I am today.
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ERNIE YANTY BINTE BORHANUDIN ASSISTANT NURSE CLINICIAN, POPULATION HEALTH & COMMUNITY TRANSFORMATION
For the past 12 years, being able to be part of my patients’ health journeys motivates me to do my best. One of my most memorable experiences was when I was able to grant a patient’s final wish before he passed away. I am blessed to be in a career where I am able to help people and their families.
TAN YI XUE
SENIOR STAFF NURSE, WARD D48, YCH
My journey as a nurse has been nothing but extraordinary. Even simple acts like helping to wash my patient’s hair can make a difference in their recovery journey. In this job, we have the ability to make our patients smile and feel better even during the darkest periods in their lives.
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urses’ Day 2021
Caring in
extraordinary ways Through acts big and small, these nurses bring joy and comfort to others. By giving of themselves, they make a meaningful impact on the lives of patients and more through compassion and dedicated service.
When COVID-19 hit, Yoke Kee (front row, second from left) was deployed to help in the ICU — a job very different from her day-to-day role with her team (pictured) as a Senior Nurse Educator
Lessons from a pandemic LEE YOKE KEE SENIOR NURSE EDUCATOR, NURSING ADMIN, KTPH I was concerned about my family in Kuala Lumpur, especially my eldest sister, who was in cancer remission. Thankfully my family supported each other well during the entire time, allowing me to channel my energy and focus on my work. I volunteered to support the Intensive Care Unit (ICU), reprising a role I once held during SARS. Going from my classroom role as a nurse educator to a critical-care setting felt like a homecoming. I worked as a Registered Nurse at the ICU Ward B26 for about four weeks before the skin on my hands became cracked and itchy. In my haste to contribute, I had forgotten about my existing lower-back condition and sensitivity to topical alcohol! This meant returning to the nursing education 40 |
department and taking up other duties, such as developing the draft for various kinds of pandemic response. My time in the ICU was meaningful. Besides doing shift work after 10 years of office hours, I had the privilege of becoming a ‘student’ again. This humbling experience gave me perspective and empathy on what it was like to learn new skills and competencies in a short period of time. I was so grateful for the guidance of the Ward B26 ICU team and leaders who took care to balance my workload, patiently and willingly teaching me despite their busy schedules. I also learnt the meaning of dedication. I saw doctors and allied health professionals — especially the respiratory therapists, patient service associates, environmental service associates, and nurses — working hand-in-hand despite fears and uncertainties. From their unseen heroism of everyday actions to the pressure marks on their faces from prolonged PPE-wearing, I came to understand and value their quiet courage. This pandemic has taught me that being a nurse is a lifelong journey of learning.
Keeping the faith SUJA RAMAN PILLAI
SENIOR STAFF NURSE, NURSING ADMIN, KTPH I had never worked in a pandemic before, so naturally the initial days were filled with uncertainty and anxiety. I was most worried about the safety of my family and children. Would my job put them at risk? I became hyper-vigilant about infection control. My concerns were shared by my parents, who urged me to resign when they learnt that I would be deployed to the ICU. However, I had faith that my training, my colleagues, and my organisation would see us through safely. My husband was a pillar of support during this time, stepping up to cover our shared childcare roles as I took on shifts in the ICU.
