SINGAPORE: With an ageing population, Singapore needs more healthcare workers, including nurses. Against that backdrop, attempts are being made to attract more people to a nursing career, partially to help fill the 9,000 healthcare vacancies that will need to be filled over the next few years.
There is evidence that progress is being made in recruiting more nursing professionals, but experts say it is more important than ever not just to attract nurses, but for the government and hospitals to do more to retain its best and brightest.
Channel NewsAsia spoke with four current and former nurses from diverse backgrounds to understand the daily rewards and challenges they have faced and what could be done to make their chosen career even more fulfilling.
NURSES ARE TREATED AS ‘HIGH-CLASS MAIDS’: NURSE PRISCILLA'S EXPERIENCE
As a new nurse, Priscilla was committed to her job. "Nursing is a rewarding career. I love that I am be able to give to the lives of others and it is my privilege to support my patients in their times of their difficult moments," she said.
Working in a public hospital, Priscilla reported to work at about 7am when she was on the morning shift. After the hand-over reports were completed, her job included changing bed-sheets, serving medication and taking patients for their shower and bathroom routines.
After that, there were administrative duties such as arranging scans for patients and also taking their blood.
But after five years, the 25-year-old decided to call it quits. This despite having left for a year to go to Australia where she attained a degree in nursing.
“I was a bit burnt out because of the whole ward,” Priscilla said. “In a lot of hospitals, nurses are treated quite badly. I got screamed at by doctors, by patients and their families. I have seen so many of my colleagues crying because of verbal abuse from families and that really burns people out as well.”
The working environment and the challenges in adapting to shift work gave her an added push to leave the hospital sector. She said she is not alone - she knows of five others who left the sector, all of them young nurses. Priscilla has now been working as a home nurse for about two months, while looking for a nursing job that would provide a shift she finds more acceptable.
She said that briefly working in Australia while she was studying opened her eyes to what it means for nurses to be respected. “In Singapore, nurses are treated like high class maids sometimes,” she said.
“A lot of people do not know what we actually do. So when they talk about nurses, the older generation has this mindset that ‘Oh nurses, clean backside one’. I have heard from so many people that they did not know what nurses do until they have been in that position where they need the treatment from the hospital or someone they know was hospitalised.”
She felt that the situation in Australia is better because nurses have more authority. “For example, this really heavy patient wants to get out and go to the toilet and let’s say the nurse in the hospital is alone and her colleague went for a break, she has the right to say ‘No. Either do it yourself or you wait for my colleague to come back because I am not going to hurt my back while assisting you alone’. In Singapore if you do that, someone will file a complaint.”
Priscilla said nurses in Australia also have an input during medical rounds, with the opportunity to discuss treatment options with a doctor. Nurses are more involved in discussions that revolve around patients’ treatment and medication options, and this was something that she valued.
But despite having left the public sector, Priscilla still sees nursing as a fulfilling and lifelong career. "I love the sense of fulfillment when I see a patient who once required complete assistance regain their full independence," she said.
"I also love that nursing is a career with unlimited opportunity for growth, there's always something new to learn if you set your heart to it."
PAY IS BETTER IN SINGAPORE: NURSE GEMMA
For ten years, Gemma worked as a nurse in an operating theatre, where her daily routine included checking equipment and supplies needed for the day and assisting the doctor with surgery.
Work was very fulfilling and she valued the supportive working environment among the nurse managers and staff. She said her superiors would look out for the more capable and driven nurses early on, and push them into more challenging roles.
But after ten years, she applied for a nursing license to work in Australia. “I just wanted a change of environment,” she said.
“There was one day I worked from 7am until late night and then after that I was called back at 3am. I was assisting a case until 5am. Then after that the patient turned bad and I had to go in again and I start my shift at 8am.”
Gemma said such incidents were not frequent, and in this case, her nurse manager told her to “go back and sleep” instead of turning up for her 8am shift. But the work load and shift hours eventually got to her, and she had heard good things from her friends about being a nurse in Australia.
