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More than meets the eye

The far-reaching and important work that nurses do is at times overlooked, or even trivialised. In conjunction with Nurses’ Day, learn more about what Changi General Hospital’s (CGH) nurses do, as leaders, advocates, innovators, educators, mentors and more as we debunk common myths about their profession.

In the ever-evolving healthcare landscape, CGH’s nurses continually keep their eyes on making a positive impact on the health and well-being of their patients, families and the communities in Singapore.

Excellence in nursing is crucial as it enhances patient care, upholds ethical standards, fosters leadership and advocacy, and promotes professional growth. As nurses contribute to the overall advancement of the nursing profession, CGH is committed to the advancement of nursing in the spheres of professionalism, innovation, empathy and the delivery of positive value-based healthcare for both patients and the community.

To drive nursing excellence, CGH empowers nurses to advocate for their patients while providing opportunities for continual professional growth and academic development. In addition, the hospital celebrates the exceptional contributions of our nurses and their impact on patient care.
  

The key cornerstones of nursing excellence in CGH include:

“Every CGH nurse is regarded as a leader, and this empowers us to develop and execute change-management strategies, quality improvement plans and research projects,” says Mr Walter Ting, Senior Staff Nurse, CGH. “This allows each nursing team to provide tailored and efficient care to our patients while optimising resources.”

As a reflection of the nursing excellence at CGH, CGH nurses earned a multitude of national achievements at the Nurses’ Merit Award 2023 by the Ministry of Health, as well as the SingHealth Nurses’ Day Awards 2023 and the Wee Foundation Nurses’ Day Awards 2023, in recognition of their excellence and contributions to the profession.
  


Nursing is a dynamic and ever-evolving profession that embraces continual innovation and improvement in patient care, education, research and technology. Today, CGH’s nurses actively contribute to healthcare innovation, by adopting evidence-based practices, implementing advanced technologies and developing creative patient-centric solutions to address complex healthcare challenges.

Nursing innovation plays a vital role in enhancing patient outcomes. It enables the care team to provide even safer care, optimises the work done by nurses and drives positive change in the healthcare environment. “With innovation at the very core of CGH nursing, we are on an ongoing mission to innovate and improve patient care and safety, as well as augment the nursing workforce and services through new, creative and effective ideas,” says Ms Nuri Sylvia Ng, Senior Nurse Manager, Nursing Quality, Informatics and Transformation, CGH.

Technology is an important enabler in transforming care delivery for the rapidly ageing population in Singapore. With the focus on value-added nursing tasks, nursing care is enhanced with the use of technology to complement overall care for patients. CGH nurses have introduced innovative robotic solutions at the wards and also leveraged telemedicine to empower patients to take charge of their own health — in line with Singapore’s Healthier SG initiative.

A recent nursing-led innovation at CGH is the deployment of robots at the Emergency Department (ED) as part of a trial. The various robots help lighten the workload of nurses by transporting medication loads, providing wayfinding services for patients’ next-of-kin, and delivering blankets to patients.

Another nursing-led innovation is the development of smart wearable medical sensors that remotely monitor vital signs. Comprising a sensor patch and a finger oximeter, the device is attached to a patient’s chest and finger to measure his or her respiratory rate, heart rate and oxygen saturation. The device can be wirelessly linked to the nurses’ station in the wards, allowing remote monitoring and patients to have uninterrupted rest. Currently undergoing clinical trials, the sensors may be considered for wider clinical application in the observation wards and ED at the hospital. The technology also has the potential to monitor the vital signs of patients post-discharge in the comfort of their homes so that care can continue in the community setting.
   


CGH’s nurses are able to monitor patients’ vital signs remotely with a wearable medical sensor.
  


Beyond the requisite basic certification needed to enter the profession, many educational options are open to nurses to enhance their knowledge and evidence-based practices. These can range from on-the-job training to postgraduate studies in the various fields of nursing.

In fostering excellence and future-readiness in nursing practice and patient care, CGH has a dedicated nursing education team that develops and conducts programmes and courses designed for all levels of learners, from students, newly-qualified nurses and new joiners to the hospital to in-service nurses and experienced nursing leaders. “Innovation is embedded in nursing at CGH,” says Ms Rifhan Nadhirah Binte Zakariyah, Nurse Educator, CGH. “As educators, we collaborate and develop creative training from the classroom to clinical practice to strengthen skills and capabilities while providing a positive learning experience for our trainees.” The CGH nursing education team regularly conducts core nursing courses. These cover practices such as the intravenous administration of medications, venepuncture (drawing blood from a patient’s vein), peripheral intravenous cannulation (insertion of a tube into the vein to administer fluids and medications), and more. Such training serves to equip nurses with the knowledge and skill competence for safe practice.