The work in this new environment was challenging — new workflows, equipment, procedures and teams meant I had to quickly adapt and learn on the go. I also gained lot of confidence from the insights and experiences shared by my seniors who encountered SARS in 2003. I first took care of patients together with an assigned preceptor and gradually nursed patients independently with minimal supervision. The work in the ICU is very challenging as it’s where patients are at their most ill. There were many moments when we had to handle bad news in a compassionate and respectful way. Once, I had to translate for a patient’s wife in India, explaining that we had to take him off life support. It was a heartbreaking experience. Although there were these tough moments, there was also joy. We celebrated every victory, however small, from negative COVID-19 tests to seeing patients recover sufficiently to be transferred out to a general ward. Through these many highs and lows while ‘in the trenches’, I have had amazing support from our nursing leadership and my ICU teammates. They have taught me so much about what it means to be a nurse. I especially learnt from one nursing colleague, one of the most empathetic communicators I have ever met. We cared for a patient who spent 10 days in the ICU after a major brain surgery. When we visited her in the general ward as part of our outreach, my colleague noticed how depressed she was. At that time, due to the COVID-19 restrictions, no visitors were allowed. My colleague took the initiative to use her personal mobile phone to make a 45-minute video call so that the patient could see her family members. It was a small but meaningful gesture that brought so much joy to them. These examples of humanity amid crisis make me very proud and thankful to be a nurse. I am grateful to use this experience for learning and growth. I realise that I’m more adaptable than before, and have been able to discover my strength and courage to continue in my chosen career as a nurse. | 41
urses’ Day 2021
Jason (second from right) and his PHCT colleagues from Regional Team 6
Building lasting connections in the community JASON TAN
SENIOR STAFF NURSE, PHCT The initial period of the pandemic was a worrying time. Like so many people, I had concerns about the severity and infectiousness of the disease. As the days went by, and more and more people were infected, it was only natural to feel anxious about what it would mean for my work, family, and the larger community. But it was also my concern for the residents in the community that gave me the motivation to be strong and continue my duties as a community nurse. My work is all about empowering, educating and enabling residents to take care of themselves. Amid the pandemic, the work has been very similar — I just had to adapt my interactions to also include infection control, and emphasise the importance of safe distancing and hand hygiene. In addition to my community-based work with residents, I was also part of KTPH’s Standby Medical Response Team (SMRT). When needed, SMRT is activated to conduct swabbing for large clusters, such as at nursing homes or hospitals. This not only meant refreshing my skills in nasopharyngeal swabbing, but also in donning and doffing PPE, which is an uncomfortable but important procedure. The work with SMRT was quite different from my 42 |
usual role, but the human touch remained. In the same way I build rapport with residents and make them feel at ease and cared for, I also made every interaction with patients, however brief, warm and compassionate. It is this personal touch that keeps me passionate about nursing. In my day-to-day communication with residents, I always keep in mind their needs not just as patients, but as people, too. It really motivates me when residents and their family are receptive and appreciate the care I give. Some days are not so good; some people are resistant to advice and care plans, or are rude and ungrateful. But these rare moments do not deter me from my main mission of care. In fact, the good days far outweigh the bad. I love learning about residents and hearing their life stories, dreams and hopes. The bonds we build over time make every meeting so meaningful. I enjoy being part of their journey when they are able to self-manage their health and chronic conditions. It always touches me when residents take the time to call or message me just to say ‘hello’ and find out how I am doing. If there’s a lesson I think we have learnt from this pandemic, it’s that every job and person matters and makes a difference. From cleaners and delivery drivers and more, we all contribute in some way. The pandemic has also highlighted the important role of nurses — which, sadly, some people still see as a ‘dirty’ job. But seeing my nursing colleagues rise up and receive recognition as heroes has helped to raise the profile of the nursing profession in the eyes of many. However, for me, it has never been about being a hero; it’s simply about helping people live their best lives.
