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Going beyond call of duty, nurse makes home visits

Nurse makes home visits under hospital care scheme and tends to ex-patient on days off

It is hard to define where Ms Loo Min Min's job starts and ends.

A regular work day for the senior staff nurse involves home visits to patients under Tan Tock Seng Hospital's (TTSH) Post Acute Care at Home (PACH) programme.

PACH is a post-discharge service for patients who need rehabilitative or nursing care after leaving the hospital.


Once inside the flat, Ms Loo cleans Mr Quek, feeds him his favourite dishes and chats with him to lift his spirits. ST PHOTO: DESMOND LIM

A dedicated team from TTSH follows up on cases for up to three months. But Ms Loo, 37, has gone further.

For the past two months, she has been making weekly visits on her days off to help a man who wants to be known only as Mr Quek.


Ms Loo uses a stick to try to retrieve Mr Quek’s house keys as the bedridden man is too weak to get up and open the door for her. The nurse of eight years, who is one of four nurses in TTSH’s Post Acute Care at Home scheme, says “my little actions can give him a more dignified death”. ST PHOTO: DESMOND LIM

He is a patient who was discharged from the PACH programme around April, and is in the final stages of heart failure.

In the stuffy one-room rental flat in Kitchener Road, she banters with the bedridden 75-year-old in fluent Hokkien to lift his spirits.

She feeds him his favourite fish soup and sugar cane juice before wiping his gaunt body and unflinchingly picking the dirt out from under his fingernails and toenails.


Ms Loo cleans a patient with the help of domestic worker Dwi Ekawati, 31, in a patient’s Boon Keng home. The 37-year-old nurse admits that the hours can be long and tiring but tells herself that “it’s not for myself but for the good of others”. ST PHOTO: DESMOND LIM

"I'm motivated, knowing that he might die soon; my little actions can give him a more dignified death," says Ms Loo, who has been a nurse for eight years.

The elderly man has been estranged from his children for years and lives with his 65-year-old brother, who has dementia. They are being taken care of by an elderly woman who is an old friend.

Mr Quek's condition worsened shortly after being discharged from the PACH programme.


Ms Loo and a doctor leave a patient’s flat in MacPherson. The nurse has about 40 patients under her care and visits an average of three every day – half the time on her own and other times with a doctor. She moves around with at least two cellphones, a tablet, a backpack and a cabin bag full of equipment and supplies. ST PHOTO: DESMOND LIM

Ms Loo advised him to get admitted again, but he prefers to stay at home.

A community welfare group now cares for him and visits him periodically.

Ms Loo says she finds it hard to stop caring for him even though he is officially no longer her patient.


Ms Loo checks her tablet (above) while sorting through medication and supplies for her patient, and executes abdominal palpation on the patient. ST PHOTO: DESMOND LIM

She says: "When I tend to patients in their homes, I become more aware of their needs than if I was in a ward. It's only in their own homes that you get to see the genuine needs."

It is a desire to help that drew Ms Loo, who is single, to nursing and eventually to become one of just four PACH nurses at TTSH.


Ms Loo checks her tablet while sorting through medication and supplies for her patient, and executes abdominal palpation on the patient (above). ST PHOTO: DESMOND LIM

TTSH, which is a member of the National Healthcare Group, said the PACH programme "aims to reduce hospital re-admissions and avoid emergency department attendances" and also reduce the need for institutionalised care by helping caregivers become more competent.

Since its start in 2008, enrolment has risen steadily and peaked at about 600 last year.

The job of a PACH nurse involves visiting patients' homes to check on their medication, dress their wounds and communicate with family members and caregivers regarding the patients' conditions.


Ms Loo dons a disposable apron before tending to a patient in his living room. She says she is more aware of patients’ needs when she cares for them at home, and “it’s only in their own homes that you get to see the genuine needs”. ST PHOTO: DESMOND LIM

Each day, Ms Loo moves around with at least two mobile phones, a tablet, a backpack and a cabin bag packed with medical equipment and supplies.

She has about 40 patients under her care and visits about three patients every day - half the time on her own, and other times with a doctor.

She has been with PACH for just under a year and admits that the workload can be challenging.


Ms Loo teaches maid Ms Dwi how to move the patient from his wheelchair to the bed. The job of a PACH nurse involves visiting patients’ homes to check on medication, dress their wounds and communicate with their family and caregivers. ST PHOTO: DESMOND LIM

"The hours can be long and tiring but whenever I feel tired, I tell myself that I'm not the only one working this way."

She adds: "It's not for myself but for the good of others."

In between visits, she writes reports and attends to patients' care- givers who call her on the phone.

"The rapport and trust I get to build with the family of the patients are very satisfying, especially when they know I'm trying my best to help," she says.

A version of this article appeared in the print edition of The Straits Times on June 09, 2016, with the headline 'Going beyond call of duty'. Print Edition | Subscribe