Wednesday, April 04, 2012

Nursing in Singapore: What did you learn?

This post was originally a reply to LIFT's "Avinology and NS in Singapore: What did you learn?" It exceeded the 4,096 characters limit of Blogger, so I'm posting my reply below.

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Hi LIFT,

I didn't go through NS but observed during my university days the effects NS has on the young Singapore-citizen male undergraduates of my cohort. There is a lost of idealism, passion, increase in self-presevation, etc.

I had a similar rite of passage through my nursing training and work in Singapore. I shall share 2 examples here.
1. Rationalization of workplace bullying
2. 自扫门前雪 [Sweep one's own doorway of snow]


I received similar advice (more than once), as you did, when I was a relatively new nurse in Singapore. To paraphrase your advisor, "Listen, the hospital is not like in school, we could get a patient who is really sick, and I have to give orders to get things done quickly, or the patient may possibly die. These new nurses are so green, they don't take seriously consequence of their actions and delays - maybe they're so pampered at home that they don't know what it is like to have to take orders. So our job is to break down their egos, teach them how to function as a unit, within a team, so sometimes, yes this kind of technique which you call 'bullying' is necessary - but it's not bullying really" and ending with "it weeds out the weak".
Please bear in mind that when I heard such rationalization for workplace bullying (click here and here for examples of workplace bullying), I was in acute medical/surgical wards, NOT in intensive care or the emergency departments.
Yes, such "army-style" attitude exists amongst some old-style nurses from the historic "School of Nursing" and is also common amongst those foreign trained nurses who received the same shit in their own homeland. Ever heard of "nurses eat their young"? Yes, that's nursing in Singapore, and I know that I'm not the only one who experienced such bullshit. [Click here for a blog entry by another nurse who had left Singapore for Australia.]

To Singaporeans reading this, think hard about the effect this has on your hospital treatment. How would you like to be the patient involved in a medication error where the system is not improved to prevent future errors because real culprit escapes corrective action through bullying another nurse to be the scapegoat? [Click here and here for examples.] It happens more often than you think, it's just that we (new nurses) have learned to suck it up and move on.


While in nursing school, I experienced your example of "You and I never had this conversation, is that clear?" too.

One day, my main nursing lecturer J called me to her office to discuss something serious. One of my subject lecturer R was accused by an anonymous student of being bias in his selection of students for an overseas nursing trip, and using the school-funded trip as a Christian missionary trip. It was made known to J that I may be the student who lodged the anonymous complaint to the school's administration. J asked me some questions, to which I answered honestly: no, I do not know anything about the complaint prior to J telling me about it; yes, I did ask R to join the trip; yes, I know that I was not selected; yes, I know some of my classmates were selected (mostly all Christians, except for 1 Muslim guy); no, I didn't care if I was selected (I didn't mention it but I had since signed new IT contract work with my clients then, so I had my hands full during the school break). At the end of our session, J advised me, "You and I never had this conversation, is that clear? I don't see, hear, or know anything. You don't see, hear, or know anything either, okay? If I were you, I wouldn't say a word to anyone."

Stupid me was naive and didn't want to see others get into trouble. So I told TT, who was one of my Christian classmates selected for the overseas trip, in confidence about the matter. I ended our conversation with, "Look, R is a good guy. Don't get him into trouble."
Hey, I used to work in IT and I consider most of my colleagues good guys. In fact, I even praised my colleagues in front of their respective partners that their husbands/fiances/boyfriends were good guys or great colleagues. Such is the trust and rapport between us that occasionally when my colleagues were too absorbed in their work to answer their partners' call, their partners would call me to help them check what's up with my colleagues.
Subsequently, it was announced that R would be removed as our subject lecturer at the end of the semester and transferred to teach other students. He would replaced by another (humorous) lecturer. My classmates didn't want to lose R who gave tips before tests. Thus they cajoled me (as one of the known outspoken students in the class) to speak up on their behalf for retaining R as our subject lecturer when the Course Manager was scheduled to meet the class. Frankly, I didn't care either way, but thought it would be good to help my classmates voice their preferences, and so I did.

2 years down the road just before I migrated, I returned to the nursing school to visit my supportive lecturer J once more. J told me in confidence that there was a rumour that I was in love with R and that's why he was removed as our subject lecturer. I replied, "Could there have been a mistaken identity? Are you sure that the student in the rumour was me?" several times, and she replied in affirmative that I was the protagonist in the rumour. I was thinking, "WTF!" So much for being an open, honest and helpful person. So much for "good" Christians not spreading lies too. Yes, I have since learnt to "sweep my own doorway of snow" [自扫门前雪].
Coincidentally, as J spoke to me while we were walking to a school canteen, R and the humorous replacement lecturer were walking towards us along the same corridor. We exchanged banal pleasantries when our paths crossed, all while my mind was still flummoxed by being the star of a 2 year-old rumour. Yes, I am a good actress.
Sorry I digress... but nursing in Singapore opened my eyes to the ugly side of human nature of some in the "caring" profession. Army is supposedly a "kill your enemy" profession (whether conscripted or sign-on), so I don't expect people inside to be any different or better.

p.s. Yes, I also learned about avoiding the tall poppy syndrome from my Singapore nursing experience. In fact, I was so good at pretending that my English was poor that my nursing colleagues were surprised by my IELTS result.

p.p.s. As for pleasing people and saying what they want to hear, I learnt that in my first career -- I was in the banking and financial services sector too. That said, if you read my blog, you'd know that I am selective about who I please. E.g. I couldn't care less about paper tigers like ADON G, but I sure gave 101% face to my DON and the other ADON S!