Stepping up with resilience STELLA LAU
SENIOR STAFF NURSE, ENT CLINIC, KTPH Wearing many ‘hats’ and playing multiple roles have always been part of being a nurse, and I knew I’d have to step up to the plate during the pandemic. As a wife, mother and daughter, there were many concerns about what it would mean for the safety of my family. I remember having to get used to many new parenting routines because my son’s childcare centre — originally based in YCH — had to relocate twice due to COVID-19 safety restrictions. And as Singapore moved through its pandemic phases, I was crossing off my own milestones as my second pregnancy advanced, making sure to take extra precautions to protect myself and my family. Things were changing so fast in the pandemic — we had to be on our toes at all times, both at home and at work. As a nurse, I had many worries about how my work at the ENT Clinic would be affected. We had to make many adaptations to our normal workflows, accommodating manpower movements to other areas of the hospital. When two members of our specialist outpatient clinic were re-deployed, it meant taking on their duties to ensure that patient care was not disrupted. At the same time, I also helped out in our clinic’s flu vaccination exercise to ensure that all our patients were safely immunised from seasonal influenza. It was not just about taking over duties and tasks, but a matter of learning new and different systems, protocols and workflows quickly, as the organisation continually improved processes and aligned ourselves to national mandates. Added to all this, we had to work in full PPE and N95 masks, which are uncomfortable and really no joke during pregnancy! I got a very different experience of working in a hectic environment when I volunteered to help at the A&E department after they
expanded to occupy Clinic C31. It was quite eyeopening, and I learnt a lot from the new environment and scope of work. It was especially interesting to work with colleagues from many different departments. I was so inspired by their dedication and each of their specialties. Take Senior Staff Nurse Ho Yiow Beng, from the orthopaedic specialist outpatient clinic. A nursing veteran in his 60s, he was very kind to share his knowledge on different kinds of bandages for different kind of fractures. And while it was not easy for him to tackle the A&E system, I was motivated by his willingness to learn and ask questions. Seeing everyone pitch in to work together, share knowledge, and support each other was truly memorable. It taught me that it’s in the hard times that we find our inner strength and untapped abilities. I have learnt how to be more resilient in difficult situations, and the experience has made me more determined to do better in my profession so that I can give back to my country.
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urses’ Day 2021
Joanna (centre) and her colleagues continue to go out of their way to care for patients in their ward
Healing, hope and the human connection JOSON JOANNA GRACIA VINA SENIOR STAFF NURSE, WARD B66, KTPH When the pandemic happened, my first concern was my family back home in the Philippines. My worst fears were realised in April 2021, when 11 members of my family — six siblings, two nieces, two nephews, and my 90-year-old father — all fell ill with COVID-19 at the same time. Not being able to go home and care for them broke my heart. At the same time, I knew I needed to fulfil my oath and duty as a nurse here in Singapore. It was not easy being caught in-between these obligations. By realising that I needed to be strong and focused in my work, I managed to overcome this difficult time, together with the support and understanding of my family, who all thankfully recovered well from their illness. This time has been a roller coaster ride not just personally, but professionally as well. While we have 44 |
had a lot of support from the community, it’s still hurtful when a small number people ostracise us and engage in discriminatory behaviour. But despite these occurrences, I know we have to remain professional and uphold the highest standards of nursing. I am proud of how my all colleagues, especially my wonderful team in Ward B66, have worked together to achieve our mission of care, not just in delivering treatment, but in caring for our patients as people — people such as a Bangladeshi patient who suffered a heart attack and could no longer continue working in Singapore. This happened in May 2020. I saw how sad and worried he was to go home and feeling that he had nothing to bring back to his family. Being a foreigner myself, I empathised with his plight. It spurred me to ask some of my friends and colleagues to donate funds or gifts. Their generosity was so inspiring and we managed to collect some cash and items that he could take home with him. The joy of seeing him smile was priceless. This is just one small way that I can contribute through my work. Being a nurse gives me the opportunity to help others in my own little way, and allows me to enjoy the reward of serving people while growing both professionally and personally.
Bringing home closer through virtual reunions LOW SING EE NURSE MANAGER, PHCT The pandemic has challenged the staff of Ward D78 — a ward I was previously in charge of — in many aspects. As the crisis unfolded, we had no idea what each day would bring. However, we strived to keep up with the fast-changing infection control recommendations and visitation policies. It was especially hard when patients were seriously ill and facing their last moments, but had to be isolated from their family. It was then that we stepped in to offer care, comfort and companionship. Every day continued to brim with tasks as we all pulled together to attend to the many demands of our work amid manpower changes and limitations. So many of my nurses sacrificed their rest time to keep day-today operations running smoothly. The pandemic was additionally challenging for my colleagues who were away from home and did not know when they could next meet their spouses, children,
parents and siblings in person. Though we were occasionally buoyed with support from the public, as the pandemic dragged on, I could tell that my nurses cannot help but miss home. Many have not been there for their children’s milestones or key celebrations with their loved ones due to the travel ban. This gave me the idea of surprising them by bringing their loved ones to them via a special video presentation. Because I do not use any form of social media, I roped in my colleagues, Noraryati Binte Rosali and Koh Xin Ye, to help me contact the family members of our nurses via private message. We requested for videos and messages to cheer on our fellow nurses. At first, we did not receive any videos, and wondered whether our requests had been mistaken for scams! After some time, we saw the contributions come in. We found ourselves struggling to hold back tears as we edited them and stitched them together — we also struggled to keep the project under wraps for so long! Everyone enjoyed the edited clip, which turned out to be light-hearted yet sincere. I was very moved by my nurses’ response to what their family members had to say. I hope that this small gesture showed my nurses how much I appreciate and care for them during their time away from home.