CGH also conducts nursing orientation programmes for newly-graduated nurses, while induction programmes designed for non-nursing staff such as Care Support Associates and Patient Care Assistants train them in housekeeping and basic care skills, enabling them to provide support to the nurses.

There is also a variety of nursing workshops — in areas such as end-of-life care, healthcare ethics, wound care, management of older adults with dementia or delirium, triaging and more, as well as non-nursing workshops — like first aid, basic anatomy and physiology — which have been designed as part of continuing education.

In addition, CGH’s Advanced Practice Nurses conduct courses in the areas of specialised geriatric care and effective communication. “It is essential for nurses to build on their professional development, and stay ahead of evolving patient care practices and constantly advancing technology, amid increasing healthcare needs and expectations,” adds Ms Rifhan.

As nurses spend a considerable amount of time at work, their welfare and well-being are integral to providing a safe, compassionate and excellent care environment. Recognising this, CGH formed the Nursing Image and Well-being Council which promotes wellness through ground-up projects developed from engagement with staff — by listening to nurses’ concerns and deriving ways to address them. “Nurses are humans too,” says Ms Parvinder Kaur, Assistant Nurse Clinician, CGH, who has been the Council Chair since 2021. “Knowing that their well-being is looked after, nurses are able to focus on providing quality patient care. They are more engaged at work and are more motivated to give their best.”

A pilot initiative developed by the council includes awards that recognise staff who have been identified by their peers as being very supportive towards their colleagues. This project serves to boost the nurses’ morale and create a positive working environment. Through this initiative, the nurses shared that they feel valued, appreciated and encouraged knowing that their efforts are recognised. This has helped to cultivate a positive working environment, which in turn builds a high-performing team, further improving patient care.

In caring for the nurses, the council also organises activities and workshops, intended to encourage physical well-being and help them unwind, such as Zumba and personal grooming classes.

To help nurses from overseas adapt to their new lives in Singapore, the council also developed an Overseas Nurses Induction Programme. Through this programme, the nurses receive a pre-departure checklist to help them prepare the required essential documents and items before their move to Singapore. They also receive important information and guides on Singapore’s culture and local practices to ease their transition. The programme has proved beneficial to the overseas nurses, with 80% sharing that they found it useful in helping them adjust better to life in Singapore and CGH.


The CGH Overseas Nursing Induction Programme helps nurses from overseas adapt to life in Singapore.

Every year, CGH celebrates the togetherness, dedication, achievements and aspirations of its nurses during the Nurses’ Day celebrations with a week of festivities. Throughout the year, CGH nurses also carry out activities to raise funds for patients in need through the sale of items like food and drinks. These initiatives not only serve a good cause, but provide the nurses with the opportunity to take a break from their clinical work to have fun together as well.

CGH’s nurses serve in a multitude of roles, such as in the Emergency Department, inpatient wards and operating theatres, as well as in the areas of community care, correctional health, palliative care, specialist outpatient services and more. Thanks to their multi-faceted skillsets, nurses — regardless of their role — have made an indelible difference in the hearts and lives of patients and their families.


 

A day on the frontline with a Nurse Clinician

We take a glimpse into a fast-paced day of Ms Ma Chongyan, Nurse Clinician, Changi General Hospital (CGH). With the dynamic nature of her work — from conducting training and caring for her patients, to developing new innovations — no two days are the same.


Ms Ma Chongyan is a
recipient of the Public
Sector Transformation
Exemplary Leader Award 2023.

With over 16 years of experience in CGH’s intensive care and high-dependency wards, Ms Ma Chongyan is no stranger to rapidly-evolving medical situations and providing critical care for her patients.

On one occasion, one of Ms Ma’s patients with end-stage cancer hoped to witness the marriage of her only daughter as her final wish. To fulfil her dream, Ms Ma and her team made arrangements to book a room in CGH, allowing a small group of the patient’s family members to hold a cosy wedding ceremony. The patient passed on soon after in peace. “I was thankful to have the opportunity to fulfil the patient’s last wish. Even though it was a small gesture on our part, I felt it made a significant difference to the patient’s family,” says Ms Ma. “I am proud that we not only address our patients’ medical conditions, but care for their emotional well-being as well.”

During the COVID-19 pandemic, many nurses in CGH, including Ms Ma, went beyond the call of duty by stepping up to serve in response to the rapidly evolving situation. In March 2020, to meet increased demand, Ms Ma and her team designed and organised training for 58 general ward nurses to be readily deployed at the high-dependency unit (HDU) within one and half months.

