SINGAPORE - Ms Margaret Lee Kwee Hiang, 45, may not have dreamed of becoming a nurse from a young age but she has risen through the ranks to become the chief nurse at Alexandra Hospital (AH), where she has transformed nursing practice.
She started a system that allows nurses, instead of doctors, to take the lead in caring for certain groups of patients, including those who are undergoing certain treatments, those in rehab, and patients who are almost ready to be discharged.
On Wednesday (July 14), Ms Lee was one of seven nurse leaders who received this year's President's Award for Nurses from President Halimah Yacob at a virtual award ceremony. Five nurses won last year. Since 2000, a total of 84 nurses have been conferred this award - the highest accolade in Singapore's nursing profession.
Madam Halimah said: "Beyond clinical achievements, many nominees also have a big heart in serving others in their community."
In her speech, she praised nurses for their "high level of dedication, determination and courage" amid the coronavirus pandemic, and called out the "abhorrent and unacceptable" harassment and abusive treatment that some nurses received from people frustrated with Covid-19 measures.
In its press release, the Ministry of Health (MOH) described Ms Lee, who started as a staff nurse in 1996, as "an outstanding change agent in healthcare leadership today".
Last year, when measures to curb the spread of Covid-19 led to restrictions in hospital visitorship, the mostly elderly patients at AH were left without caregivers by their side.
"I told myself, no, it cannot be like that, there has to be a better way," said Ms Lee.
The immediate solution was to allow liberal Zoom or online visitations so the elderly patients would not feel isolated from their loved ones, she added.
Ms Lee, who has a Master's in Health Sciences, is now piloting a project under which caregivers are involved in the patient's hospital care.
"The whole episode in the hospital is transient, it's to prepare the patient for the eventuality of a home setting," she told ST. This means even allowing the caregiver to stay overnight, as some patients do better when they have someone familiar by their side, she said.
Two other chief nurses were among the winners: Ms Christina Lim Poh Ying, 51, from Sengkang General Hospital, and Ms Lim Voon Hooi, 48, from National Healthcare Group Polyclinics, who have both made notable contributions to nursing.
Two Advanced Practice Nurses (APNs) also won the award.
The first, Dr Huang Fang, 54, became an APN in 2009. Since then, she has has trained and developed eight more APNs in women's service at KK Women's and Children's Hospital (KKH).
Now the KKH assistant director of nursing, Dr Huang obtained her doctorate in nursing practice in 2015 and can prescribe certain medications to patients, after having completed the 14-week prescribing programme that MOH introduced in 2018.
Dr Huang attends to patients on her own within an authorised scope, actively participates in ward rounds, and gives advice to junior doctors and nursing staff. A certified traditional Chinese medicine physician, she has volunteered many evenings of work at the Singapore Chung Hwa Medical Institution.
The other APN winner of the award, Ms Katherine Leong Shiao Pheng, 50, is assistant director of nursing at the National University Hospital's Khoo Teck Puat - National University Children's Medical Institute. She is Singapore's first paediatric APN working in oncology, and has helped expand the role of paediatric APNs.
She obtained a Master's degree at the National University of Singapore's Alice Lee Centre for Nursing Studies (NUS Nursing) in 2014 and has been an APN since 2015.
"I was 44 years old when I finally completed my studies and earned my full licensure as an APN here. The greatest challenge for me was getting there, as I had to juggle being a wife and mother to two primary school-going boys, with studies and examinations," she said.
"After that, everything else was empowering and enabling."
A nurse academic also won the award this year. Dr Shefaly Shorey, 42, an assistant professor at NUS Nursing is the only nursing academic to have received more than $2 million in grants for parenting research here. She has published her research in more than 100 journals.
Dr Shorey was a teacher with a Master's in Biological Science and married with a son when she made the switch to nursing at age 25.
"Nursing was a calling I knew I wanted to pursue to help others after seeing my grandmother battle with cervical cancer," she said.
"After getting my Nursing diploma and while working as a registered nurse, I earned my BSc (Nursing) degree and midwifery specialisation."
She went on to pursue a PhD at NUS Nursing in 2011.
The award also went to Mr Christopher Soh Kok Keng, the assistant director of nursing at Tan Tock Seng Hospital's Emergency Department, who led staff in setting up the screening centre at the National Centre for Infectious Diseases in 24 hours, in the early days of the Covid-19 outbreak.
Nurses form the largest professional group in Singapore's healthcare workforce. As at end-2020, there were more than 42,000 nurses registered with the Singapore Nursing Board, up from 36,000 in 2013. Around one-third of them are foreigners.
The President's Award is among schemes introduced to increase the recognition of nurses. Singapore is also working to improve nurses' prospects and raise their salaries, as it seeks to grow its local workforce due to the rising nursing needs of an ageing population.
Ms Lee, AH's chief nurse, said the career path for nurses is more defined today and there are now more opportunities for growth. Still, the mother of three children - aged 16, 14 and 11 - has had ample opportunities to advance her career, becoming a deputy director of nursing in 2018 and director of nursing last year.
And she did not even set out to be a nurse.
"It wasn't like, from when I was young, I wanted to be a nurse or to be like Florence Nightingale (founder of modern nursing)," said Ms Lee.
"I didn't do as well as I had expected in my O levels, so that was really a tough lesson for me. So, when I got accepted into nursing (at Nanyang Polytechnic), the only thing that was on my mind was, I cannot disappoint my parents. I had to just keep pushing myself to do well with whatever opportunities I was given."
She added that if others believed in her, she must also play her part in believing in herself so as to pay it forward.
Nursing may not have been her first dream but it has given her meaning and success. Ms Lee now wants to develop more nurse leaders for Singapore.
"Being able to answer this call to nursing is a privilege," she said.