(inset) A screenshot from the video compiled by Sing Ee and her colleagues (left) A group shot of Ward D78 | 45
urses’ Day 2021
Away from Family Putting duty first
The upheaval of the COVID-19 pandemic has seen many nurses sacrificing precious time with their respective families for the last few years. Despite this, their inner strength and commitment to duty have buoyed them through the heartache and homesickness.
MARSHAL LIM SENIOR STAFF NURSE, A&E CARE CENTRE, KTPH There were so many concerns flooding my mind when news of the pandemic started. I knew that there was a chance that it would affect us because Singapore is a global travel hub. If travel restrictions began, it would mean that my wife — who was also a nurse in Singapore — and I wouldn’t be able to continue our weekly trips home to Kuala Lumpur to see our two-year-old son. I was also worried about what it would mean for the vulnerable, especially the seniors. As a nurse who takes care of the elderly at A&E, I knew the virus would likely affect
them badly as they are more prone to infections. There was also a high risk of spread in settings such as nursing homes. Should a pandemic force us to limit or cease community services for the elderly, where would they go? I knew the A&E was going to become the frontline of care and, as it turned out, many of my fears came true. As a family, my wife and I made a tough decision: she took unpaid leave to return to Malaysia in May 2020 to be with our toddler and family. I would stay on in Singapore to work and support them financially. This way, I could do my duty to provide for the family, and also as a nurse. It has been hard, but necessary. Things back home in Malaysia have not been too good; by staying on and helping with the crisis, I can make a bigger difference here.
Marshal (right) says his colleagues at work have been great support while he remains far from his family 46 |
It has been a very challenging year, especially at the height of the pandemic. The A&E had to continually expand to meet demands as we began to isolate, test and treat patients coming from the dormitory clusters. Various tented areas were set up to house patients while they waited to be sent to isolation facilities. They were understandably stressed and scared about the situation. Despite the language barriers and cultural differences, we tried our best to nurse them and reassure them. My work with geriatric patients over the past year has also had many communication challenges. Wearing the N95 mask makes it very difficult to interact with older patients because they are unable to see our mouths, faces and expressions. Increasing the difficulties are stricter visitor policies, the need to isolate suspect cases, and typical anxieties of being in the A&E. To show empathy for such patients, my colleagues and I take more time to make sure they understand their care journey, and follow up on recommendations. It takes time, but it is time worth spending to help make their stay a more comfortable one. The day-to-day ups and downs of the job and being apart from my family have not been easy. But focusing on my work, the well-being of my patients, keeping active, and upgrading my own professional learning help me to pass the days fruitfully. I always look forward to chatting with my wife and family through messages and video calls. I also spend time with good friends and colleagues, letting loose over online games and karaoke. Having them by my side really helps. Whenever on or off shift, they have my back and are so supportive. I remind myself that, as long as we do the right thing, we can overcome this crisis. Living and working through this experience has taught me to really cherish our blessings and freedoms, such as travel and socialising, time with family, and the company of friends. Importantly, it has really confirmed that my career in nursing, which has always been my first choice, has been the right one. It has imparted to me so many skills in keeping my family and friends safe. In these hard economic times, I am grateful to have a stable job that is not only useful, but essential.
