Lim Chi Ching, who is currently 20-years-old, had wanted to be a doctor all along, and with her stellar ‘A’ level results – she got four A’s – it could very well have happened. But when the time came, she didn’t apply to study medicine. She chose to take up nursing instead.

“I realised that my character is more suited to nursing. A doctor provides care from diagnosis, but pre-operation and post-operation preparation and encouragement is important too. I want to be able to support a patient on his route to recovery, to cheer him up,” she says.

Studying nursing
It happened to be a good time for such a decision, as Singapore’s first local nursing Bachelor’s degree programme was initiated in August 2005, when Chi Ching was applying to enter university. The three-year course is offered by the Alice Lee Centre for Nursing Studies, which is part of the NUS School of Medicine.

Chi Ching clinched a full scholarship with National Healthcare Group (NHG), and she will be serving her bond at National University Hospital (NUH) for three or four years after she graduates, depending on whether she would pursue an Honours qualification.

Nursing students are taught subjects like nursing sciences, pathophysiology, immunology and psychology. Chi Ching believes that these modules will help equip future nurses with the necessary skills to do their jobs well.

Knowledge of pathophysiology, for example, allows nurses to help with the diagnosis process by identifying symptoms of certain illnesses or conditions and interpreting blood test results. They can then notify the doctor if the patient needs immediate attention. “This will give nurses more autonomy and let them have better control of urgent situations,” she says.

Practical experience
As part of the nursing course, students also have to take up clinical attachments. This consists of holiday attachments and weekly practicums during the school term, where they practise the skills acquired throughout the week.

“A lot of these skills like tube insertion may seem easy in the lab, but when it comes to doing it on real patients it isn’t that simple, especially when conditions are not as controlled,” Chi Ching says.

These attachments start from the first semester, and each student will follow a trained mentor to gain on-the-job experience.

So far, Chi Ching’s attachments have given her greater exposure and understanding of working life. During her practicum in October last year, for example, she witnessed a breast cancer patient’s death. It was the first time that she had seen a death. “It hit me that patient education is so important. Breast cancer deaths are preventable, and as nurses we have to reach out to patients and educate them about early diagnosis,” says Chi Ching.

Another incident that left a lasting impact was when an elderly Bangladeshi patient complained of chest pains and his heartbeat raced to 195 beats per minute (adults usually have resting heart rates of 60 to 100 beats per minute). “To be honest, I was quite scared when the alarm sounded and I didn’t really know what to do because I didn’t have enough skills then. I could only hold his hand and sit beside him,” Chi Ching confesses.

Fortunately, the man recovered and was discharged a few weeks later, but it led her to wonder what if a patient she looked after couldn’t pull through.

“I realised that although I have to be empathetic to the patients, a line must be drawn and it’s necessary to separate my own life from the job so that I wouldn’t have to carry the additional emotional burden.”

Changing perceptions
Chi Ching admits that some people think that nursing is a “dirty job”, since they have to do things like handle excretion and bathe the patients. But she says that there’s also a lot of satisfaction. “Nurses provide holistic care from top to bottom. They don’t just handle the disease alone. All these are part and parcel of the job.”

“Growing old or getting sick is something everyone has to go through, we must remember that these patients are just like us, but they cannot do things that we take for granted,” she adds.

On top of providing direct care for patients, nurses also have to handle written work. “Everything has to be documented properly, from what medicine is given to the food intake and excretion. Also, nurses have to follow up on doctor’s orders and make arrangements accordingly. This is why time management is very important,” she says.

Despite the importance of nurses in the healthcare system, Chi Ching admits that there is still a general perception that nursing is a “lesser” profession. She says firmly, “Health-care is a system, and without support from all the health-care professions, it cannot be sustained.”

“The SARS epidemic did lead people to appreciate and recognise nurses more than before. But to really change that perception of us, we still have to prove that we nurses have more knowledge than people think we do.”

Career path for nurses
People with a Bachelor’s degree in nursing like Chi Ching would typically start as Staff Nurses, and then move on to become Senior Staff Nurses. After that, they can branch out to three different tracks: Clinical, Management or Education.

Nurse Clinicians are involved in bedside nursing and improving patient care, Nurse Managers are responsible for managing a ward, and Nurse Educators are in charge of teaching nurses.

After achieving senior levels in their respective tracks, they can become Advanced Practice Nurses, Assistant Directors in Nursing Management, and Assistant Directors of Nursing Education. Finally, they may one day become Directors of Nursing.

Follow your heart
Chi Ching feels that the job scope of nursing is changing and that nurses will have more autonomy in the near future. This is why she hopes that potential nursing students can see the different aspects of nursing beyond bedside care.

“You should assess whether your character suits the job as a nurse, and most importantly, follow your heart. Keep that passion burning and remind yourself of the care you provide. The patients really do appreciate it,” she says.

“The job satisfaction that nursing offers is something that you cannot get from other jobs,” Chi Ching concludes. “Seeing a patient recover is like seeing a new life being born – you’ll come to appreciate life more.”

"This article was first published in the Vol 2: 2007 of Career Central Magazine and is used here with permission.
For more information about Singapore's only campus career magazine, please visit http://www.careercentral.com.sg"