Cutting the cake at the Nurses’ Day celebration at SIT@Dover (from left to right): Associate Professor Genedine Lim, Programme Director (Nursing), Health and Social Sciences, SIT; Associate Professor Dora Howes, Programme Director (Nursing), University of Glasgow (UofG); G-o-H Professor Lee Chien Earn, CEO, Changi General Hospital, Deputy Group CEO (Regional Health System) SingHealth; Ms Paulin Koh, Chief Nurse, Changi General Hospital and Deputy Group Chief Nurse, SingHealth; Associate Professor Alan Wong, Cluster Director, Health and Social Sciences, SIT; Dr Pauline Tan, Chief Executive Officer, Yishun Community Hospital and Member of the Industry Advisory Committee (Health and Social Sciences), SIT.
To meet the needs of a rapidly-ageing population, how care is delivered needs to be transformed. The Ministry of Health (MOH) is making three key shifts to tackle the challenges ahead. The first, to move beyond healthcare to health, by investing in preventive health services and promoting healthy lifestyles. Second, to go beyond hospital to home, by strengthening community-based care to enable seniors to age well within their communities and third, to go beyond quality and focus on providing value.
Our current and future nurses play a key role in this transformation journey. The SIT-UofG joint-degree Nursing programme is very much in line with MOH’s three key strategies for the future of nursing. First, the adoption of job and process redesign as well as automation so that nurses focus more on direct patient care. Second, to develop community nursing as a strong career track to support the transformation of care beyond hospital to community. And finally, to strengthen nursing education.
To celebrate the contributions of our nurses in the healthcare landscape, SIT and UofG celebrated Nurses’ Day 2018 on 3 August at SIT@Dover. The theme centred on delivering quality care to the community, in the community.
Organised by the Nursing degree programme (SIT-UofG) and attended by more than 150 guests that comprised mostly nurses across the various healthcare sectors in Singapore, the event was graced by Guest-of-Honour Professor Lee Chien Earn, CEO, Changi General Hospital (CGH), Deputy Group CEO (Regional Health System) SingHealth.
Associate Professor Genedine Lim, Programme Director, Health and Social Sciences, SIT said the ‘Community Nursing’ theme was timely, given the backdrop of Singapore’s ageing population.
“Nurses are integral not only in delivering and coordinating effective quality care across all healthcare settings, but also in ensuring that health and social services are also accessible and timely for those in need but prefers to be cared for at home. And if we are to alleviate the strain on our acute healthcare institutions, it is important for our nurses to appreciate and be skilled in community healthcare,” said A/Prof Genedine Lim.
Beyond Hospital to Community
Prof Lee said SIT was right on target to have a ‘community’ theme for this year’s celebration as he shared CGH’s journey to extending care “beyond hospital to community”.
“CGH’s mission is ‘partnering communities to keep well, get well, age well’. If we were to achieve our mission well, we obviously have to take care of our patients beyond the hospital walls. If we only look at patients in the hospital setting, which is an artificially controlled environment, obviously they are going to be well at the time of discharge. But the real task is to keep patients well after they return to their homes in their respective communities,” said Prof Lee.
Thus, Prof Lee added that the greater challenge was to have solutions that would optimally minimise the number of times that would give patients cause to re-admit themselves into a hospital. In moving care from the hospital to the community, there is a need to understand how patients take care of themselves within the real world of their communities, and not just in the hospital.
CGH, like many other hospitals across Singapore, is transforming their model of care according to the nation’s Healthcare 2020 Master Plan and beyond. The aim is to move ‘beyond hospital to the community, beyond quality to value and beyond healthcare to health’ in order to meet the nation’s long term healthcare needs in a sustainable manner.
Community Nursing
Ms Paulin Koh, Chief Nurse, Changi General Hospital (CGH), and Deputy Group Chief Nurse, SingHealth, sharing the hospital’s community care strategy.
Reinforcing Prof Lee’s message was Ms Paulin Koh, Chief Nurse, CGH and Deputy Group Chief Nurse, SingHealth.
