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#CouragetoCareSG: Never take a breath for granted


Senior Respiratory Therapist Emelin Tan hustles in the Intensive Care Unit (ICU) at Tan Tock Seng Hospital (TTSH), where she provides critical care to patients requiring respiratory support. Today, she works closely with a team of medical professionals in the fight against COVID-19 at both the National Centre for Infectious Diseases and TTSH. Emelin’s thoughts, below.

When I chose to enter the healthcare industry as a respiratory therapist, I knew I would have to care for patients with highly infectious diseases. I was mentally prepared and had accepted the risks associated with my job. Despite the rigorous training to equip myself with the skills to safely don my protective gear and perform procedures in a safe manner, I still felt apprehensive when I was assigned to care for COVID-19 patients during the early stages of the pandemic. At that time, we had little knowledge about the disease, and the rising global death toll exacerbated my fears.

Given the constant changes that our hospital experienced, it was a challenge creating new protocols for the Respiratory Therapy department that were easy to follow yet ensured the safety of our patients and my colleagues. The team effort is immense as we need to communicate, educate and train our department staff. Apart from collaborating with the other healthcare professions to ensure the alignment of work processes, I planned, coordinated and assisted other leaders in my department to prepare our therapists and assistants for the fight against COVID-19.

With the large volume of information and changes happening daily, to ensure that everyone was up to date, I enlisted the help of colleagues to conduct daily quizzes to reinforce knowledge and awareness of new work protocols. All of this would not have been possible without our indispensable and experienced colleagues who provided me with excellent advice and support.

Outside work, I had to make some changes to my personal lifestyle. Though the Singapore government implemented circuit breaker measures in April, my colleagues and I started observing these measures since January to protect our families and other vulnerable populations! Meeting my friends for exercise sessions and heading out with my family in search of new eateries became things of the past. I moved out of my bedroom into a spare room and ate meals alone in the balcony, while my family members sat at the dining table. Watching my family from the balcony was a small comfort for me as I could still feel involved in their conversation. Though these measures were challenging, they were necessary to protect my loved ones.

I’m truly blessed to have an amazing support system of family and friends. To allow me more time to rest, my parents and husband take turns to shuttle me to and from work. When I was deployed to care for COVID-19 ICU patients in the early months, I slept in a guest bedroom apart from my husband. One Saturday morning, I woke up to knocking on my bedroom window and was surprised by my husband with breakfast from McDonald’s! Friends, and even neighbours whom I did not know well, sent me care packages and encouraged me to keep up the good work. Small gestures like these mean a lot to me and keep me going.

Unfortunately, not all my colleagues are as fortunate as I am. Some of my foreign colleagues have been greatly impacted by the travel ban. They are not able to return home to visit their loved ones, attend important events like weddings and funerals, and some even had to manage unreasonable landlords who demanded compensation for “contaminating” their houses. Their sacrifices to serve our country and sense of duty is truly admirable as they endured personal stressors while delivering quality care to the increasing numbers of patients at work.

Working in the ICU means I have to be quick on m​y feet and attend to emergencies immediately. In today’s context, I must fight the urge to provide immediate attention to a patient. The extra minute or two taken to don the numerous layers of protective gear before entering a patient’s room feels excruciatingly long, especially when I see my patient struggling from behind the glass doors.

There are limited opportunities to meaningfully interact with COVID-19 patients in the ICU as they are often very ill and heavily sedated. I was fortunate to have a memorable encounter with a patient who was admitted during the early phase of the outbreak. When he arrived into the ICU, I remember feeling awful as he was an essential worker who got infected while simply performing his job. His condition deteriorated quickly and the first few weeks were a struggle. Every time we thought we had made progress and tried to reduce the level of support, the patient got extremely breathless, forcing us to take a few steps back in his treatment. We wondered if he would ever recover meaningfully and leave the ICU.

Thankfully, the patient improved after a few months and eventually tested negative for COVID-19. During my downtime, I would go into his room and chat with him. Because of his breathing tube, he was unable to speak with me but was able to write on a board. Patients typically do not have memories of when they are extremely ill, so I would tell him stories about how we struggled with his care and how worried we were for him.

From that day on, I felt a shift in his attitude. Instead of simply communicating his needs, this patient became extremely welcoming whenever I entered his room, and gave me the thumbs up sign when I left. Eventually, we managed to remove his breathing tube and transfer him out to the general ward. This was a huge win for us as a team!

After years in this profession, my appreciation has grown for everyone in the healthcare family – from my allied health colleagues, doctors, housekeepers and especially nurses. Nursing is a profession that exemplifies immense compassion, patience and selflessness as they stay with patients throughout their care journey and are their patients’ biggest sources of support. Imagine being all of that for a stranger.

As for me, watching my colleagues grow and work together as a team during these tough times warms my heart. Helping patients get better or ensuring that palliative patients pass on comfortably and with dignity means a lot to me. It’s the little things that count!