Nurse, innovator, educator: She brings hospital care into homes – and trains others to do the same

At family dinners, it is common for conversations about work to trail off quickly. Different professions come with different demands, and not everyone around the table understands what the other does.

In Ms Joyce Er’s family, that barrier does not exist. With three other nurses in the household – her younger sister, younger brother and his wife – conversations are grounded in a shared understanding of care and service.

Ms Er, now 48, is the eldest and the first among her siblings to enter the profession. Over time, others followed suit and nursing became a shared point of reference rather than something that needed explaining.

Watch this video to find out more about what Ms Er does.

Today, she is a nursing lead for education and training at NUHS@Home – a service that provides hospital-level care in patients’ homes – and an Advanced Practice Nurse at Alexandra Hospital.

Over 26 years in the profession, her career has taken her across acute hospital settings, specialised oncology services and, more recently, into shaping how care can be delivered safely beyond hospital walls. She shares more about her journey and how the profession has evolved.

Q: You have been in nursing for almost three decades. How did your career journey begin, and how has it evolved?

I started my nursing career in 1999 after completing my diploma in nursing at Nanyang Polytechnic. At the time, I was deciding between becoming a nurse and a teacher. There was strong demand for nurses then, and conversations with my parents helped affirm my decision.

My early years were spent at KK Women’s and Children’s Hospital, where I rotated through obstetrics and gynaecology, as well as paediatric medical, surgical and intensive care units (ICU).

One defining period was during the SARS outbreak in 2003. I was deployed to Tan Tock Seng Hospital to help set up a temporary paediatric ICU to care for children suspected of having SARS. That experience deepened my understanding of the responsibility nurses carry and reaffirmed my commitment to the profession. But it also made me realise that I wanted to do more beyond paediatrics.

I later spent time in Australia, where I completed my Bachelor of Nursing at the University of Sydney in 2005. While studying, I worked part-time as a registered nurse at Royal North Shore Hospital.

In 2006, I joined the National University Hospital’s Cancer Centre and later became part of the gynaecological oncology team, where I helped initiate and expand women’s cancer services. This included surgical care, clinical trials, survivorship programmes and cancer genetic counselling. I was also involved in organising patient support groups and training primary care nurses in cervical cancer screening.

Then, I moved to Alexandra Hospital in 2019, where I continue to work in acute general medicine while leading nursing research and evidence-based practice. In 2023, I took on an additional role at NUHS@Home, expanding my portfolio to include the development of nursing services, education and training for home-based acute care.

I am also pursuing a Doctor of Nursing Practice to strengthen my ability to lead and influence nursing practice at a systems level.

What has stayed with me over the years is the human connection. I cannot think of a day in nursing where there is no human touch involved, and that is what continues to bring me joy. Knowing that I am needed by others is what motivates me every day.

Q: What does your current role at NUHS@Home involve, and how is it different from traditional nursing roles?

My role at NUHS@Home is more focused on training and education as well as service development. I help to bring hospital care into homes.

Earlier in my career, patients would sometimes ask if care could be extended into their homes, but that was not possible then. Nursing was largely confined to hospital settings. As the healthcare landscape evolved, programmes such as NUHS@Home now allow nurses to provide more continuous and holistic support to patients beyond the hospital.

Because many nursing skills have traditionally been hospital-based, a key part of my work involves developing training programmes to prepare nurses for this home-based model. I work closely with nurses to understand their challenges, identify learning gaps and ensure care is aligned with best practice, supported by technology where appropriate.

Q: What are some initiatives that you have started?

In 2022, I worked with a group of nurses at Alexandra Hospital to simplify nursing documentation. We reviewed both clinical and non-clinical forms, removed duplication and digitised processes where possible. The number of forms was reduced by almost half and it helped improve efficiency. This approach has since been adopted across other NUHS institutions.

At NUHS@Home, we introduced Entrustable Professional Activities, a framework used to assess how ready newly joined nurses are to carry out specific tasks independently in home-based settings.

We also implemented emergency simulation training to strengthen nurses’ ability to recognise and respond to clinical emergencies during home visits. These initiatives show that nurses can play a leading role in improving systems and processes.

Q: What are some of the key skills required to be successful in nursing?

Agility, critical thinking and the courage to step into new roles are increasingly important in nursing today.

Healthcare is constantly evolving, so nurses need to adapt to new care models, technologies and patient needs. Critical thinking is just as essential, as patient care today is more complex, and nurses are expected to assess situations, make sound clinical judgments and work closely with other healthcare professionals to shape care plans.

Courage also matters – the courage to take on responsibilities that may not have existed a decade ago, and to keep learning and growing.

A career in nursing does not always follow a straight path, but there are now structured pathways across clinical practice, education, research, management, innovation and informatics, as well as hybrid roles that combine these areas.

My advice is to approach nursing with openness and a willingness to keep learning. It is a profession that offers growth, purpose and the opportunity to make a meaningful impact on patients and communities.

Find out more about the career opportunities in nursing here.