ANC Faith Ng providing care to one of the residents during a home visit.

Working as a community nurse for more than three years, Assistant Nurse Clinician (ANC) Faith Ng is our first trained community nurse who provides care right to the homes of elderly residents.

For vulnerable seniors who require assistance in managing chronic health conditions, Community Nurses are deployed for post services and home visits, to allow these nurses to continue administering care for residents through the Regional Health System (RHS) under SingHealth. These residents, who are 60 years old and above, require monitoring and education on how to better care for themselves within the community.

ANC Faith Ng was the first trained community nurse from NHCS to be deployed to the community nursing post service in 2018. She had been working at different Community Nurse Posts (CNPs) of the Katong Community of Care zone; caring for residents mainly living within the vicinity.

Caring for residents

Her role as a community nurse includes visiting homes of vulnerable seniors with complex health and social care needs and reviewing residents’ health conditions through physical or virtual consultations at the CNPs. In the course of her work, ANC Faith also attends to senior residents with heart conditions and among them, most have other comorbidities. She has to ensure that these residents’ health are properly managed. For instance, some may be referred to NHCS for further assessment for appropriate cardiac care and some have to continue to be followed up in the community or monitored at home.

As the seniors progress in age, their risk factors may also increase such as uncontrolled hypertension, diabetes, or smoking, which can lead to an increased risk of heart disease. ANC Faith shared that residents with cardiovascular conditions mainly include those with heart failure and had underwent coronary angiograms or angioplasty procedures. For those with chronic heart failure, ANC Faith has to monitor their weight, educate them on the importance of a healthy diet, and make sure they comply with fluid restrictions. For example, when ANC Faith learnt that a resident with heart failure had been eating unhealthily, such as consuming too much salty food, she encouraged him to cut down on his salt intake, which is a seemingly simple but critical step to manage his condition.

Besides health monitoring and medication compliance of the residents, ANC Faith also assists residents to seek early medical attention when they experience adverse events, such as uncontrolled hypertension and potential injury from falls at home.

Such home visits provide immediate, direct care and advice to the residents, fostering long-term rapport building with the residents and offering social support to those who do not have someone readily there for them. When necessary, ANC Faith will also initiate Advance Care Planning conversations to educate residents’ understanding of their physical health and discuss their wishes and care preferences, before arranging for formal documentations of their care plans.

Skills for the job

ANC Faith shared that the role of community nurses is increasingly important to meet the needs of the ageing population in Singapore. A community nurse has to be resilient, work well independently and possess good critical thinking and interpersonal skills. Keeping an open mind towards the myriad of problems faced by the residents in the community is definitely helpful in providing the appropriate care without being judgmental.

She added that unlike acute care nursing or other nursing roles in clinical settings, the training for community nurse covers a wide range of areas including health promotion, chronic disease management, geriatric care, mental health, and palliative care. Nonetheless, her foundation in acute care settings and on-the-job experience in inpatient settings have allowed her to gain specialised nursing skills such as wound dressing methods which are essential for her role as a community nurse.

ANC Faith is still enthusiastic and determined to continue in this role though it has been three years.

“I feel a great sense of satisfaction and achievement when I realised I have made an impact in their lives. Simply seeing how their faces light up whenever I visit brings me great joy,” expressed ANC Faith.

Empower for lifelong healthy living

Community nursing programme aims to empower elderly residents to take charge of their health and lead a fulfilling life. Community nurses can effect positive changes in the lives of vulnerable seniors towards healthier living by equipping and supporting them to better care for themselves.

With similar goals in mind, NHCS will soon roll out a community outreach programme for patients with heart failure. The programme will empower patients in self-care management so that they can live well in the community, as well as support community nurses in the care of these patients. The programme is expected to roll out in the next few months.

This article is from Murmurs Issue 39 (January – April 2021). Click here to read the full issue.