“They like the work-life balance there and they say the doctors are so much more polite and there is just a slower pace of living there. My best friend works in Australia as well, so I was like okay - why not?”
Before she could move, however, she met her boyfriend, who is now her husband. Gemma moved to Europe shortly after, and now has a toddler. She plans on working as a nurse there, but has heard salaries for foreign nurses are low in comparison with Singapore.
“I was having a discussion with some of the foreign nurses here, and I said, ‘Oh in Singapore we have year-end bonuses’ and they said they don’t have it here.”
“I think in the beginning my pay (in Singapore) sucked because after we graduate, we start off as staff nurse then your probation period your basic pay is $1500 then you have CPF deducted so it’s like $1200 to bring home,” Gemma said.
“That was probably the first three months then when you start to go on shift duties, you get a little bit of extra allowance. After 6 months…it increases slightly. At the end of 10 years, my gross was about $4,000, so by then I was comfortable.”
NURSING IS A CALLING: NURSE ABIGAIL ON WHY SHE JOINED THE SECTOR IN HER 30s
When Abigail decided to pursue a career in nursing, she was a single mum in her early 30s. Having worked in the food and beverage industry and later in a bookstore, nursing was a career she never gave much attention to.
That changed after a surgical procedure. While in hospital, she was inspired by the nurses who were caring for her. “It made me think ‘what do I want to do with my life?’” she said.
“Honestly, people do ask me why this career switch at that age. They say nursing is a calling and I honestly felt like it was for me.”
She started work, after graduating from ITE, as an enrolled nurse.
“I was thinking…I’ve got my hospital benefits for me and my kid. I was happy with that,” she said. “But as I was working, I realised that I really liked what I was doing. I really enjoyed the interactions with the patients, but not so much with the doctors. Then I told myself that I can actually be of further use to these patients. I can actually broaden my knowledge and I decided to continue with a polytechnic (diploma).”
Abigail went on to self-fund her way through university, recently graduating with a degree. She has observed the number of those switching careers mid-way to become nurses seems to have increased. And with them, they have brought a different attitude and passion for their job.
“I would say the passion is more, the patience is more, everything is more compared to the ones who have stayed there longer,” she said. “But if you ask me this in five years’ time, my answer might change! Because these people have been here for so many years.”
Abigail said burn-out is a challenge for those who started out young. “For a lot of them, the passion dwindles because of exhaustion and again it falls back to the quality of life,” she said.
“I’ve been there for 11 years now and I have a colleague who has been there longer than me and she’s the same age as me. She just comes in and does her job and goes.”
“She’s not local (and) she just wants to make her money because she’s got a family back home. She does not want to upgrade herself but just make the money and eventually leave. She’s exhausted. I think her priority is to come to work, do her work, not make mistakes and just leave.
“When I look at her, I tell myself I hope I don’t end up like that because I do enjoy what I do.”
THE REWARDS OF HOME VISITS: NURSE SALLY
As a home nurse, Sally tends to patients’ medical needs, be it cleaning wounds, changing a feeding tube or packing medication. But she also goes beyond her job scope when the need arises. “If patients stay alone they will need showering, housekeeping, mind-stimulating activities. So I will come in and assess all the patients,” she said.
This type of work suits her better compared with the shifts at hospitals, where she worked for 13 years before she decided to leave after the birth of her eldest child.
Sally said her current job gives her the flexibility of taking her children to childcare before visiting her first patient, usually by about 9:30am. She said her salary is much less than what she would be getting working in a hospital, but she values the extra time the job gives her to look out for her family.
When asked if she would go back to working in a public hospital, Sally said home nursing provides her with not just flexibility but a greater sense of meaning.
"In home care they really look forward to us coming. I do spend some time and talk to the patients and even their helpers. So they really appreciate my presence. Sometimes they will cook for us also. You start to build a rapport with the patients"
*The names of the nurses have been changed at their request.
This is the second of a two-part series on the future of nursing in Singapore. The first part seeks experts' opinions on how to ensure Singapore has enough nurses to deal with an ageing population. Read part one here.