So long & thanks for all the fish

I have not been blogging much, mainly because every time I thought of something to write about, I would be distracted by Life. Then a few days would pass and I would re-think about the topic and conclude, "Nah, it would be so mundane to others."

[06-Feb-2014, A flock of birds flying overhead in Richmond]

E.g. Who would be interested about watching flocks of birds? Or kids dancing, mimicking the life-size XBox display at a shopping mall? Or the mesmerizing snow flakes falling? Or watching the fog as it creeps in and as it rises? Or the excitement of seeing buds in trees heralding the arrival of Spring? Or of gangs in Metro Vancouver? Or thoughts inspired by seeing a bird eating a road-kill rat? And for all of these, nothing beats being there to experience it for oneself.

Anyway, I started this blog 5 years ago. At that time, I was about to enter nursing in Singapore professionally, and I knew that I would have to make a decision about emigration soon. Thus, I started the blog as a coping mechanism to "let-off steam" and to have a record to remind myself that life has its ups and downs. 5 years on, I've:

• changed country of residence,  
• changed jobs, and re-entered nursing in a new country, and 
• changed my marital status. 

IMHO, that is a lot of changes. I have shared some of my journey/challenges/excitement because I thought that others on similar paths may benefit/learn from my experience. [FYI: Here's my inspiration.] Indeed, from the blog search statistics, readers land on my blog while seeking information about:

• nursing in Singapore and/or WDA's career conversion to nursing, 
• nursing in Canada, especially CRNBC's SEC (or here for CRNBC's Web Learning Modules or here for CRNBC's FAQ about Nursing Standards), CRNE preparations and/or results for IEN, and/or
• Singapore and emigration.

While my life journey continues, I would recommend those who are searching on any of the above topics to go online to search for the most current information directly from the source. E.g. Singapore's WDA website, CRNBC website, Canadian universities' websites, and the Citizenship and Immigration Canada website, etc. After all, policies change -- sometimes surprisingly (click here, here and here) and/or suddenly (click here, here and here).

[06-Feb-2013, A Canadian RN at last, 
3+ years after the initial 16-Nov-2009 IEN application]

As for those looking for overseas Singaporeans' views on life/events in Singapore and life overseas, there are plenty of other bloggers who write well. Please feel free to check out some of the blogs listed on the right column. Besides, whatever that needs to be said has been spoken of repeatedly by many bloggers. If one still does not wake up, then I guess this individual needs his/her "Aha!" moment for a paradigm shift. IMHO, it might take 1 to 3 generations, but the writing is on the wall for Singapore's future. Click here, here, here, here, here and here. [Note: I sincerely hope that I am wrong, for I am the only one in my family who emigrated.]

Besides, this blog was also meant for me to let-off some steam anonymously. But as we all know -- there is no such thing as true anonymity when one starts to share details from one's personal life online, especially as one's social circle expands. [See also here.] I stand by what I wrote, my feelings/opinions are true at the time I wrote my blog entries. That said, I would prefer if people take time to get to know me face-to-face, rather than knowing so much about me when I hardly know anything about them.

To those who ask, "Are you Winking Doll? I read so much (about you & your life) from your blog": Thanks for asking, Winking Doll is my online persona, there's lots about me that I do not share online. I hope we'll get to know one another slowly over time -- i.e. let relationships develop/die organically.

I am not hanging up my online pen instantly or forever. For one, I still want to get around to sharing about my emigration planning process as discussed with ASingaporeanSon previously on our occasional Facebook chat. I think it may give hope to those who think that they are stuck on a little red dot because they don't have paper qualifications, money and/or connections. For another, I will still lurk around online to comment on various blogs, and maybe write once in a blue moon. And I want to share one more post on my thoughts on destiny before I go.

Otherwise, life is calling. So long, and thanks for all the fish!

So Long and Thanks for all the Fish
-- The Hitchhiker's Guide to the Galaxy

The Suay Kuan [The Unlucky Ones]

Just to share a real-life story from Anonymous who commented on Thursday, November 07, 2013 8:14:00 AM on my blog post "It's not so simple". If you want to believe how Singapore's healthcare system is "world class", then perhaps people like Anonymous and I are the just "the suay kuan" [i.e. "the unlucky ones"]. Otherwise, you'd question whether the occasional reports that leak about the aggression and violence faced by healthcare workers (nurses in particular) in Singapore are really the tip of the iceberg of an endemic issue.

