With the nation’s transition to endemic living with COVID-19, restrictions to our daily lives are gradually adjusted. But the fight is far from over — with the healthcare system withstanding immense pressure since the beginnings of the outbreak. The team members of Changi General Hospital (CGH) have steadfastly held the fort on the hospital front while caring for patients from hospital to home, and coping with the new normal. They share their stories of commitment, resilience and solidarity.
“It was particularly gratifying to be able to make a difference, by providing accurate information, and allowing people to make an educated decision on their health. Even though it seems like a small thing, it serves as a reminder to everyone, that our actions — no matter how small — can make a difference.”
Dr Tan Seow YenDepartment of Infection Prevention and Control (IPC), CGH
WITH GREAT KNOWLEDGE COMES GREAT RESPONSIBILITY
It’s never an ordinary day for Dr Tan Seow Yen, who heads the Department of Infection Prevention and Control (IPC) at CGH and wears multiple hats in the fight against COVID-19. Dr Tan is involved in the epidemiological investigation of COVID-19 cases within the hospital. Together with her team, she plays a critical role in keeping patients and fellow colleagues safe from COVID-19 by formulating infection control protocols. They also carry out in-depth investigations of positive cases, and set in place measures to mitigate the risk of transmission.
Besides helping out on the ward rounds to care for patients, Dr Tan is also involved in the stewardship of COVID-19 therapeutics, which involves the holistic assessment of the patients’ overall medical condition to determine the evidence-based prescription and care which would best benefit them. She partakes in COVID-19-related research projects, such as studying its clinical features, diagnosis, treatments and vaccination.
Transiting into endemicity has brought along a different set of challenges on both the clinical management, as well as infection prevention and control fronts for Dr Tan. The Delta variant, with its increased transmissibility and shorter incubation period, and most recently, Omicron, has kept everyone on their toes. The nature of cases is also starkly different, as the profile of patients has changed over the past two years. “In the first year of the pandemic, the patients consisted largely of young and healthy migrant workers. This gave way to more complex cases as more elderly patients — often with underlying medical conditions and some requiring longer durations of critical care — were admitted into the hospital,” says Dr Tan.
Change is the only constant, as Dr Tan continues to helm the timely alignment of the hospital’s protocols — which includes the management of symptomatic and asymptomatic patients and staff — that are adjusted accordingly almost every week. The fluid situation also requires constant acclimatisation from every member on the frontlines. Coupled with the fact that the healthcare workers have been on heightened alert for two years, it has proven no easy feat retaining highly-stringent infection control protocols in the hospital. “My team constantly engages our colleagues to keep them informed and to clarify doubts. It is important to communicate not just the protocol itself, but also the rationale behind it, so that it aids understanding and implementation,” says Dr Tan. Despite these heavy responsibilities on her shoulders, Dr Tan’s level-headedness and cheerful personality has stood her well in the crisis. She shares a memorable experience, of when she gave a talk to seniors at a community centre to encourage them to get vaccinated. She recalls a particular elderly gentleman who asked many questions during the Q&A session and once his questions were answered, promptly headed to the vaccination centre at the community centre to get his jab.
“We also had to be pillars of support for these patients. Though it was quite tiring and draining, being able to alleviate their pain and grief, even if it was by a little, made our work meaningful and worthwhile.”
Ms Faithe Poh
Senior Staff Nurse, CGH
STAYING STRONG IN ADVERSITY
CGH Senior Staff Nurse Faithe Poh typically works in a ward that provides specialised geriatric holistic care for elderly patients with multiple problems and geriatric syndromes. Working closely with a multi-disciplinary care team, ward nurses provide acute medical care and treatment, as well as undertake the holistic planning of their post-discharge care to ensure a smooth reintegration back into the community.
