SINGAPORE - At the Institute of Mental Health (IMH), senior nurse clinician Aziz Ab Hamed, 60, has been preparing a selected group of long-staying patients for life outside the hospital.
The work started in 2015 when he and several colleagues spearheaded a rehabilitation programme to equip these patients with independent living and vocational skills, to show that it is possible to recover from mental illness.
It has since led to the discharge of 120 such patients, whose stay at IMH lasted for about a year to as long as 18 years. They include a man in his 60s now living at a care home and others in their 20s and 30s. The majority have schizophrenia and have never worked.
Mr Aziz is among six nursing leaders who are always looking to improve the way things are done, constantly learning and inspiring other nurses to do better.
On Tuesday (July 26), they received the President's Award for Nurses, the highest accolade in Singapore's nursing profession, from President Halimah Yacob in a ceremony at the Istana.
At IMH, the long-staying patients under rehabilitation had started on soil gardening, among other programmes. Mr Aziz later set up a hydroponics garden where patients grow vegetables, which are now sold at the IMH lobby twice a week.
As motivation, the patients - Mr Aziz calls them clients so as not to treat them as patients - are paid a small hourly rate that corresponds with the difficulty level of the work, from seed sowing to transplanting, harvesting and so on.
He also started a fund with the excess money, and set up a cafe in the long-stay wards to train selected patients in cooking local dishes and kitchen management skills, and is thinking up new projects to help his patients.
"In the past, we made sure they ate and slept well. Now, we embrace recovery," which meant teaching the patients the skills to survive on their own, said Mr Aziz.
"I believe I can do more to instil hope in my clients, to make their lives more meaningful."
Before joining nursing 30 years ago, Mr Aziz, who is divorced with two adult children, had worked as a birdkeeper, a production operator and forklift driver.
New ways to care for patients
"I always dream big, and would advise them (new nurses) to take small steps to reach their dreams," said Ms Julia Eng Chui Lee, 47, deputy director of nursing at KK Women's and Children's Hospital (KKH).
She studied to be an advanced practice nurse (APN) in Melbourne, Australia, in 2002, and has since groomed 34 APNs, who can diagnose and manage chronic illnesses as well as provide complex nursing care to patients.
Ms Eng, who also leads KKH's nursing research and nursing education department, started several APN clinics, including one in 2015 where gynaecological cancer patients consult an APN to prepare for their surgery. This has helped to cut their post-surgery stay from seven to eight days to two to three days, she said.
The nurses would check to see if the patients are malnourished and need nutritional tips, or are frail and need a referral to a physiotherapist, for instance.
"A lot of times, with bad news, they can't retain information very well and so when they come (to see us), they still have a lot of questions," said Ms Eng, whose work may also involve end-of-life care for patients.
Married with two teenagers, Ms Eng also finds time to lecture at two schools.
At Assisi Hospice, senior nurse educator Liu Fang, 42, played a major role in developing a workshop to help staff handle the challenging communication with patients and their families in a palliative care setting, which was made worse by the Covid-19 pandemic.
"The most important part of palliative care education is shaping the right attitude and mindset," said Ms Liu, adding that it is about getting nurses to truly understand the philosophy of palliative care, and not just help patients to die peacefully but to live well till the end.
For Ms Zhang Di, 46, an APN and assistant director of nursing at Sengkang General Hospital (SKH), her contributions to community nursing are obvious, among her many achievements.
She set up SingHealth's first Community Nurse Post in a senior activity centre and was instrumental in the development and delivery of geriatric-care training at SKH.
Beacon of strength in pandemic
Ms Png Gek Kheng, 50, became the chief nurse at Changi General Hospital (CGH), with more than 2,500 nurses under her in the middle of the pandemic in 2020.
This saw her having to rally staff through innumerable workflow changes in order to continue caring for patients in the hospital and migrant worker dormitories, where swab operations and medical posts were set up.
She is also an APN and co-director of the CGH Wound Healing Centre, the idea for which started a decade ago with a task force she set up to address the pressure injuries of the patients.
Ms Png, who took up nursing in 1993, believes in challenging herself and her colleagues to re-imagine the role of nurses in a multi-disciplinary team.
At Tan Tock Seng Hospital, Ms Nirmala Karmaroon, 56, deputy director of nursing, led the nursing team through the surges in Covid-19 cases.
Among her achievements in a field that she entered as a teenager 40 years ago was managing manpower planning to ensure patient care could be maintained alongside a balance in nurses' work lives.
Lifelong learning is a common thread among the awardees. If they are not pursuing a course, they are busy imparting knowledge to other nurses or nursing students, or contributing to the development of new nursing frameworks.
Age is no barrier. For instance, Mr Aziz pursued a Masters of Nursing (Mental Health) at the National University of Singapore at the age of 48. He was the oldest student in the course.
Ms Zhang is doing a doctorate in nursing practice at Duke University.
The President's Award for Nurses started in 2000, and has since recognised 90 recipients, including the latest awardees, for sustained outstanding performance and contributions to patient care delivery, education, research and administration, said the Ministry of Health.
Recipients of President's Award for Nurses
- Mr Aziz Ab Hamed, 60, senior nurse clinician at Institute of Mental Health
- Ms Julia Eng Chui Lee, 47, deputy director of nursing at KK Women's and Children's Hospital
- Ms Liu Fang, 42 , senior nurse educator at Assisi Hospice
- Ms Nirmala Karmaroon, 56, deputy director of nursing at Tan Tock Seng Hospital
- Ms Png Gek Kheng, 50, chief nurse at Changi General Hospital
- Ms Zhang Di, 46, assistant director of nursing at Sengkang General Hospital