Apart from the ageing population, where one in five Singaporeans is expected to be 65 years and above by 2030, the country’s declining birth rate will also mean less young people will be supporting the elderly above 65 – from the current 5.7 young persons to 2.1.
“Putting the emphasis on community healthcare means the nursing profession has extended beyond healthcare institutions into the community. The focus on person-centred, holistic care also means that the roles of nurses’ have evolved to meet changing healthcare needs,” said Ms Koh.
This effectively means that nurses will have new roles and responsibilities across the whole spectrum of continuum of care – from preventive care, to acute and chronic care, and intermediate and long-term care services.
“CGH is learning from Hong Kong’s community care model which started in 1967. The community nurses in Hong Kong are so familiar with the districts they are serving in, that you would think they are residents at the districts – as they could tell you the best places to eat, the social habits of the residents and the various support systems they need to put in place,” said Ms Koh.
However, Ms Koh acknowledged that while CGH may not be as advanced as its Hong Kong counterparts, the hospital has already begun to make progress. She added that CGH’s community nurses now understand that family and the community have important roles in helping patients to comply with their health plan. Community nurses also have better resources to monitor and care for patients within their own communities.
Ms Koh also explained that community nurses have made inroads into preventive care within communities through health education programmes, which are based on promoting healthy living and preventing health problems so that patients are empowered to take charge of their own health.
Takeaways from Glasgow
First year SIT-UofG Nursing students (from left to right): Muhd Nabil Fikri from SingHealth, Joanne Lim Siew Hui from the National University Health System, and Evangeline Tan Si Hui from the National Healthcare Group.
As the Bachelor of Science in Nursing with Honours at SIT is a joint degree with the University of Glasgow (UofG), our current nursing students had to do a four-week Overseas Immersion Programme (OIP) at the home campus in Glasgow at the end of their first year, before the embarked on their final year of study.
A majority of the 64 OIP nursing students come from various healthcare institutions in Singapore. Glasgow’s standing as a city with a well-established community healthcare eco-system served as an ideal OIP venue.
A few first-year students shared their reflections and takeaways on the Intermediate and Long Term Care (ILTC) health sector from their OIP, where they learnt how patients were transitioned from hospital care to community care.
“Nursing practitioners seem to have more autonomy. Patients are happy and content on consulting nurses. Although in Singapore, it will take more time for patients to adopt this mindset, there has been lots of progress made. Nurses now have greater clinical accountability and more authority to make decisions. There are nurse-led clinics where the nurses perform tasks normally done by doctors, such as monitoring adverse drug reactions and issuing repeat prescriptions for medication. Some nurses are also empowered to initiate certain interventions and order procedures for patients, as well as discharge them after procedures. I’m confident I can be part of this constant progress both in the acute and community settings as an aspiring Nurse Educator,” said nursing student Ms Evangeline Tan Si Hui (Khoo Teck Puat Hospital, National Healthcare Group).
On the topic of Advanced Practice Nursing (APN), nursing student Ms Joanne Lim Siew Hui (National University Hospital, National University Health System (NUHS)) added, “The degree programme’s module on clinical care include APNs teaching me how to critically perform health assessments and clinical analyses. Upon graduation, I am looking forward to putting these skills in practice and have greater clinical accountability towards the health of my patients.”
From the hardware perspective, nursing student Muhd Nabil Fikri (Changi General Hospital, SingHealth) hoped to engage the use of technology more.
“Glasgow was able to tap onto the extensive network of healthcare centres, such as a polyclinic in Singapore’s context, within a district and activate nurses from these centres to administer homecare treatment to patients. All centres are connected via an electronic health record system that includes alerts on patients’ scheduled nursing assessments, diagnostic tests, and therapeutic interventions. These alerts enable nurses to deliver the nursing care required by patients at the community setting in a timely manner. Since Singapore is already big on technology and has robust and reliable systems in place, I feel this idea has a lot of potential here,” said Muhd Nabil Fikri.
SIT wishes all nursing students at SIT@Dover and other IHLs, plus all other nurses in Singapore the very best in their steadfast, selfless and compassionate commitment to fulfilling their calling!
