​ANC Cheung donned in full PPE at the nurses’ station outside the ICU at NCID.

While many of us were busy adjusting to the new normal, the battle against Covid-19 rages on in the healthcare sector.

At ground zero, the National Centre for Infectious Diseases (NCID), high-risk, critically ill Covid-19 patients continue to fight for their lives in the intensive care unit. What keeps them alive is the Extra-Corporeal Membrane Oxygenation (ECMO) machine which helps take over the functions of the body’s heart or lungs.

Since January, two of our nursing staff, Assistant Nurse Clinician (ANC) Cheung Pui Leng and Senior Staff Nurse (SSN) Duan Shuya, have been involved as part of the NCID’s multidisciplinary team to manage patients requiring ECMO, and are on roster for 24/7 deployment. 

Mobilised to the battle’s forefront

With more than 18 years of experience at the Cardiothoracic Intensive Care Unit (CTICU), ANC Cheung is a highly skilled critical care trained nurse who specialises in managing patients with complex cardiothoracic conditions, including those on ECMO support.  

In preparation to provide ECMO support for the critically ill COVID patients at NCID, the multidisciplinary ECMO team would hold several discussions, process simulations and even conduct a mock exercise. ANC Cheung was selected as the sole nursing representative from NHCS, to ensure the process was safe, effective and efficient.

On 18 March 2020, ANC Cheung was activated for the very first ECMO case at NCID. 

We find out more from her first-hand experience as an ECMO nurse at the frontline of the pandemic.

What were your thoughts on being deployed?

When I was first informed in January that I will be on the ECMO team at NCID, I was anxious. Then, we knew very little about the new virus and I was not sure what to expect. However, given the training and experience I had, I believe I could contribute and provide support at the frontline, and could overcome the challenges. I also managed to assure and convince my family who was initially apprehensive and concerned about my deployment NCID.

All the orientation, training and preparation at NCID have also boosted my confidence. The close collaboration of the team in sharing information, planning and simulating scenarios for preparation, and the training on PPE and PAPR helped me to get on with the work very quickly.

What was your first encounter with a Covid-19 patient like?

On 18 March 2020, while I was preparing to leave for my afternoon work shift at CTICU, I received the activation message. I felt a rush of adrenaline as I made my way to NCID and the scenario from the mock exercise started replaying in my head.

 
ANC Cheung (right) with her new colleagues at NCID.
 
The process went as planned and the case was no different from the other EMCO cases that I had dealt with previously. The only difference was it was happening in NCID and we had to don full PPE whenever attending to the patient. The staff in NCID were very friendly and helped me to get familiarised with new environment quickly.

How does taking care of Covid-19 patients differ from your usual work?

The isolation and anteroom set up at NCID is a totally different environment from what I was used to. Besides having to wear full PPE at all times, protocols and instructions changed quickly due to the dynamic situation. I have to keep myself updated with the changes so as to plan and organise my activities, and minimise time spent in the patient’s room.

Unlike in CTICU where many of the nurses were ECMO-trained, I was the only one on-site in NCID. I had to ensure that the ECMO machine was running well, troubleshoot problems, check for clots in the machine and look out for any complications in the patient. I am glad to be given the opportunity to share my learnings, and provide support and consultation to the nurses on managing the care of ECMO patients.

What were some challenging and memorable moments working at NCID?

Even though nurses are deployed to NCID from different healthcare institutions in Singapore, we are like one family and all in this together for the same purpose of overcoming the pandemic. While some practices and protocols may differ from one institution to another, we were determined to work together and adapt to the needs of the time.

How do you feel about being at the forefront during this pandemic?

A ‘Thank You’ wall made up of post-it messages expressing words of appreciation to healthcare workers at NCID.
 
I feel honoured and proud to be part of the team at the frontline. All the well-wishes and support we received have given us a lot of encouragement. It is very heartwarming to know that our efforts are appreciated.