Finding myself in nursing KANG XIAOLING STAFF NURSE, WARD D97, YCH I’ve never been away from my family for this long before — it has been extremely difficult because two family members passed away last year within two months. One of them was my grandfather. When he asked me, “Will you come back to see me for the last time?” it broke my heart that I couldn’t do so because of travel restrictions. These losses were hard to take. My grief was overwhelming — I felt down, frustrated, and couldn’t rest well. I had so many regrets about not spending as much time with my family as I should have. What kept me afloat was the kindness and care of my colleagues. They looked out for me when I was on duty, and some of them even sent messages to check on me when I was on leave at home. One of my seniors said something that really resonated with me: “People who always take care of others don’t always have much time for their own family. But your family would not want to see you sad and give up.” I reflected on this and realised several things: One, although I am apart from them, my family will always be with me, and they are the people who give me the will to live and be happy. Second, there is nothing I can do to change what has happened, but I can act to change the future and care for myself so that I can care for others, including my family and my patients. When I put on my uniform again, I felt more energised for my duties. Seeing patients get better, or hearing a simple word of thanks really makes my job worthwhile. Even though the work has been very stressful with the pandemic, I am uplifted that my team and my training will see us through. Though the initial days were scary and uncertain, we worked hard to lay down systems and processes to keep everyone safe. At YCH, we have taken a lot of effort to strengthen clinical and nursing procedures, enhance security, and improve infection control measures. We just need to continue our vigilance. I have been asked many times, “Why did you choose nursing? Is nursing your first choice?” If I had to make my choice all over again, I would still choose nursing. It has given me so much happiness, satisfaction and self-worth. | 47
urses’ Day 2021
Apart, but always in my heart BUENAVIDEZ GLENDA FULGAR SENIOR STAFF NURSE, WARD A62, KTPH While working away from my family for the past 13 years has been a challenge, I could always look forward to seeing them once or twice a year. The pandemic meant that we’ve had to forsake even this rare luxury, and I’ve not been home to the Philippines for the last two years. We are fortunate that we can keep in touch through technology, but there’s always a lingering sense of guilt and loss. Of course, I worry about how they’re doing back home, and about their safety and well-being. I think about my parents, who are getting older, and how I cannot spend time with them. I also think about having missed so many milestones in my daughter’s life. There are times when I feel burnt out, extremely sad, and frustrated. But I remind myself that there is always a reason in God’s plan — if we have faith and keep on doing the right thing, we can overcome. I am grateful for my work. I think about how it helps me to still be there for my family in other ways, like providing them with financial stability. It also enables me to give back to the community, such as donating protective gear to healthcare workers in the Philippines. As a nurse, I was actively involved in Yishun Health’s COVID-19 interventions, moving beyond my usual work in a surgical orthopaedic ward to working in a
48 |
medical ward. The transition was not easy, but we soon overcame the initial challenges and adaptations by working together as a team. There have been many changes to tackle, such as higher-than-usual safety measures, manpower limitations, different job scopes, and more. But as nurses, it is important that we adapt. This is a new world for all of us, and we will be living with and battling COVID-19 for a long time to come. Even as we react and adapt to the crisis, it has been important to reflect on how we can take this chance to grow in our abilities and mindset. For myself, I’ve come to appreciate and treasure every single moment, even if it’s a simple gesture. Through embracing my purpose, I’m able to fulfil my roles as a good mother, daughter and colleague. By dedicating myself to the care of others, I can make the best of my life and my skills. By committing towards quality patient care, honouring their interests, and acting with integrity and compassion, I can be a living legacy that will inspire others and give even my own grandchildren an example to follow.
