APN Loo Yu Jen (2nd from right) is one of eight SingHealth nurses to clinch the inaugural Wee Foundation Nurses’ Day Awards 2022 – Nursing Leadership Excellence.

At the recent SingHealth Nurses’ Day 2022 celebrations, Advanced Practice Nurse Loo Yu Jen from Nursing Specialty Care Unit, took home the inaugural Wee Foundation Nurses’ Day Awards – Nursing Leadership Excellence. This award recognises nurses who possess extraordinary passion and dedication to the nursing profession, and are respected as visionary, innovative leaders and change agents.

As an Advanced Practice Nurse (APN), Yu Jen is a Registered Nurse (RN) who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for extended practice. She is also trained in the diagnosis and management of common medical conditions, including chronic illnesses, and works collaboratively with doctors and other allied health professionals to provide complex nursing care to patients. 

For instance, as a key member of the multi-disciplinary Transcatheter Aortic Valve Implantation (TAVI) team, APN Yu Jen not only participates in the management of TAVI patients, she puts her specialised knowledge to good use through advocating for not just the patients but her fellow nurses during clinical rounds and in-service teaching sessions. She also assists in performing advanced procedures such as removal of invasive lines, an additional skillset of an APN, thus to enhance patient’s recovery process. Together with the team’s continuous efforts to improve the workflow and experience of TAVI, they received the SingHealth Excellence Awards 2022 – Distinguished Team Award. 

CardioConnect speaks to APN Yu Jen to find out more about her multi-faceted roles.

What is your role as a nurse member of the TAVI team?
I have been in the TAVI team since 2018. As an APN, I provide collaborative patient care management through serving as a clinical nursing expert in the care of patients with severe aortic stenosis undergoing TAVI. My care of aortic stenosis patients starts from the first consultation in the outpatient clinic. Together with the team’s doctors, we assess the patient’s condition and detail care plans for subsequent investigation and treatment. During the initial consultation, the volume of new information regarding TAVI treatment and possible complications that the patient and family members have to assimilate can be overwhelming. To help them better understand the information and their condition, I will help to address the patient’s fears and concerns. Upon completion of patient’s various investigations, I also aid in collating the results that are used in regular multi-disciplinary discussions to tailor patient-specific treatment plans.  

During patient’s admission for TAVI procedure, I help to coordinate care amongst different disciplines as well as educate patients and their family members post-procedure, on useful information such as antibiotic prophylaxis and post-TAVI wound care. After their discharge, I follow-up with phone calls to ensure their well-being and also remain as a point of healthcare contact if there are any concerns or complications that may arise. When patients come back for follow-up appointments, I aid in their review together with team’s doctors and help coordinate their transition of care back to the primary healthcare system. Presently, I am working towards a nurse-led follow-up clinic to ease the workload of the doctors as well as to expand the TAVI APN’s roles and responsibilities in care of the aortic stenosis patients.

The NHCS TAVI Team is the proud recipient of the SingHealth Excellence Awards 2022 - Distinguished Team Award.

Education plays a large part of our continuous improvement efforts to ensure excellent care to our TAVI patients, and hence part of my role also includes conducting and coordinating inter-professional education amongst healthcare professionals in our team. 

What changes did you champion in the management of TAVI patients?
Early ambulation helps to improve blood flow, speeding up wound healing and promoting early discharge. I aid with the prompt removal of invasive lines such as temporary pacing wire and central venous catheter thus facilitating patients’ early ambulation post-procedure. 

Additionally, I am part of the Inter-professional Education (IPE)-TAVI sharing session, a platform for all healthcare professionals involved in the patient’s journey to share their respective responsibilities and goals so that everyone involved will have a better understanding of how to support one another in providing the best care possible to the patient. This initiative, in line with the SingHealth Education Masterplan, envisions a collaborative, practice-ready healthcare workforce.