Thank you, Anonymous, for sharing your personal story.

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[The following is copied from a comment left by Anonymous on Thursday, November 07, 2013 8:14:00 AM on my blog post "It's not so simple". Changes in font size, bold, italics and underline are added by me for emphasis.]

As a student nurse in Singapore, I bore witness to the most horrifying situation that happened in the hospital. There was a patient which was coding, and there were only 2 student nurses (one of which is myself). The emergency button was pressed. Guess what...a registered nurse (foreign trained) appeared but she took a look and walked off saying she needed to fetch her patient from OT. Needless to say , patient died because there were only 2 of us to do cpr and suction the bloody emesis while yelling for help after she left. Worse timing was it happened during break and the other nurse was in the private room doing a tracheostomy dressing. After she heard us, that nurse ran out of the private room and immediately took action. I reported that foreign nurse.

HO HO HO. I got blacklisted for pushing the matter. The senior nursing officer was telling me to keep quiet if I wanted my career. I stuck to my principles. Worse of all , I was bonded. So you can imagine what happened to me.....

When they made my life a total misery and told me that I was the most useless nurse etc , that I will never make it anywhere else ...etc ....making my rosters 12 days in a row and one day off at each end [checked, I have experienced that]. Even better, making me work when I was having a fever [checked, I have experienced that too], and landing me in ED with a 40 degree fever and a fit. THEN telling me that if I take more than 3 days leave, I can forget about my performance review. That went on for more than 3 months. 

It broke me down. For doing the right thing, I got marked. All the time, I kept it from my family until my father found me at the edge of our study window deciding whether I should jump or not. He decided to buy out the bond. 

Even better when I sent the resignation letter in, matron called me down and asked me if I can 'even afford' to pay off and I would be 'stuck' with the debt as well as saying 'you know....your family is not that rich and you might need to wash the dishes ' when she did not even know my family background. I looked at her and said "cash ,cheque or credit card? Which payment option to take". She retorted at me "how dare you talk to me like that girl [again I have a similar experience]... your family is poor and you want to drive them into debt" [again similar to my experience].

The day after my father came, suddenly I was called down.....the matron met my father. HAHAHAHA She asked me if I told him anything about the hospital and the complaints I was making. I looked at her and informed her that whatever I said to my father is covered under lawyer client privilege and I know my rights. She was frightened. My father's old classmate was the CEO of that particular hospital and he told me while the matron was coming out, the CEO was just walking out to lunch and greeted him. HAHAHAHAHAHAHAHA

Suddenly the matron decided that I was the poor nurse getting bullied by senior nurses and she will discipline them ...and that every ward would be happy to take me in if I decide to withdraw the cheque and my resignation. My final words to her : Go to Hell. 

I was naive and never used my dad as a connection. Had I revealed who my father was sooner, perhaps they would have licked my ass and gone after the incompetent nurse.

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To my readers: The stuff that I wrote on my blog about nursing in Singapore has already been "censored" by me to avoid stuff that may cause lawsuits to my previous employer, etc. So I am not surprised at all by the stuff that Anonymous shared. Nursing in Singapore has a long way to go before it is truly a respectable profession.

SG Nursing Board - To be or not to be?

I received the renewal letter for my registration renewal with the Singapore Nursing Board recently. 

[SNB letter sent to my Canadian postal address]

Previously, I have maintained my Singapore nursing registration (just in case I need a Plan B) while working towards my Canadian (i.e. British Columbia) nursing registration. Now that I've obtained my B.C. nursing licence, the question is whether to continue with my Singapore registration.

I do not see myself returning to nursing in Singapore, given the very different work and/or nursing culture there. [IMHO, it is a rather inhumane and inequitable work culture. Click here to see what FrugalIntrovert wrote about the Singapore work and lifestyle norms.]

That said, it is hard to give up on one's roots. Similarly, on the issue of "to be or not to be a Singapore citizen" -- as per my comments on ASingaporeanSon's blog entry.