My family, my strength GUCE ARLENE ROBLES STAFF NURSE, WARD B85, KTPH Working as a nurse in Singapore during this pandemic has meant being miles away from my family in the Philippines for the longest time ever. I used to see my husband and son at least four times a year, but travel restrictions have taken these precious meetings away from us. The heartbreak is compounded by the fear and anxiety for their health and the uncertainty of whether they can avoid getting sick. It has been hard to get used to being away from my family and my hometown. Almost every day, I will videocall my husband and son to speak with them. I can even mother my son and check on whether he has done his school work, practised his piano, and eaten his meals. These moments motivate me to continue in my work. My family gives me strength. I know that my work helps me to provide for them and give my son a good life. This knowledge helps me press on to achieve my goals — even in hard times. When the time is right, we will be able to spend quality time freely again with our families. At the same time, there have moments when I just wanted to give up because of
the exhaustion and unending demands. Feeling burnt out, I took some time off. Though I could not travel back home, I spent my leave resting and recharging. Taking some time for myself, I learnt to appreciate things more and see things positively again. Caring for myself helped me to care for others better. I took this mindset with me when I came back to work. I was caring for a terminally ill patient who was often in a bad temper. I put myself in her shoes and was patient with her complaints, and continued treating her with compassion. Once, I was taking her to use the toilet when she smiled at me with tears in her eyes, and said, “When you grow old, do not be sick like me.” I was so touched by her kindness and her change in mood that I almost cried. From then on, she would share stories and we would laugh and talk together. Words can’t describe how fulfilled I felt to be a nurse, walking together with people through their darkest times, and being there for them when no one is able to.
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urses’ Day 2021
Proud to be a nurse PEGGY PAU STAFF NURSE, WARD B66, KTPH Being a nurse is not an easy job — the demands are high, the hours long, and the workload can be very heavy. And yet, it’s a job that’s sometimes overlooked. But there are many bright spots, too — helping others, bringing some comfort to patients, and seeing our efforts result in good health and wellbeing makes it worthwhile. But these two years have not been without its low points. I’ve been a lot more anxious and low-spirited than usual because of the pandemic, especially when I think of infection numbers and positive cases in the hospital. Another was the death of my grandmother in Malaysia. Because of travel restrictions, I was unable to return to my hometown to pay my respects and send her off — it was a big personal 50 |
blow. Though it has not been easy to accept this loss, I am grateful for the huge amount of emotional support from my family, friends and colleagues during this difficult time. Being able to focus on work and continue to help people the best I can has also helped me to manage my grief. At work, I took on quite a different role as part of Yishun Health’s pandemic response. Compared with my job as a cardiovascular nurse, being on the Swab Team was a unique experience. The procedure is straightforward, but requires taking extreme precaution at all times to prevent exposure to potentially infectious droplets. Doing this work really cemented the importance of infection control, patient safety, and the need to stay vigilant at all times. I will take all these lessons from the crisis in my stride to cope with the new normal. While COVID-19 has taken a lot from us, it has also given us perspective to count our blessings, and reinforced my pride in being part of the nursing community! I am very proud that I have been able to contribute, and very happy with my decision to be a nurse.
Doing small things in great ways YEOH WUAN CHIANN
Like many of the healthcare workers away from home, birthday celebrations are now done through videocalls for Wuan Chiann (bottom right, right)
SENIOR STAFF NURSE, MAJOR OPERATING THEATRE, KTPH The support of friends and family has been so essential in the past year; even though my family lives in Malaysia, their unwavering love and encouragement from afar has really kept me going. Not being able to go home for almost two years has been very hard, and I’ve felt quite homesick. I’ve also felt a lot of anxiety for my parents because of the high infection numbers in Malaysia. There’ve been many times when I felt bad about not being able to take care of my own parents and be with them during this period when they need my support; but I also feel a sense of responsibility and accountability to fight against COVID-19 with my colleagues — my siblings are also nurses here in Singapore. And I am glad that my team and I can make a difference. As a perioperative nurse, I saw myself taking on an additional role to care for COVID-19 patients. Apart from my usual duties as a nurse in-charge of the
Wuan Chiann (middle) continues to stay dedicated to her calling to nursing alongside her colleagues at work
Operating Room, I adapted to splitteam arrangements and took on longer 12-hour instead of eight-hour shifts to accommodate the changes to our manpower numbers. The longer working hours really challenged our stamina and concentration spans, but thanks to teamwork, we have been each other’s cheerleaders. The unity and friendship of my team has really helped us all overcome the hectic days. Working hand-in-hand, we give each other the boost we need to continue providing quality holistic care to our patients during this crucial period. Every frontline staff has had to work with the challenges of wearing PPE and the N95 mask; many of us on night duty at the pandemic Operating Rooms have also had the unique experience of midnight showers, which we are required to take after supporting every case. It makes me smile to recall the sight of us all trooping down to the shower rooms, cold and shivering, in the dark and misty hours of the early morning. The pandemic has taught me to treasure every moment I have with my family and friends, from the daily video calls with my parents to socially distanced birthday celebrations and the small moments of pleasure when we get to sample special snacks and treats gifted to us. We truly do not know what tomorrow holds. I have been telling myself to stay positive at all times even though the journey has been long and tiring. I have no regrets about my chosen profession, and I am proud to be a nurse during these challenging times. Knowing I can contribute my skills and expertise, and learn important lessons while weathering this pandemic together with my colleagues give me a sense of fulfilment. It reminds me of something Martin Luther King said: “I cannot do great things, but I can do small things in great way.” | 51
urses’ Day 2021
STEPPING UP TO THE PLATE
Extending themselves beyond their day-to-day routines and job scopes, these nurses went the extra mile to bolster the frontline and keep the community safe.
