International Nurses Day Special: Angels in White Who Are Guardians of Palliative Patientspublished by 8 World News on May 12, 2020
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Translation of article:
International Nurses Day Special: Angels in White Who Are Guardians of Palliative Patients
“Who says we are not at frontline, I feel that we are the ‘front frontline staff’. We enter their houses even before they step into the hospital. We are facing the risks ahead of others.”
It is International Nurses Day today (12 May). During the Covid-19 outbreak, most people are focusing on the healthcare workers who are taking care of Covid-19 patients. However, there are many nurses who are toiling silently and faithfully, doing all they can to be guardians of other patients.
Palliative Home Care nurse Linda Chew is one of them. 37-year-old Linda Chew has been a nurse in Assisi Hospice for four years. Her work includes visiting the homes of terminally ill patients, providing nursing care for them, and educating family members of patients on how to take care of patients at home.
Increase in Palliative Home Care patients
Assisi Hospice and HCA Hospice Care are two palliative organisations that provide palliative home care. During Covid-19, restructured hospitals and community hospitals try to discharge palliative patients as early as possible to prevent them from being infected by Covid-19. Additionally, more patients are choosing to die at home, and these factors have increased the number of Home Care patients for Assisi Hospice and HCA Hospice Care.
The admission number of Home Care patients for HCA Hospice Care in April 2020 has increased by 40% compared to April 2019; the admission number of Home Care patients for Assisi Hospice from January to March 2020 has also increased by 42% compared to the same period last year.
There are 14 Home Care nurses in Assisi Hospice, and Linda Chew is one of them. To support the work of the nurses, Assisi Hospice has started a fundraising campaign on International Nurses Day.
Though the number of home visits has reduced from four to five patients a day to three to four patients a day during the circuit breaker period, she has not relaxed. The ever-evolving preventive measures and having to face patients who may be high risk have added to her challenges. Despite so, she finds the work even more meaningful during this period of the pandemic.
“To prevent the spread of the virus, there has been restriction in the number of visitors in the hospice. We only allow two visitors per patient. It has been a very trying time emotionally for me, witnessing many not being able to spend time with their loved ones like before. Serving as a Home Care nurse in these times is especially meaningful to me, as helping patients stay at home would allow more families to spend more time with their loved ones during the final moments in their lives.”
“For patients near their end of life, they do not have much time left, hence these moments are very precious.”
Sweaty in full gear
Challenge in finding place for a meal
Linda Chew starts work at 8am every day. The first thing she does is to call the patients she cares for, asking how their condition is, before deciding if she needs to visit them. As patients with life-limiting illness are more vulnerable and their risk of infection is higher, hence Assisi Hospice stipulates that all Home Care nurses have to adhere to strict infection control measures, including sanitisation, donning the protection gown, gloves, shoe covers and masks before entering the patients’ homes.
As the weather in Singapore is hot and humid, Linda is usually drenched with sweat after a visit. “It is actually very challenging to be working in this gear. Some homes have no fan and it is very uncomfortable during our visits at times. After our visits, we are usually drenched with sweat.”
Having meals is also a big challenge. As she is unable to find a place to sit down and have her lunch, she usually waits till she is back in office before she has a proper meal.
“Seats in coffee shops and hawker centres are blocked. Even though NEA has told the food stallholders that community healthcare workers can eat in the premises for short while and alone, they are still very fearful and have been disallowing us to do so. We would usually skip lunch, and just eat some snacks or bread first.”
Palliative Care nurses bear with physical and emotional stress
In addition to physical challenges, palliative nurses like Linda Chew experience the grief of witnessing the passing of her patients. During this period, she feels more deeply about the heartache of not being unable to show care for her patients physically.
She said that after the pandemic ends, she hopes to give her patients a big hug. “It’s very sad that now we can’t do what we took for granted, like a hug, a handshake.”
“Our patients are mostly near their end of life, you see them now, but after a few hours or a day, you may not see them anymore. So after the pandemic, what I want to do is to give them a big hug.”
Similar to other healthcare workers, Linda Chew bathes immediately once she reaches home. She will separate her clothes from those of her family members, and minimise contact with them, including not having meals together with them.
“I spend most of the time in my own room, and I can’t hug them too. This is difficult for me, but for the sake of everyone’s safety, it is worth it.”
Even though she needs to go out for work and be in contact with patients during the pandemic, Linda’s family is very understanding of her work. However, she needs to constantly reassure her mother. “I need to reassure my mother and let her know that we do the necessary precautions.”
“My family is very proud of my work, they feel that we are angels in white.”
During the pandemic, frontline workers face enormous pressure. As it is International Nurses Day, Linda Chew wishes to encourage all nurses and healthcare workers to take good care of themselves physically and emotionally and learn to self-care.
“Only then we can play our part well and take good care of our patients.