Nurses are highly trained healthcare professionals who provide comfort and care to those who have fallen ill. But contrary to popular belief, that isn't all that nurses do.

Like doctors, nurses can pursue different tracks in their career, allowing them to improve professionally and expand their knowledge across diverse fields. Some nurses may opt for roles in community health, providing support and healthcare services directly within the Community Care sector.

Others choose to specialise in surgical procedures, focusing on assisting with surgeries as a perioperative nurse. Besides clinical work, nurses also have the option to be involved in research and educational work and training a new generation of healthcare providers.

In this article, we interview five nurses from Tan Tock Seng Hospital (TTSH) to examine their various nursing specialties and how they navigate the challenges and rewards of their chosen paths.

  Technology has helped reduce the burden placed on healthcare professionals in Singapore. The SMART ward at Tan Tock Seng Hospital (TTSH) gives a preview into the future state of inpatient care where it adopts a sandbox approach to rapid test innovations safely in a real-world patient environment. General ward nurses like Isaac, one of the pioneering SMART Ward team members, have the opportunity to incorporate digital technology and Artificial Intelligence (AI) into his work to improve patient care and work productivity.

Smart Ward predominantly manages general medicine patients who are mainly elderly with complex needs. Thus, Isaac must be well-versed with all sorts of medical conditions.  

Isaac said "Being in General Medicine ward means we get exposed to a variety of cases across a wide spectrum of acuity. We also tend to have sick patients who suddenly deteriorate or even collapse, requiring resuscitation."

This makes for a fast-paced work environment where things are constantly changing. Because of this, Isaac and his colleagues have access to various innovative tech devices designed to free up repetitive and labor-intensive tasks so that they can focus more on patient-interaction time and see to more acute and complex cases.

One example of how technology is helping nurses like Isaac is using automated bed turners, which turn patients over every two hours to prevent bed sores.

"When patients are bedridden for an extended period, they may develop pressure ulcers, which occur as a result of prolonged pressure on the skin and underlying tissues. This constant pressure reduces blood flow to those regions, depriving the skin and tissues of oxygen and essential nutrients," explains Isaac.

"Over time, this lack of blood flow causes the affected tissue to break down, forming sores or ulcers."

In the past, nurses had to turn patients over, using their own strength, which was laborious, time-consuming and prone to back injury. But thanks to these automated bed turners, Isaac and his colleagues no longer need to turn bedbound patients by themselves every two hours and unintentionally disturb patients from their sleep.  

The Smart storeroom is an inventory management system which uses smart weight sensors. This helps nurses to track item consumption and restocking while also providing automated report generation for more streamlined inventory accountability.

“All I need to do is walk in and type what I want on the display panel, and I'll know where to find it and how much is left. No more time is wasted getting lost in the storeroom!"

Other examples of tech still on trial include using augmented reality (AR) communication headset which allows clinicians to issue voice commands to contact relevant personnel for virtual discussions, so that timely decision-making or care plan can be made anytime and anywhere, even off-campus. The headset has a voice-to-text command function, which will enable nurses like Isaac to treat a wound and document the clinical procedure hands-free.

From Isaac's perspective, technology, data analytics, and even AI have a vital role to play in the future of healthcare. Innovation is no longer a wait and see luxury, but one that is mission critical. Initiatives and ideas in Smart Ward are constantly being rapid tested, re-purposed and planned for scaling up to strengthen the re-design of care and work processes in TTSH.  

  Nurses can also be found outside the acute hospital setting, and for Community Nurse Pearlyn Chee, this is what makes her job so rewarding.

Pearlyn, now as part of the National Healthcare Group Population Health Campus explains, "Besides the usual nursing care that we provide, community nurses also engage with different community partners. We help to connect members of Singapore's elderly population with different community and health resources."

In her role as a community nurse, Pearlyn performs home visits to check on patients, holds health screenings for the community, and leads health workshops to boost healthcare awareness.

Rather than being based in the hospital, community nurses travel into the heart of Singapore's communities to provide care.

"In a community care setting, you can expect to deal with a broad spectrum of disease and physical, social, and mental issues. Because of this, my role requires me to collaborate with other healthcare professionals and community organisations."

"If my team is looking after a senior who is at risk of social isolation and frequent falls, we would collaborate with the Active Aging Centre (AAC) for befriending services. And if it's needed, we may put the seniors up for close monitoring in the community and also explore if other services such as Meals on Wheels (MOWs) or Home Personal Care (HPC) are required."

Alternatively, Pearlyn may reach out to a primary care physician to rule out primary causes and get a Physiotherapist or Occupational Therapist onboard to maximise function and possibly assess the home environment.

Bringing all these resources together, Pearlyn acts as a pivotal link between the elderly patient and the comprehensive care they require. She coordinates with various service providers, ensuring that each aspect of the patient's needs—be it medical, social, or psychological—is addressed.

By conducting regular assessments and maintaining open lines of communication with all parties, Pearlyn can adapt care plans as the patient's condition evolves. This holistic approach not only enhances the quality of life for the elderly in her care but also empowers them to maintain their independence for as long as possible.

  Perioperative nurses, also commonly referred to as surgical or operating room nurses, specialised in providing care to patients before, during, and after surgery.

In the operating theatre, perioperative nurses comprise Scrub, Circulating and Anaesthesia nurses.