Through adversity, affirmation CATHERINE HU NURSE EDUCATOR, NURSING ADMIN, KTPH When I began work in May 2021 to be part of Yishun Health’s mass staff vaccination exercise, there was a sense of relief and optimism. The past year-and-a-half has been eventful; though there have been uncertainties and challenges, I weathered them with calmness and confidence. I knew Singapore had encountered and triumphed over past pandemics. I knew in my heart that my colleagues and I were well prepared; our training and commitment would aid us in our battle with this new virus. I volunteered to be part of the vaccination rollout because I wanted to do my part as a healthcare worker. Since face-to-face training had been temporarily suspended, I also had the bandwidth to do so. It was quite different from being a Nurse Educator. At the vaccination centre, I took on a managerial role to oversee the workflow, allocation of nursing manpower, manage resources, and monitor vaccine counts to ensure smooth operations. We had to deal with the challenge of monitoring a tight supply of vaccines, which needed to be stored at specific temperatures. To prevent waste, we had to ensure we had the right amount, and cope with missed appointments due to unforeseen circumstances. We also had to remain vigilant in monitoring staff after they were vaccinated. At the same time, I still had to fulfil my role as an educator, conducting checks on vaccinators to ensure infection control standards and precise vaccinating procedures 52 |
were followed. There were also a few times when I had to comfort those with an extreme fear of needles — they held my hand throughout the process while I distracted them. It was very motivating and heart-warming to see staff from different departments all coming together to achieve this important milestone in our pandemic battle. It has been truly rewarding to be part of our nation’s crisis response, enabling me to experience diverse ways of being a nurse: a manager, educator, advocator, collaborator, care provider, and leader. However different these roles may be, they all add up to contributing, serving, educating and providing care — and that’s why I’m proud to be a nurse.