In October 2021, with a surge in critically ill patients, Ms Ma’s ward was converted to a COVID-19 intensive care unit (ICU) and HDU. The ward’s surgical high-dependency patients were relocated. To ensure the continued delivery of high-quality care to these patients after the move, within a short period of time, Ms Ma and her team planned and organised trainings in surgical procedures for the nurses in the ward where the patients were relocated to. Despite the race against time, Ms Ma enhanced the learning experience on surgical procedures and skill-based training through theory, hands-on simulation and live training videos, making the training more effective.

As a nurse clinician at the HDU in CGH, Ms Ma assesses, plans, implements and evaluates the overall nursing practices and standards of care for patients in the ward. “Nursing training is the foundation upon which we develop our clinical expertise and patient care abilities, ensuring that we deliver quality patient care,” she explains. Besides overseeing the development of the nurses in her team, Ms Ma also plays an active role in working with her department to develop and implement new innovations that improve patient safety, experience and outcomes.

For her contributions that have helped enhance CGH’s nursing practices and standards, as well as the quality of care for patients, Ms Ma clinched the Public Sector Transformation Exemplary Leader Award, which recognises exemplary leaders who have led and grown their teams, as well as driven excellent service, innovation and change.

Follow Ms Ma at work on a typical day at CGH, from dawn to dusk.

Ms Ma arrives at CGH and checks on her ward’s nursing staffing and workload for the day ahead, ensuring that the patient care assignments are equally distributed.

Ms Ma supervises the morning roll call for the nurses in her ward, communicating important messages, updates and follow-up actions required for high-dependency patients under their care.

Ms Ma assesses the ward environment to ensure the safety of patients, staff and visitors. She also engages patients by checking in on their health status and well-being.


A nurse approaches Ms Ma for advice on complex wound management and the application of Vacuum-assisted closure (VAC) therapy. Together with the nurse, Ms Ma assesses the wound and provides advice from counselling to documentation for the patient.

Joining a team of doctors on their rounds, Ms Ma discusses the development of the patients’ conditions and proposes beneficial interventions.

Ms Ma facilitates arrangements for a computerised tomography scan for a patient, and the urgent insertion of a peripherally-inserted central catheter line for another patient requiring long-term antibiotics and early nutrition (total parental nutrition).


Ms Ma enjoys a bowl of yong tau foo and recharges herself through conversations with her colleagues.

Ms Ma addresses queries during the afternoon roll call. She shares latest updates on clinical practices during the monthly in-service training for nurses to enhance their clinical care knowledge and professional skills.

Ms Ma hands over ward duties to the nurse clinician of the afternoon shift to ensure continuity of care, and highlights important areas to follow up on.


Ms Ma monitors the effectiveness of a unit-based simulation training for nurses on caring of a patient with an external ventricular drainage device, through the use of a high-fidelity manikin. This helps nurses — especially new nurses — to strengthen their knowledge and skills in this area.


Ms Ma follows up on quality improvement projects with the nursing team, to improve the delivery of care to patients.

It is the end of the workday for Ms Ma and she heads home. To unwind after a day of work, Ms Ma plays with her children at the park, or sometimes goes cycling, refreshing herself before another day of work.
  



Unwavering pillars of care

Saluting Changi General Hospital’s (CGH) nurses’ stalwart commitment to providing quality healthcare.

Nurses are our everyday heroes, the heart and soul of healthcare. In conjunction with Nurses’ Day, CGH celebrated and honoured the dedication and compassion of its nurses with special events around the hospital.

CGH’s senior management team and SingHealth leaders flagged off this year’s Nurses’ Day celebrations, making stops around the hospital to express appreciation to the nurses.

Assoc Prof Png Gek Kheng, Chief Nurse, CGH (left), thanking CGH’s nursing staff for their hard work and dedication.

   

 


   

Celebrating Nurses’ Day 2023 at the Caring General Hospital.
   

Ms Tong Kai Lian, Senior Staff Nurse, CGH (centre), was the recipient of this year’s SingHealth Chief Nurse Award, in recognition of her professional competency, professional conduct and contributions, leadership qualities and voluntary services. She received her award from Assoc Prof Png Gek Kheng, Chief Nurse, CGH (left); and Clin Assoc Prof Ng Kee Chong, Chief Executive Officer (Designate), CGH (right).
   

Capturing moments of joy and camaraderie at the Nurses’ Day celebrations.
   


   

A Professional Home for Nursing Education

Officially opened on Nurses’ Day 2023, the CGH Nursing Education Institute (NEI) is a dedicated training facility that brings nursing education and skills training under one roof on home campus. “NEI is a place where nurses can learn and achieve professional growth, gather to generate and exchange ideas, and work collaboratively to bring these ideas to life,” says Ms Hanijah Abdul Hamid, Deputy Director, Nursing Education and Research, and Talent Development, CGH.

Celebrating the opening of the CGH Nursing Education Institute.