The Nurse today is no longer the traditional, stereotypical figure of a “document-hugger” walking beside the doctor. He or she is a professional health care provider; a vital link between the physician and patient.
In addition, nurses are involved in research, education and even informatics. They are equipped with clinical expertise and are expected to take the lead in managing change and rethinking processes for continuous improvement.
With the challenges of an ageing population and the manpower crunch, upskilling nurses is necessary to ensure a sustainable care model. Said Dr Ayre, “Nurses are expected to think on their feet and perform skills that they may not have been taught in school. They need to be able to practise at the top of their licence in their clinical areas.
A recently introduced initiative that allows nurses to expand their clinical roles is the Resident Nurse Training Programme. Under this scheme, nurses are trained to examine patients, take history and conduct specific medical procedures. There are 127 Resident Nurses across SingHealth, complementing the work of Advance Practice Nurses and the healthcare team.
First, do no harm
One of the biggest roles for nurses today is acting as an advocate for patient safety. Ms Ng, who is also Chief Nurse at KK Women’s and Children’s Hospital (KKH), underscored the critical importance of open sharing in achieving SingHealth’s goal of ‘Target Zero Harm’. “Patient safety is our priority, and anyone involved in patient care is encouraged to speak up if something does not feel right.
When members of a team are held to a common standard of accountability, and empowered to raise concerns – regardless of role or seniority – this can only strengthen existing safety measures for patients.”
"Nurses make up the majority of hospital staff and form the bedrock of healthcare systems. When we move in synergy, challenges are overcome." - Ms Ng Gaik Nai, Deputy Group Chief Nurse, SingHealth
For a more holistic approach towards patient safety, nursing meetings and rounds in Singapore General Hospital now involve staff from other professions. Dr Ayre explained, “This way, doctors and operations staff can provide different perspectives based on their experience and expertise so that we can keep doing better.”
More than 79 physicians, nurses, allied health, operations and other hospital staff in KKH, and 114 in SGH, have been appointed Patient Safety leads to spearhead safety and care improvement initiatives in their respective areas.
“Patient safety is a collective responsibility. We are encouraged to see increased and open sharing of ideas, and crossdisciplinary implementation of patient safety recommendations in this ground-up effort,” Ms Ng said.
Learning from the younger generation
As Chief Nurses with six decades of combined experience, both Dr Ayre and Ms Ng keenly value the ability of the new generation of nurses to adapt to change and voice concerns or opportunities to improve.
Dr Ayre said, “I’m amazed by my younger colleagues’ adaptability. Not only do they embrace new ways of working, they value-add by giving constructive feedback for improvement. When we ask for volunteers to work on new projects, we are never short of people coming forward. This enthusiasm to try new things is invaluable today.”
The culture of mentoring is strong across the nursing profession in SingHealth, with senior nurses guiding each successive generation. Dr Ayre continued, “Our nurses have diverse expertise and strengths. With a robust mentoring system, each nurse can realise his or her full potential in providing the best care.
"When we ask for volunteers to work on new projects, we are never short of people coming forward. This enthusiasm to try new things is invaluable today." – Dr Tracy Ayre, Group Chief Nurse, SingHealth
"The learning is reciprocal: more experienced nurses share their wisdom while picking up new ideas and ways of thinking from younger colleagues. More junior nurses benefit from the guidance and advice of their seniors.”
Both Dr Ayre and Ms Ng look forward to the day when nurses can seamlessly work across different specialties and institutions in SingHealth. “Nurses make up the majority of hospital staff and form the bedrock of healthcare systems. When we move in synergy, challenges are overcome and patient care is greatly transformed,” Ms Ng said.
“We need to look at ourselves as one big family and work together, sharing knowledge and best practices openly across disciplines and institutions. This is instrumental to the advancement of the nursing profession.”
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