Venturing into the community

June 2018

It was just 12 months into community nursing when I encountered an unconscious patient in her home.

You may think that I would be accustomed to such incidents as a nurse. To some extent, yes; before I switched to community nursing, I had worked in a general ward where I had to handle emergency cases. However, I was working with other healthcare professionals in the hospital and I could count on them for guidance and advice. As a community care nurse on a home visit, there was no one I could look to except myself.

It was just another day, another routine home visit. But as I got closer to my patient’s home, I heard sobbing and yelling coming from her home. Alarm bells rang in my head. Something was amiss.

I dashed into the house and found my patient – who was once in a stable condition – lying on the floor, face purple. I was frightened; this was the first time I had encountered such an incident during a home visit. However, I knew I had to keep a clear head as my patient’s family was looking to me for support. My instincts kicked in and I dived straight into checking her vital signs before commencing CPR (cardiopulmonary resuscitation). I also got her family members to call an ambulance and did the necessary to prepare for their arrival.

Eventually, the ambulance soon arrived with a team of adept paramedics. You have no idea how relieved I felt when I saw my fellow healthcare workers! They took over and brought her to Tan Tock Seng Hospital. Unfortunately, even after multiple rounds of resuscitation, my patient did not make it. Heartbroken as I was, I knew deep down that I had done my best and given my all.

I have been a community care nurse for almost two and half years now. When I tell others about my job, they think that I only change my patients’ diapers, clean and feed them – a common misconception I am sure most nurses are familiar with.

My job is so much more than that. Do you know that community care is just as important as care in the hospital? After my patients are discharged, I visit them in their homes to ensure that they are recuperating well by checking their medication, wounds and the safety of their environment. My work also extends to their families and caregivers. I teach them the correct methods to care for the patient and provide them with regular updates to alleviate any anxiety they may have. I also develop closer bonds with patients and their families because of the regular visits to their homes.

Before every home visit, I discuss patient cases with a multi-disciplinary team that comprises doctors, fellow nurses, physiotherapists, occupational therapists and medical social workers. During these visits, I work independently to administer necessary treatment for chronic illnesses and make care decisions on the spot if necessary. The role can be demanding and the job definitely has its challenges but like Bob Marley once said, “You never know how strong you are until being strong is your only choice.”

Community nursing has been growing in importance in recent years. This is largely due to the ageing population and an increase in chronic illnesses among the elderly. In order for these elderly folks to recuperate comfortably in their homes instead of an unfamiliar hospital environment, community nurses step in with their medical luggage and attend to their needs at home.

My name is Johnson Kow, and I am a Staff Nurse from Tan Tock Seng Hospital’s Community Care Team.