Ms Paulin Koh, Chief Nursing Officer,
Ladies and Gentlemen,
1. It gives me great pleasure to join you today to recognise and celebrate the achievements of our 125 recipients of the Nurses’ Merit Award (NMA) 2022.
2. Today’s ceremony is particularly special, because due to the pandemic, we have not had a physical ceremony for the past two years. More importantly, having gone through and still going through a gruelling pandemic, today is a good occasion to pay tribute to the outstanding performance and dedication of our nurses.
The COVID-19 Journey for Nurses
Year 2020 – Managed migrant worker dormitories, ramped up isolation and ICU beds, and set up Community Care Facilities
3. It has been a trying two and half years.
4. It started in 2020, when COVID-19 was still an unknown virus and came to our shores. Soon, it forced us to shut our borders and curtailed personal freedoms. The operating posture in hospitals changed overnight. All of you stepped up, caring for large numbers of patients while donning full Personal Protective Equipment (PPE). Many of you stayed at designated accommodations to minimise exposure to the community and protect your loved ones.
5. A bigger crisis hit when the disease broke out in several foreign worker dormitories. But our healthcare workers did not back down in the face of adversity. You rose to the occasion. In the migrant worker dormitories, you set up health posts and healthcare processes. You administered swab tests and implemented infection control protocols to curb the virus spread.
6. As the community cases surged, nurses were an integral part of our effort in ramping up isolation and Intensive Care Unit (ICU) beds in hospitals, and setting up Community Care Facilities (CCFs) to care for COVID-19 patients with milder symptoms. You are the ones who kept these critical facilities running.
Year 2021 – Supporting National Vaccination Programme, riding through the Delta wave
7. The first turning point of the pandemic occurred in 2021, when vaccines became available and we started our National Vaccination Programme. You helped run the vaccination centres, administer vaccines to millions of people, put at ease those who were nervous about taking the jabs, and took care of those who felt unwell after the injections.
8. Today, over 93% of our total population is fully vaccinated, and 78% and counting have received their first boosters. Singapore has recorded one of the highest vaccine coverage rates in the world. It makes a huge difference in preventing infected individuals from developing severe complications from COVID-19 infections.
9. Then the Delta wave struck towards the end of 2021. This is a particularly nasty variant, as many individuals, especially the elderly and sick, were admitted to the ICU. This affected regular hospital operations very significantly as it diverted resources from non-COVID-19 patients who also needed care. Once again, you stepped up, stretching yourselves in caring for both COVID-19 and non-COVID-19 patients. Non-ICU nurses had to take up ICU duties. You cared for and witnessed numerous severe cases, including many who unfortunately passed on with you by their side.
2022 – The Omicron Wave
10. When the Delta wave subsided in end 2021, it was a relief, but the respite was short-lived. Soon, we heard of a highly-mutated, more transmissible new variant from Africa – called Omicron. We delayed its arrival through border restrictions and domestic social restrictions, but by February 2022, we were confronted with a massive Omicron infection wave.
11. Fortunately, the symptoms of Omicron infections were less severe compared to Delta. The burden of care then shifted from the ICU to the Emergency Department (ED) and normal wards. Once again, nurses took on the high surge in patient load. While we could discharge many patients every day, more patients would arrive the next day. Every week, we hoped the situation would ease, but it went on and on, from one week to the next, and lasted for about 12 weeks.
12. To ensure hospitals could still cope, we intensified the medical care provided at previous CCFs and converted them to COVID-19 Treatment Facilities (CTFs) and expanded their capacity. Again, nurses stepped up to operate and provide support at these facilities. In fact, nurses from all over Singapore – from both public and private institutions, from acute and community hospitals, from specialty centres, and even from the Health Promotion Board – all came together to run the much-needed CTFs.
13. Our nursing students played a key role too. We were desperate for nursing manpower, and so worked with Nanyang Polytechnic (NYP) and Ngee Ann Polytechnic to mobilise our nursing students. The Polytechnics brought forward the 10-week final hospital posting from December to November, for about 1,200 nursing students. The Singapore Institute of Technology also facilitated the extension of clinical placements from two weeks to four weeks, for 190 nursing students who are already Registered Nurses. And just earlier this year in March, about 300 nurses undergoing advanced training at NYP returned to the hospital frontlines for two weeks.
14. Most of our nursing students are young. But they knew what was at stake and took on their assignments with gusto, including sacrificing vacation breaks. They had an early induction on what being a nurse is about. Their spirit and dedication bode well for the future of the profession.
