For children with specialised needs, home care nurses are a pillar of support.


A biomedical engineer by training, Clara Lam made a career switch to nursing 13 years ago to fulfil her passion of caring for paediatric patients through the Career Conversion Programme. After seven years in the Children's Intensive Care Unit at KKH, she moved on to her current role in the Children's Complex and Home Care Services department. Clara works closely with families and caregivers of children with complex conditions who rely on medical equipment for basic needs, to support and care for them.

"I chose to work in KKH because I love children and am passionate about paediatric care. As a home care nurse, part of my role is to help children with complex needs integrate into the community while supporting their families to establish a lifestyle for their child, which would include regular outings to the park or mall, regardless of the medical equipment the child has on his or her body," she said.

Clara's primary responsibility is to provide training and support to caregivers of children who require specific care, such as ventilator support for breathing and gastrostomy tubes for feeding assistance. Clara teaches caregivers how to remove secretions from the child's nose, mouth or tracheostoma (an opening in the throat for a trach tube), as well as emergency care skills like basic cardiac life support.

Clara also goes on home visits to check on the child's condition, ensure that the caregivers are coping well, and monitor the appropriate placement of medical equipment in the patient's home. These visits help her assess the home environment, revise care procedures where required, and address the patient or caregivers' concerns. Children who may require further medical assistance will be referred to their doctor, while caregivers who may be facing difficulties coping with home care will be offered the necessary support.

A special bond
Patients under Clara's care range from newborns to 18-year-olds. Some require support while undergoing treatment or therapy, while other patients with genetic conditions may require lifelong care. Through regular interactions with caregivers, Clara would often find herself becoming a friend or a shoulder to lean on, as she supports them alongside their journey of caring for the child.

"Over time, we become good friends and talk about things beyond medical care for the child. I really cherish the rapport, which motivates me to continue wanting to do this job better," said Clara, who is a mother of a two-year-old herself.

"One of the parents even got her older child to be the flower boy at my wedding!" she chimed.

In addition to recommending suitable support groups to caregivers, Clara and her team of nurses would also organise annual gatherings before the pandemic. These gatherings were good opportunities for patients and caregivers to widen their support circle, and offer or seek support from other patients and caregivers whom they may be able to relate to.

"I find it most rewarding when I am able to play a part in empowering caregivers to care for their child independently. It is heartening to witness the patients' progress over the years, as their parents become more confident in caring for them," she explained.

Offering a shout-out to all caregivers, Clara said, "Believe in yourself that you are the best caregiver for your child. And we are here to support and guide you in your caregiving journey."

Complex and Home Care Services
Launched in 2001, the Home Care Nursing Programme has evolved into a multidisciplinary department known as the Children's Complex and Home Care Services since 2018. Currently, there are 435 patients under its care. Since its inauguration, the department has successfully transited 2,300 technology-dependent children from the hospital into the community.


To read about how our nurses are broadening the spectrum of services available in the community to enable seamless care for mother and child, download the latest issue of the Singapore Health Special Nursing Supplement 2022.