Veteran's guiding hands


When reports about the spread of Covid-19 from China began to emerge early this year, Sister Patmawali K and her team braced themselves for an imminent outbreak in Singapore.

"We are always prepared for any form of emerging diseases," said the 62-year-old Assistant Director of Nursing who currently oversees the wards at the National Centre for Infectious Diseases (NCID) and has more than 45 years of nursing experience.

"Each pandemic or disease outbreak requires a unique skill set from the staff due to the difference in the collection of specimens. For instance, the junior staff are less familiar with nasal swab tests for Covid-19.

"Adjusting the patient's position, inserting the swab stick to collect the specimen, putting it in the bottle and sealing it properly for dispatch - these things have to be done with precision."

A leader of the disease outbreak workgroup, which plans for people, material and waste movement at NCID, Sister Patma had also mapped out the patient transfer routes between NCID and Tan Tock Seng Hospital.

Such early preparation, she said, allowed the NCID staff to act much faster when Covid-19 broke out in Singapore.

"After a table-top exercise involving planned route maps and scenario discussions showing the right entry, movement and exit points, we had the staff undergo drills on a regular basis, especially in the cases of patient transfer, direct admission to the hospital and deaths," she said.

"We had also trained the staff on the procedures relating to increasing bed capacity and opening wards to deal with the surge of new patients in a matter of hours."

The NCID has 224 "negative pressure" (where air flows into the rooms, but not out of them) and isolation rooms, 330 beds and more than 100 "surge beds", which are used for emergency purposes.

Sister Patma said a real-time location system, which tracks the movement of staff, patients and hospital inventory with an electronic tag, serves as a strong, added layer of precaution.

"Besides making contact tracing easier, the tag also reminds our staff to ensure proper hand hygiene," she said.

"These tags, among other procedures, will beep to prevent high-risk patients from leaving the hospital."

Since her current role is mainly administrative, Sister Patma works office hours. When there is a need, she attends to patients.

The current situation, however, has led to long, late hours as she attends to the needs and concerns of her team.

"We do manpower planning in such a way that there will be senior staff to provide guidance to junior staff," she said.

"When every shift of nurses comes for duty, we do a 'safety huddle' - where instructions and updates are shared.

"In the course of my work, I always supervise my nurses to give them the confidence that they are safe when they go into a patient's room."

Her presence at the wards where nurses are taking care of Covid-19 patients has been described by her colleague Chen Jin as "empowering".

"She prepared us to respond quickly to the surge of Covid-19 patients by leading in the opening of new wards, redesigning work processes and frequently inspecting the ground to ensure adherence to infection control standards," said the senior nurse.

"Each pandemic or disease outbreak requires a unique skill set from the staff due to the difference in the collection of specimens."

- Sister K. Patmawali


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