6 comments:

  1. hello winking doll, it's my first time chance upon your blog. I'm a registered nurse in sg too! whatever you wrote just now was/is so true. although i nv work in wards before, but i heard it from my peers.. i hate to say this but my nursing experience in sg is pretty limited but at times i felt that i've seen enough. unfortuntely, my last workplace/healthcare institution was the straw tt break the camel's back.. i think i'm out of nursing for good. :-(

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  2. Hi jingyu,

    Thanks for visiting my blog and sharing your comment. No worries about your experience being limited. Trust your guts. I felt I've seen enough on my very 1st day of clinical attachment in Singapore (as a student nurse), and I wasn't too far off -- maybe I would share this in future.

    > the straw tt break the camel's back

    Before giving up on nursing, I would encourage you to check out what nursing is like overseas. Yes, there are still those who practise bullying (my friend AA calls them assholes). Nevertheless, my 1st experience of bullying as a student nurse in a Canadian hospital proved to me that things can be different. I will get around to writing about it someday.

    Take care!

    WD

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  3. Hi Miss Doll,


    One of our closer friend in Perth now, Grace, was a nurse in SGH. After she went for further studies in Perth, she refused to go back to Singapore despite her a parents' disapproval.


    A few years later, I met her in Perth for the first time and she told me all about her experience in SGH. You told no lie, it was as bad as you described. Needless to say, she was all praise for working as a nurse in Perth. She has been working for the same hospital here for 7 years. 3 more years she will be awarded a long service award.


    Her reward would be 1 FULL YEAR OF LEAVE and she is not required to clear it within a specific period or whatsoever. She is also allowed to spread out her usage of the award any way she like it.


    I'm not a nurse so I wouldn't know the difference between working in Singapore as a nurse compared to overseas. But for that long service award alone, I think we have nothing to debate about here.


    Another thing I noticed is that all the hospitals in Perth have a policy which tolerate no violence or abuse from patients. Offenders will be escorted out with no exception. I'm sure this kind of policies allow nurses to have a peace of mind working.


    It's just a freaking job and working as a nurse in Singapore makes it more than that.


    I will be recommending your blog to another nurse whom I met online via my blog. She is a nurse working in Singapore now and have applied to come over to Perth. Guess she knows the story well too and she'll find your blog interesting.

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  4. Hi A Singaporean Son,

    Thanks for dropping by, commenting on my blog and recommending others to visit.

    > a policy which tolerate no violence or abuse from patients

    You're right. The anti-violence policy and its enforcement makes a huge difference. The problem in Singapore is there is no effective union to speak up for the workers (nurses or otherwise), so whatever policy, that may look nice on paper, will fail at the implementation stage due to the power differential (employees fear losing their jobs or denied opportunities).

    E.g. See the 3rd paragraph of my blog post below.
    http://winkingdoll.blogspot.ca/2010/06/time-to-change-tune.html

    In Canada, there are human resource laws that enforce protection for employees and demands workplace safety measures -- not just physically safe but also mentally, psychosocially safe. Thus if an employee lodges a complaint (even if it is emotional bullying), it is taken seriously because the company can be fined big time and/or sued by the employee big-time too. In fact, I personally came across someone who got a million $ pay-out from a previous workplace due to a back injury from safety issues. She still can walk, work, just not lift heavy weights, but the pay-out is punitive in nature. Also if one feels forced to resign due to workplace bullying or safety issues, etc, one can claim Employment Insurance (i.e. unemployment benefits), so long as one has an outstanding case pending investigation.

    I am not sure about Australia, but I would bet that there are similar policies.

    In short, by losing an effective union (f* "NTUC's tripartite") and the right to strike, Singapore workers have lost their much of their human rights.

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  5. NTUC? simi lai eh? buy grocery one issit?

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  6. PAP created NTUC as the "sole national trade union centre" in Singapore.
    http://en.wikipedia.org/wiki/National_Trades_Union_Congress

    IMHO, it is to eliminate independent unions in Singapore, so that they have full control over the labour force. That is, to indirectly castrate the powerful unions that once brought PAP into power in the 60's.

    Well, NTUC did a good job at selling out the labour's rights. "Tripartite" is supposedly business, labour and government negotiating as equals, but we know where the recommendations from NWC (National Wage Council) has been heading towards for the last decade. As of now, how many Singaporeans think of NTUC as a union vs how many think of it as a supermarket/insurance company (like you did)?

    Look at the joke of the "labour chief". More like Indian chief (no offence to the native Indians), lots of hot-air and smoke only.
    http://www.youtube.com/watch?v=O4_KHjDsDag
    http://www.youtube.com/watch?v=b_GRJHcHHws
    http://www.youtube.com/watch?v=ao-DGAw1Q2o

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