Where angels tread
The profile of nurses has been raised over the years. Some now have diplomas and degrees, perform special duties and take on increasingly important roles in patient care.
June Cheong
Sat, Aug 16, 2008
The Straits Times
Just as in the time of Florence Nightingale, nursing today is still a calling, summed up by TLC - tender loving care.
If you are thinking of nurses merely as people in the background, keeping mum, discreetly emptying bedpans and changing dressings, wake up and smell the antiseptic.
What is different and more exciting about the profession is the assortment of new skills needed, like IT know-how.
'Over the years, the perception of nurses has changed,' said Ms Pauline Tan, chief nursing officer at the Ministry of Health (MOH).
'All over the world, with the need for increasingly complex and specialised medical care, nursing skills have rapidly scaled up in terms of competencies and professionalism,' she said.
Madam Lim Swee Hia, 58, director of nursing at SingHealth's Outram Campus, said: 'In the past, we had to get the doctor's opinion for everything. Now nurses can confidently share and discuss with patients things like what their medicine does and what symptoms they need to look out for.
'With more knowledge and information, nurses can participate in discussions with doctors and with the families of patients.'
| Mind, heart and soul in job |
| Staff nurse Jonathan Q Ubana joined the nursing profession to fulfil his mother's dream.
She had to give up her dreams of becoming a nurse when she got married and became pregnant with Jonathan. Torn between raising a family and becoming a nurse, she chose to give up her studies. The 35-year-old Filipino had wanted to become an engineer, but he said: 'Both my grandmother and my aunt encouraged me to take up nursing to fulfil my mother's dream.' He graduated with a nursing degree in the Philippines. After working in the emergency room of a hospital in the Philippines for four years, he applied to work at the Institute of Mental Health (IMH) in Singapore as he wanted to gain overseas experience in a different nursing discipline. He said: 'Working at the IMH is a totally new experience as I'm in a foreign land. It is also my first time working in psychiatric nursing.' Mr Ubana, who came here six years ago, has been working with intellectually disabled patients at IMH since. He said of the challenges in his job: 'One obstacle is the patients' mental state and those with mental retardation have difficulty expressing themselves, making it difficult to understand them.' Language has been another communication barrier as some of his patients speak only Mandarin, Malay, Tamil or their dialect. He said: 'At first I had to use gestures and hand signs, or ask my local colleagues to translate but this was not easy and I felt like a clown sometimes.' Mr Ubana resolved to pick up at least a smattering of these languages and attended in-house language courses conducted by IMH. He said: 'I believe one should put in one's best in everything. Since I chose nursing, I have always to put my whole mind, heart and soul into helping my patients.' |
A registered or enrolled nurse today needs at least a diploma in nursing or health sciences from a local polytechnic or a nursing certificate from an ITE respectively.
All practising nurses here are required to register with the Singapore Nursing Board.
Last year, there were more than 22,100 nurses in Singapore, roughly 36 per cent more than a decade ago.
Their numbers will go up, said MsTan, due to new hospitals being built and the expansion of health-care services in the public and private sectors. 'Our rapidly ageing population will also require more nurses,' she added.
The MOH will increase the annual local nursing intake to at least 2,000 every year, while encouraging more mid-career people to become nurses.
It will boost funding for nursing scholarships too. For example, scholarship funds for practising nurses will be more than doubled from the current $3 million to $7.7 million a year from 2011 onwards.
Last year, the MOH revised nurses' salary structures, with the starting gross salary of a registered nurse in a public hospital now between $2,100 and $3,498.
The President's Award for Nurses, now in its ninth year, honours and inspires the nursing fraternity.
Meanwhile, more nursing programmes are now catering to the wider scope of nursing specialties.
Among the start-ups that were set up in the last three years are Parkway College of Nursing and Allied Health, and The Alice Lee Centre for Nursing Studies in the National University of Singapore's Yong Loo Lin School Of Medicine.
Such schools emphasise medical theory and practical application.
Professor David Arthur, head of the Alice Lee Centre for Nursing Studies at the Yong Loo Lin School of Medicine, said: 'We encourage the students to be active problem solvers and to think critically.'
Ms Carol Tong, business development executive at Health Management International, which specialises in training foreign registered nurses, added: 'Nurses have to face more educated patients today with higher expectations.'
Ms Cheryl Chew, 22, who was in Ngee Ann Polytechnic's pioneer batch of nurses, found that her school's inclusion of attachments at hospitals and health-care institutions was a reality check. She understood that a passion to care for others is a must-have.
She said: 'Attachments are about relating what you learnt in school.
'On my second day, someone had died and I had to clean his body. I didn't dare touch it at first. But when I had the time to think about it, I knew it was a learning opportunity.'
Indeed, one aspect of nursing is still necessary: the 'hands-on' care.
While X-rays and blood tests for patients are now ordered and processed on the computer, nursing fundamentals like changing bedpans and washing dead bodies still have to be done by them.
Ms Tham Chui Mun, 49, a senior nurse manager at Tan Tock Seng Hospital's Emergency Department, said: 'I can't deny that nursing is hard and dirty work but it depends on how you look at it. When you attend to a patient with diarrhoea and change their soiled clothes, you actually learn more.'
Nurse manager at Gleneagles Hospital, Ms Siti Hosier, 38, said: 'Nursing is an invisible job. People see nurses cleaning patients' bums and carrying bedpans. What they don't see is that we're the patient's advocate and we plan their care.'
After all, nursing is one of those vocations that require an underlying compassion for the community.
Dr Premarani K, director of nursing at the Institute of Mental Health, said: 'A nurse's main motivation is the promotion of patients' well-being. She must possess the virtues of honesty, compassion, patience and courage.'
Ms Shane Lee, 35, a senior staff nurse at Gleneagles Hospital's paediatrics ward, said of her 12 years on the job: 'Passion is what keeps me in the job. I like children a lot and that's one big reason I'm still in paediatrics after all these years.'
Ms Siti said simply: 'Nursing is not about making money.'
Meanwhile, the image of nursing overall and also that of male nurses here has improved greatly.
Mr Nidu Balakrishnan, 32, a nurse clinician in orthopaedics surgery at the Singapore General Hospital, summed up the sea change in the last 10 years.
He said: 'Before, people thought nursing was a sissy profession or a dirty job or what people weak in academics do.
'That's because it was thought that nursing was about basic care for patients and everything to do with bedpans. Now we think more critically and are more involved in appraising a patient's situation. Now there's also training for nurses from ITE level right up to PhD.'
This article was first published in Mind Your Body, The Straits Times on Aug 14, 2008.