"Perioperative nurses (like myself) are typically rotated within our own disciplines amongst the various sub-disciplines. As a scrub nurse specialising in orthopaedics, I can be assigned to areas such as trauma, adult reconstruction, and sports, just to name a few."

As a perioperative nurse, Rachel assists surgeons during procedures, but keep in mind that this goes beyond just handing surgical instruments.

Before surgery even begins, Rachel and her colleagues are already busy at work preparing the operating theatre (OT) and checking surgical equipment.

After that, they will prepare the patient for surgery by confirming vital information such as the patient's name, IC, and when they had their last meal.

"It's important to confirm patient details and perform safety checks prior to each procedure, especially knowing when they last had a meal helps to prevent anesthesia-related complications such as aspiration. Aspiration occurs when food or liquid present in the stomach is vomited and then breathed into the lungs, which can cause serious issues."

After the surgery, scrub nurses clean, dress, and transfer the patient back to their bed and they are subsequently sent to the post-anaesthesia care unit (PACU) for recovery. The nurses then reset the theatre and get ready to receive their next patient.

Given the nature of Rachel's specialty, she is no stranger to high-pressure situations, but one incident still stands out to this day.

"I was the scrub nurse for a procedure involving an orthopaedic trauma patient (someone who has sustained injuries to their bones or joints due to an accident or fall). The patient was an elderly and had other comorbidities, which increased his general risk for surgery," says Rachel.

The case was a complex one, and the patient lost a significant amount of blood. At the six-hour mark, the patient's blood pressure started to crash, and there was a rush to stabilise the patient and complete the surgery.

"It was all a mad rush, and it felt like organised chaos, and the scrub nurses had to work in tandem to prepare the necessary items. Surgeons were calling out for "more gauze", "sutures", and haemostatic agents - these are drugs used to stop bleeding."

At the end of it all, the patient pulled through and was wheeled off to the ICU. For Rachel, it was all extremely gratifying, and it confirmed her passion for nursing, reinforcing her commitment as a scrub nurse.

  As an Acute Internal Medicine Services Nurse Kimberley-Ann Tan combines clinical and communication skills to care for her fellow Singaporeans.

On TTSH's Acute Internal Medicine Services Ward, Kimberley and her colleagues treat patients with acute issues with the aim of discharging them within three days. Their responsibilities include screening patients from the emergency department, physically checking on those under their care, administering medication, and following up with doctors' instructions.

When Kimberley first joined TTSH as a Staff Nurse, it was at the height of the COVID-19 pandemic. Due to the strict safe distancing measures back then, orientation programmes were delayed and carried out online.

Because of this, much of Kimberley's learning was ad-hoc or on the job. All of which added to the stress of working throughout a pandemic, but Kimberley stayed strong and reminded herself that she was entrusted with the duty of looking after someone else's life at their most vulnerable state.

In addition to caring for patients, Kimberley is also a member of TTSH's social media team where she collaborates with other nurses to produce social media content for the hospital.

For Kimberley, this is an excellent opportunity for her to utilise her background in communications while still caring for the ill.

As she puts it, “This (hybrid arrangement) allows me to get the best of both my communications and nursing backgrounds."

In fact, Kimberley's involvement with the TTSH social media team has allowed her to achieve one of her childhood dreams which was to become a radio DJ.

“Nursing has been so fulfilling, but my passion for media and comms has remained close to my heart. Now with the launch of TTSH Nursing's nursing podcast: “Roll Call", it's a dream come true for me."

  As a nurse in TTSH's Medical High Dependency Unit, Lim Xin Min cares for General Medicine and Neurology patients. Given their conditions, patients in this ward must be closely monitored for any sudden changes in their conditions, and if needed, stabilised to prevent further deterioration.

As she explains her duties, “I am responsible for the care of patients who are considered 'too ill' to be managed in a General Ward but does not yet require admission into Intensive Care Unit. Some cases include patients with respiratory failures, severe systemic infections, or drug overdoses."

Besides caring for patients on the high dependency unit, Xin Min has also been working on the path towards the TTSH's Hybrid Nurse-Clinician Scientist career track. This career track is designed to allow nurses to leverage on their proximity to clinical areas to pursue research that is clinically relevant.

“As part of my Hybrid Nurse-Clinician Scientist training every week, I am given a day to work on any ongoing research and data analysis projects."

Xin Min's research work includes a variety of tasks such as confirming research topics, writing applications for grants and review boards, and liaising with stakeholders. Her other responsibilities include developing interventions for research projects or providing consultation support to nursing peers.

“Through this work, I have been able to represent my department and the hospital in facilitating workshops and presenting my research work at conferences, so that other nurses and healthcare professionals can learn about the good work we do in Nursing Research and Evidence-Based Practice," says Xin Min.

Being paved for this career track has also allowed Xin Min to take on additional training outside for nursing. For example, this includes being accepted into the Support for Aspiring Research Talents (StART) mentorship programme.

Under the StART programme, Xin Min participated in research-related courses such as Grant Writing and usage of basic statistical software. She also had the chance to write a Domain Specific Review Board (DSRB) application and work on her primary study.    

Keen to Pursue a Career in Nursing?

All nurses play a key role in Singapore's healthcare system, providing expert care across various medical specialities.

MOH Holdings (MOHH) is offering local and overseas scholarships to nurture the next generation of nursing, pharmacy and allied health professionals. These scholarships are in partnership with public healthcare institutions and allow you to study in local and overseas universities. For more details on the health science disciplines (including nursing) offered, check out this page.