Did you encounter any memorable challenges as part of the TAVI team?
One of my patients, an elderly female, was initially very resistant to undergo TAVI. She had multiple concerns such as her advanced age, the lack of symptoms, surgery complications and cost. With the training I received as an APN, I patiently explained what TAVI entails. Together with the clinical team, we further explained to her about her medical condition, treatment options available and details of the TAVI procedure so that she had a clearer understanding. After multiple consultations, she finally felt confident to undergo the procedure. It was a memorable and encouraging experience to have been able to work together as a team to make a positive difference in the patient’s health. 

You were the Chairperson of the NHCS Nursing Research and Peer Review Council. Can you share more about this role? 
One key role of the Nursing Research and Peer Review Council is to help facilitate nurses’ research studies and evidence-based practice projects. There are numerous research grants available in SingHealth as well as NHCS’ National Heart Research Institute Singapore (NHRIS) that supports our nurses in the pursuit of their research. As an academic centre, there are increasingly more support resources available to encourage nurses in their research journey hence my dream is to see more nurses embark on nursing research to ensure our practices are evidence-based and of course, to see them share their findings at academic nursing publications and conferences.

NHCS Nursing Research and Peer Review Council members with Chief Nurse, Ms Amy Tay and guest speaker at the inaugural Virtual Nursing Research Day (Hybrid) in 2020.

To better prepare our nurses in their research work and presentations, I would help to review and provide feedback to the presenters in their submissions and slides to make sure they are succinct. Additionally, I also organise rehearsals for them to practice their presentations. It is exceptionally rewarding when I see fellow nurses complete their nursing research studies and receive opportunities to share their findings at various meetings. I am really proud to share that more of our nurses will soon present their research findings at various upcoming local and international platforms, in addition to ongoing publication submissions!

What is the most challenging research task you have encountered?
I would say it had to be taking up the role of mentoring a NUS nursing student during her final year research project. I had to ensure I was providing her with sufficient guidance every step of the way and to do this, I had to clarify processes such as the applications with the SingHealth Centralised Institution Review Board (CIRB) which protects the rights of human research subjects, and Redcap, a secure web application for creating and managing online surveys and databases – all of which I was not well acquitted with. I often had to seek advice from my seniors or NHRIS before proceeding. Nevertheless, the journey had been particularly enlightening as these processes are also essential for NHCS-led nursing research. Through this, I have honed my mentorship skills and gained greater insight into nursing research. 

As an APN, you volunteered to be deployed to the Intensive Care Unit (ICU) during the pandemic. How did your skills enable you to cross over to an acute setting, and how was the experience?
In my APN role, I always make sure to patiently analyse each of my patient’s situation and needs, even under stressful conditions so as to provide high-quality and personalised care for them. When necessary, I would break down complex medical information for patients and their families. 

APN Yu Jen (middle) with her fellow colleagues at the refresher course held for ICU-trained nurses as well as nurses from high-dependency and intermediate care areas.

Although I volunteered for the deployment, I was quite worried initially because it had been seven years since I last worked in an acute setting. Nonetheless, with my previous training and experience in critical care at the Coronary Care Unit (CCU), coupled with the guidance from my CCU colleagues, my worries were somewhat eased. To better prepare for the deployment, I also attended a preparatory ICU Refresher Course organised by Nursing Development Unit to re-familiarise myself with the fundamentals and updates on the latest ICU management.

With your multi-faceted roles, how do you manage stress and unexpected challenges to keep moving forward? 
I love travelling as it allows me to “switch off” from work and experience the other side of the world, gain new insights and recharge. Exercise is known to improve mental health and mood hence I have also started jogging weekly since the pandemic started which has been a great form of stress relief as well. More importantly, when I face unexpected challenges, I see them as opportunities to build resilience which motivates me to overcome them. 

When asked if she had any words for aspiring young nurses, APN Yu Jen had this to say - “Nursing is an ever-changing profession with constantly evolving roles and responsibilities. Be enthusiastic and never stop learning because this will empower you with the knowledge to provide the highest standard of nursing care to our patients.” 

With such a positive and aspiring attitude, it is little wonder that APN Yu Jen has received numerous compliments from patients and colleagues. We wish her greater heights in her nursing career as she continues to seek professional development and continuous learning.