As hospital resources were reallocated to handle the surge in cases due to the pandemic, Ms Poh’s ward was converted on a few occasions to contribute to the care of COVID-19 patients and those on quarantine order requiring medical attention. Like many of her fellow nurses, she had to adapt to providing a wide spectrum of care needs and closer monitoring as the virus proved unpredictable in its effects on different patients.
These days, Ms Poh dons the full personal protective equipment (PPE) to care for patients diagnosed with COVID-19. “The turnover is very fast as we strive to make space for patients who need acute care. We also minimise breaks to ensure that we do not over-utilise the PPE as it has to be discarded every time we drink water or visit the restroom. It’s very hard work,” says Ms Poh.
Despite the volatile situation and evolving protocols, the close-knit community of nurses is a lifeline to Ms Poh. It is an immense source of quiet strength and reassurance, she emphasises, “to know that others are in the same boat as you and fighting the same battle”. Her fellow nurses also formed a team who shared their experiences to help others familiarise themselves with procedures.
Ms Poh’s work is not only physically draining, but also extremely emotionally challenging at times. As healthcare workers on the frontlines, she and her fellow nurses show up at work daily knowing that they may have to activate emergency step-up medical care for deteriorating patients or even deal with a death.
There were also times when she cared for grieving patients who had lost their family members to COVID-19 complications, just days prior to their admission. Some had to miss the funerals or cremations of their loved ones. It was especially difficult for the elderly as they had limited means of communication with their family. Ms Poh recalls the most difficult moments to be the ones when these patients would be in tears as they lay in the hospital bed. “I remember one morning as I served the medication, this patient told me in tears, ‘It is 8am and they are sending my husband to be cremated now’. What brought relief to the patient was that we were able to video-call their family to allow her to be virtually present.”
“It is important for me to think on my feet and be competent in the assessment, prioritisation and provision of assistance for various scenarios efficiently and effectively. Thankfully, the Antigen Rapid Test (ART) has proven a huge help for quick detection and decision-making for admissions.”
A&E Senior Staff Nurse
The Accident & Emergency (A&E) Department has always been a busy place in hospitals, but with COVID-19, frontliners like Ms Chow have been experiencing the full brunt of this long-drawn battle. The introduction of the home recovery programme for asymptomatic patients last year proved a great relief, as frontliners at A&E are now better able to focus on treating emergency and acute patients.
“I feel proud to be part of the strong CGH family who work tirelessly to serve the community. The past two years have been challenging, but fulfilling with many humbling lessons learned. I am confident that the healthcare family will continue to excel and improve for the betterment of the community.”
Candyce LeeInpatient Operations Executive
Having joined healthcare to help others, Ms Lee leads a team of Patient Service Associates at the wards in supporting doctors, nurses and allied health professionals to ensure a smooth journey from admission to discharge to home for patients. Beyond administrative work, the team’s operative duties range from rapid contact tracing and ward management, to the activation of COVID-19 wards.
“The challenges as a frontliner are not easy — the worry and uncertainty of patients and accompanying visitors are what we face each day. As we are working in a high-risk area, we sometimes also feel anxious when a colleague tests positive. The support and encouragement from my family members, colleagues and the community helps me to press on.”
Nennie Fadillah HasnawiA&E Patient Service Associate Executive
Patient service associates like Ms Nennie are usually one of the first touchpoints that patients and visitors encounter during their visit to CGH — she registers outpatients, facilitates admissions, provides financial counselling and runs counters at the A&E. On top of these duties, Ms Nennie works closely with the nurses to assign patients for consultations, activates the escalation of cases, and manages the flow of patients at the A&E.
“It is always a race against time, so teamwork is important in communicating and ensuring that these updates are carried out promptly and results are released smoothly.”
Eng Li ChingSenior Medical Laboratory Scientist
The CGH microbiology laboratory operates around the clock to support the hospital’s COVID-19 operations, with the release of test results affecting key decisions such as patients’ treatment and ward movements. Ms Eng oversees the COVID-19 laboratory processes, from keeping track of priority-testing protocols to registering swab samples and the release of test results.
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