“A patient confided in me about her marital problems, and I wanted to console her. I knew what to say – but in Burmese. I couldn’t find the right words in English. That incident happened when I first arrived in Singapore from Myanmar 15 years ago,” recalls Senior Staff Nurse Lwin Lwin San. “I had difficulty expressing myself in spoken English because it was not commonly used in Myanmar.” 

She had started in Singapore General Hospital (SGH) working in the geriatric ward, looking after patients above 65-years-old with multiple chronic conditions including uncontrolled diabetes and hypertension. Some of them could be in hospital for as long as three months, ample time to develop close rapport with hospital staff such as Lwin Lwin.   

“I had a solid foundation in reading and writing English, which I learnt in nursing school in Yangon. I had no problem understanding and explaining medical knowledge to my patients or doing documentation. But speaking English socially was a challenge when I first came to Singapore. It frustrated me because when my patients told me they were worried or sad, I could not reassure or comfort them,” adds Lwin Lwin, who joined SGH after seven years as a nurse in Yangon. 

“I need to be able to convey empathy to my patients so that I can bond with them and build trust. When my patients trust me, they are more likely to comply with my medical advice. This enhances the quality of care that I can provide them,” explains Lwin Lwin.  

Determined to overcome the communication barrier, Lwin Lwin took proactive steps. “I searched for and attended classes to improve my spoken English.” 

Lwin Lwin’s colleagues were understanding of her challenges and were supportive. “On one occasion, a patient shouted at me because I could not clearly explain that I will attend to her after I have finished another task, my colleagues stepped in. They also encouraged me to talk more with them. Every chance I got I would speak to my colleagues and patients in English. SGH also sent me for classes where I also learnt basic Malay and Mandarin,” says Lwin Lwin. 

As her language skills grew, Lwin Lwin found herself better able to address her patients’ concerns. “Now what I feel, I can express. I even speak Singlish, Mandarin and Malay. Sometimes, I speak rojak, a mixture,” laughs Lwin Lwin. 

“I also became better at handling difficult situations, such as patients who are angry when we do not allow them to eat or drink before surgery. I could explain well enough for them to understand and be placated. I have received compliment cards from patients who say that I was very understanding and attentive.” 

Even though Lwin Lwin had improved her spoken English, she still had to face up to her greatest fear – public speaking. “As a Senior Staff Nurse, I do clinical teaching rounds. Every time I went on stage to present, I was very nervous, stumbling over my words and losing my train of thought. My fear was preventing me from sharing my knowledge,” says Lwin Lwin. 

The seeds of her fear in speaking up were planted when she left her village to go to the capital city of Yangon for university. Explains Lwin Lwin, “I grew up in a remote village in Myanmar. It is near the Indian border and surrounded by the Gangaw mountain range. We had limited electricity and water supply, with power available only for a few hours a day. After high school, I was one of the few girls to leave my village to start my journey as a nurse in the University of Nursing in Yangon.” 

“In the city, making myself understood was one of my challenges. I grew up speaking mainly dialect, so my Burmese sounded different. When I went to the market to buy groceries, people would laugh at my accent. From then on, I developed a fear of speaking in public.”  

 

 

“To help me improve, my colleagues would coach me. They would tell me when to slow down, or to incorporate gestures at some parts. Whenever I was stumped, they prompted me,” says Lwin Lwin.  

 

Her supervisor Nurse Clinician Ye Lizhen suggested that she join her in the SingHealth Toastmasters Club.  

  

Recalls Lwin Lwin, “I still remember my first presentation at SingHealth Toastmasters. I was so nervous that I forgot some of my lines. I also went too fast. When I finished, I felt inadequate and useless. To my surprise, my fellow Toastmasters – most of whom were nurses from SGH - clapped and praised me for completing my ice breaker.” 

 

Encouraged, Lwin Lwin returned and has been attending the monthly meetings for the past four years. “I learnt valuable public speaking skills, such as how to project my voice, structure my thoughts, choose appropriate words and convey my message in a way that is easily understood by my audience.” 

 

“The encouragement I received from my toastmaster mentors - my supervisor Lizhen and fellow nurses Lee Min, Kehua, Nazirudeen, Umma and Chen Ting - gave me the courage to keep moving forward.” 

 

Practice makes perfect 

 

The effort has paid off. Today Lwin Lwin communicates well with her patients and their families in the SGH Haemodialysis Centre. Throughout their hospital stay, patients with kidney disease would go there for dialysis about three times a week. Lwin Lwin manages the dialysis procedure and attends to the patients during the four-hour sessions.  

Her advice for any colleague in this situation? “Do not be afraid to speak up. If you want to say something, don’t hold back. Just say it. Also, seize every opportunity to learn. And practise, practise, practise. Practice makes perfect. You can consider joining us at SingHealth Toastmasters - just contact me or any of our members.”