<<Since the onset of the COVID-19 pandemic, many frontline healthcare workers, including respiratory therapists like Ms Chou Sin-Yi, continue to tirelessly support critically ill patients.>>

Behind the scenes, respiratory therapists like Ms Chou Sin-Yi support patients with COVID-19 and those with breathing-related conditions to optimise their breathing efficiency.

Ms Chou Sin-Yi was only in her teens when the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak happened. At the time, she did not think that she would encounter another infectious disease outbreak in her lifetime, much less battle it head-on as a healthcare professional.

Now a respiratory therapist at Sengkang General Hospital (SKH), Ms Chou is among the many frontline medical professionals fighting the COVID-19 pandemic worldwide.

The 31-year-old has helped some of the most critically ill COVID-19 patients who require breathing support to use a ventilator, which delivers life-sustaining oxygen to their lungs and in the body.

Together with the healthcare team at SKH, Ms Chou manages patients in the intensive care units (ICU) and high dependency units by boosting their breathing efficiency. This includes optimising their ventilators by adjusting the settings, and administering drugs to the lungs.

Ms Chou’s work also involves managing patients suffering from lung conditions that can affect breathing, such as pneumonia, bronchitis, and chronic obstructive pulmonary disease. Additionally, she assists in ‘Code Blue’ situations, which refer to medical emergencies like cardiac or respiratory arrest.

“Most of my patients need to be intubated. My job is to assess their condition. We make sure they feel comfortable while on the artificial airway devices,” she said.

Lessons learnt

Even with her expertise in this area, Ms Chou had her own fears and faced uncertainties when she and her colleagues encountered their first patient with COVID-19 in the ICU last year.

“Like others on the frontline, the team felt stressed and overwhelmed. It was scary but all of us worked together as a team to support one another,” she said.

“The hospital provided us with adequate personal protective equipment (PPE) so I was not worried about my safety. My worry was how and whether we could help the patient, as we have never had such cases before. It is also much more difficult to care for patients while in full PPE.”

Ms Chou said that the team brainstormed ways to care for critically ill patients, and subsequently manage the gradual process of weaning them off the ventilators to restore their ability to breathe on their own.

This experience offered her invaluable insights into managing severe lung disease. What she found particularly striking was the devastating impact the coronavirus had on the respiratory system and how quickly patients with COVID-19 could deteriorate, compared to those suffering from other lung conditions.

“I have never seen such severe lung conditions before. I learnt a lot from the doctors managing these patients. We actively participate in clinical decisions by ensuring proper provision of ventilator use and exercise independent judgment in providing care to our patients,” she added.

Overcoming challenges

Inspired by her sister, who is a nurse, Ms Chou decided to become a respiratory therapist although she was not familiar with the profession.

“My sister told me how respiratory therapists have helped her a lot in caring for and managing patients in her course of work, especially in emergency situations,” she said.

“Never did I imagine that it would be so challenging. I did not think I would sometimes have to witness a patient’s heart rate falling to zero.”

Despite having been on the job for close to seven years, being by her patients’ side when at their dying breath still affects Ms Chou to a great extent. “I feel sad, especially when I see family members devastated from the loss,” she said.

Still, Ms Chou finds her work fulfilling in many ways, particularly when patients recover. “Some of the patients are unable to respond to us when we first treat them. It is amazing to see someone, who was so critically ill earlier, doing so well a few weeks later.”

Ms Chou was once involved in a case where a patient was in a life-threatening state due to severe bleeding in the lungs and respiratory tract. The healthcare team spent several hours to resolve the critical issue successfully.

“It is difficult work, but such incidents inspire and drive me to continue being a respiratory therapist, and to save lives,” she said.

To those considering the profession, Ms Chou is candid about how fast-paced and challenging it can get. However, there is never a dull moment at work, and those who wish to make a difference in patients’ lives will find it hugely rewarding.

“If you like a different challenge every day, you will love this job,” she said.

Away from the sounds of the breathing machines that she is so well acquainted with, Ms Chou cherishes the quiet moments. On her days off, she likes to visit the park alone, armed with a camera to take photographs of nature. She also recently picked up cycling and enjoys going on long rides.

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