Seow Keng (bottom right) on duty at one of the staff swabbing booths
Fear not, soldier on WEE SEOW KENG SENIOR ENROLLED NURSE, PHCT Steady and calm — that was how I felt in response to the pandemic. Though the situation was serious, I knew that what we needed to do as healthcare professionals was to rely on our training, our experience, and our commitment to safe care. Armed with this mindset and guided by sound leadership, we had nothing to fear. Since May 2021, I have expanded my work role from community nursing to also take part in the hospital’s swabbing exercises. It was busy at the beginning as we embarked on the big task of getting all staff swabbed. Over time, it became less hectic after routines were formed and more swabbers were eventually engaged. Swabbing is a skill that I picked up last year when
my PHCT team went out into the community to assist nursing homes in a similar exercise. For this recent exercise, I updated my skills to keep up with the enhanced operations and techniques. The procedure itself is not hard, but the physical nature of the job is a challenge. PPE, in addition to feeling very hot and sweaty, also brings about other inconveniences. In particular, it makes taking a bathroom break hugely difficult. In order to cut down on the times we need to don and doff PPE, many of us refrain from drinking too much water. The shifts structure also impacts meal times. When I was on morning shifts (7.30am–12.30pm), it meant a long time before lunch! But it was something I soon got used to and I was able to focus on doing my job well. It helped me to build discipline and a strong mindset to keep going. I know that if it’s something I have to do, I willingly do it regardless of how difficult it is. And I saw so many of my colleagues doing the same. As a nurse, it’s my duty to contribute to managing the pandemic. Swabbing may not be a very big and noble job, but I feel good to be able to do my part in this small way. | 53
urses’ Day 2021
Together, we can overcome WONG KOO SIANG STAFF NURSE, WARD D97, YCH The pandemic has been many things: scary, inconvenient, life-changing, and more. I’ve had many mixed feelings about this battle with an unseen enemy, but I’ve tried to focus on the positive things that I can do to help in this crisis. Being a nurse, I am privileged to be in a position where I can contribute in many meaningful ways to my community, my colleagues, my organisation, and my nation. During this time, all the more we ought to be committed to our duty as healthcare professionals. We need to brace ourselves and be mentally prepared to act as the situation demands. I’ve had to widen my role as a rehabilitative nurse because my ward was converted to care for COVID-19 54 |
patients. I am so proud of my team and how we all united to ensure that the patients entrusted to us received safe and quality care. It has made us closer and stronger than ever. Apart from clinical work, I’ve also had the opportunity to take on the role of being a COVID-19 swab trainer and a vaccination nurse. These have been great learning opportunities, and the skills I learnt have helped me to better appreciate the work on the ground and at the frontline. The experience has also broadened my horizons, and enabled me to meet and make friends with many new colleagues. Although we all came from different roles and departments, we shared a common goal. It was motivating to build rapport and team spirit by working side-by-side, safe-distanced but connected in spirit. It was especially heartening to see the example of our Yishun Health leaders, who were the first to be vaccinated, rallying confidence in all the staff as well as to the public. Being a nurse in this pandemic has been an unprecedented challenge. But it has validated my decision to make nursing my lifetime career. It also strengthens my belief that, as long as we work together, we can overcome.
The beauty of team spirit CARRIE LIM SENIOR STAFF NURSE, CASE MANAGEMENT, KTPH One of the best things to come out of the COVID-19 crisis has been the opportunity to bond and strengthen our commitment to nursing and the healthcare profession. It has been so inspiring to see my colleagues and peers in the healthcare sector continue in their duties steadfastly, and adapt with resilience. I had the chance to do the same in small ways, helping at the Hospital Command Centre from March to
September 2020, and working in our swab teams since May this year. It never crossed my mind as to why I took up these roles, and whether it would be something I would find suitable. To me, it was a matter of contributing where I could. I believe in accepting these opportunities to learn and grow, and do my best! I have really learnt a lot from these experiences. At the Command Centre, I was at the heart of the organisation’s pandemic response, working as a team to keep pace with many changing protocols and workflows from MOH. We had to be very resourceful and collaborative. Work at the swabbing station entails similar levels of unity and teamwork, in addition to crowd management, resource planning, and working with efficiency. This work — done with full PPE in the open air — is very physical. We stand for long hours in the heat, so it can be very draining; we sweat so much that we are often dripping! But in all these settings, it is heart-warming to see how we take care of each other and work together to overcome any issues that come up. I often check on my colleagues to make sure they rest whenever possible and hydrate frequently. I am in turn looked after, too — my colleagues are very helpful in guiding and supporting me. I have also received a lot of support in other ways, from childcare help from my mother-in-law to coverage from my team when I am away from work. It has helped in some way to allay many of my worries about my family. As a mother, I struggle with the decision to send my children to childcare during the pandemic because I have to work. I am also anxious about possible infection because I am at the frontline. Because of this, I am mindful about my PPE and shower both before and after my duties. These are some of the inconveniences that we have to adapt to. From higher levels of infection control and more digital interactions to fewer social gatherings, we must all make way for the new normal. But as a team, we can make the best of these times and stand ready and prepared for the changes to come. | 55
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