15. We are now in the middle of another wave. As I have always said, going through a wave is like riding a bicycle downslope. If you do not do anything – you will accelerate faster and faster, until you crash. So, we always have three things with us to control this bike going downslope – left brake, right brake and cushion at the end. The left brake is Safe Management Measures (SMMs) to reduce transmission and infections. The right brake is vaccinations, so that it also reduces transmission and more importantly, if you are infected, you are less likely to fall severely ill. But that will still make the bike go down at quite a high speed. When you go down and hit the road, you have the cushion, which is our healthcare capacity. You are the last line of defence when all else fails. When patients appear before you, you take care of them.
16. What is happening in this current wave is that the left brake – SMMs – there are almost none. The only thing that we have implemented is wearing masks indoors. This is such an important juncture in our journey towards endemicity, because it is the first time since the pandemic that we are going through a wave without a circuit breaker, without heightened alert, not even with group sizes of five, and no capacity limits – none of that. We are trying our best to avoid doing that, because that is an important mark of living with COVID-19.
17. Our right brake – vaccinations. We are still vaccinating, but our coverage is already very high. So on the left, we try not to do; on the right, there is only so much we can do. What is left is the cushion at the end, which is our healthcare capacity. In other words, in this Omicron wave, by and large, the burden falls on you, on our hospitals, on our nurses, on our medical personnel.
18. As the rest of Singapore goes through a wave like this, and people go about our lives normally, I hope you all remember who is carrying the burden. Who is carrying the burden to make sure that the rest of Singapore, businesses, students, people who enjoy themselves – recreation, sports – everything goes on, because our hospitals are working and our nurses and doctors are working flat-out.
19. I believe there are good reasons, looking at the numbers, that the trajectory of the wave has almost peaked or is at its peak. I really hope from here, things will get better.
The Nobility of Nursing
20. I just gave a broad sketch of what you have gone through over the past two and a half years. Today, the pandemic is not over, but thanks to vaccines and a good healthcare system run by good people, we are much more resilient to the COVID-19 virus and are making good progress to live with COVID-19.
21. It is with deep gratitude that I thank you for what you have contributed, in our nation’s journey towards endemicity. The prolonged battle has been unprecedented for our healthcare system, but nurses stood the test, with many going beyond your normal call of duty. And your contribution is deeply appreciated.
22. Let us pause on the word “contribution” for a while, to talk about what that encompasses. Indeed, an important part of healthcare is the practical knowledge, science, diagnosis, treatment, care procedures, and day-to-day running of hospitals. Many of these are easily observable and even quantifiable, in terms of number of infections, beds occupied, patients attended to, tests conducted, vaccinations administered, etc.
23. But nurses also bring something else that may not be so easily discernible, much less measured. Yet it is essential and irreplaceable – and that is human compassion. Not everyone can be a shoulder to cry on when a loved one is in distress or lost. Not everyone can bring peace to a patient or loved one in times of anxiety. Not everyone can make a patient smile even at his lowest moments, or look into the future with optimism as he regains his strength.
24. In a crisis as isolating as COVID-19, the human compassion of nurses is empowering, comforting and invaluable.
25. Back in 2005, when I was the Chief Executive of the then-Singapore Workforce Development Agency, we started a mid-career skills conversion programme for nurses. It started with not many applicants, but gradually it gathered momentum. I saw many people who wanted to join nursing for various reasons – from practical considerations like it is an industry that needs manpower, or following the footsteps of a parent or sibling, to having experienced the need to care for a loved one. These experiences can leave an indelible memory of what it is like for someone and their family to journey through care and treatment.
26. I asked the senior nurses at the Ministry of Health what motivated them and their colleagues to take up this profession. They told me that everyone at some point in life will need care, and even more so in the last moments of our lives. It is here that they, and perhaps some of you, found your calling: being there in the last moments of another person’s life, helping them fill the last pages with meaning, helping them make sense and make peace with their life’s journey.
27. Indeed, it is a huge sense of purpose and fulfilment to be there for others in their most difficult moments. And in our country’s hour of need, when we are besieged with the debilitating virus, and uncertainty about the future, your never-say-die attitude is uplifting, and an inspiration to the whole nation. This goes beyond human compassion, and represents the spirit and essence of our people and nation.
A Tribute to All
28. As I come to the end of my speech, I want to pay all nurses a tribute – you are the backbone of our healthcare system. Without you, our system cannot stand. Thank you for choosing to do what you do, for serving selflessly, for all the work you put in – the work we see, but especially what we do not see.
29. Congratulations to all our awardees this afternoon, and I wish everyone a Happy Nurses’ Day!