Privatized healthcare vs universal access

While chatting with my boyfriend DD today, he mentioned that one of the factors (amongst several) of his decision to return to Canada was the way healthcare system works in USA (pre-Obamacare). [Note: USA was a country with better job prospects in his industry compared to Canada at the time of his relocation.]

I shared with DD that, IMHO, the Singapore healthcare system is even more "right-wing" than USA's. E.g. A couple, who despite having bought insurance for their child and both holding well-paid professional jobs, going into credit card debts to pay for healthcare for their child with congenital issues. E.g. An elderly childless-woman who was told to sell the remaining lease of her 3-room HDB apartment (leaving her with no home of her own and having to live under her niece's equally small HDB) before she could apply for Medifund funding for her repeated acute hospital care.

As I am currently working in paediatric home health nursing in B.C., Canada, I can see the difference in the kind of support (from the provincial government) given to parents with children who lucked out on rare, chronic or deadly illnesses. In addition, Uncle Wing's (bless his soul) own experience is testimony to how the B.C. healthcare system takes care of its seriously ill elderly. [Click here to see my year-2009 blog entry about BC nurses petition against healthcare underfunding and Singapore's privatization of healthcare.] While I do not deny that Canada's system has its weaknesses, I feel that it caters well to “不怕一万，只怕万一。” ["Not afraid of the common scenarios (that one can plan for), but fear the exceptional scenarios."] After all, how many of us would choose (for the sake of maximizing our usage of universal healthcare): 

• to be involved in major road traffic accidents (and thus requiring extended intensive care and probably repeated restorative surgery and extended rehabilitation); or
• to have children with rare, chronic and/or deadly illnesses; or 
• to have elderly parents with chronic, debilitating and/or incurable illnesses?

Yet there will always be Singaporeans who would defend that the Singapore healthcare system is better (e.g. more efficient and/or more cost-effective, or more equitable because specific-user-pays instead of risk-sharing) than Canada's, Australia's, UK's, etc. [Just check out the comments on those blog posts.] I hope that these "loyal", "patriotic", defensive Singaporeans will never have to encounter any major/repeated healthcare issues personally and/or amongst their loved ones.

Another issue I have with the way private healthcare works in Singapore is that until recently (see below), there was little control on the runaway costs/mark-ups in private healthcare. Note: I have met a significant number of private specialists who would waive/discount their fees to help the "needy" patients, thus it would not be fair to tarnish all kind-hearted doctors because of one black sheep. Nevertheless, IMHO, it is human nature to compete to be the better paid specialist. After all, it is so very much in Singapore's culture to judge people by the size of their income.

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[Extracted from The Straits Times Online website.]

Dr Susan Lim loses appeal against SMC's guilty verdict

Published on Jul 01, 2013 1:39 PM

By Selina Lum And Kc Vijayan

The highest court in Singapore on Monday dismissed an appeal by general surgeon Susan Lim against her conviction on charges of professional misconduct over the amount she charged a patient from the royal family of Brunei.

In a 109-page written judgment, the three-judge Court of Appeal said Dr Lim's case was "clearly one of the most serious cases - if not the most serious case so far - of overcharging in the medical profession in the local context". The court dismissed her claims that she was justified and there was no ethical obligation to charge a fair and reasonable amount and pointed out her approach showed she had shown no remorse.

In the judgment, the court ruled there is an objective ethical limit on medical fees that operates outside contractual and market forces, The court found that, given a doctor's specialised knowledge and training, there arises an ethical obligation on the part of a doctor not to take advantage of his patient. And this ethical obligation to charge a fair and reasonable fee is not superseded by a valid agreement between the doctor and his patient, the court held.

In 2012, Dr Lim was found guilty of 94 charges of professional misconduct by a Singapore Medical Council (SMC) disciplinary committee for charging about $24 million for the services provided to Pengiran Anak Hajah Damit Pg Pemancha Pg Anak Mohd Alam for 110 treatment days from January to June 2007. Dr Lim was then given a three-year suspension and fined $10,000 - which was upheld by the appeal court.

The Art of Bond Breaking

Earlier today, an anonymous person wrote a comment asking the following in my other blog post "Equal pay for equal work in Singapore?" Let's call Anonymous "CBF" (short for "concerned boyfriend").

Comment from CBF on Monday, April 15, 2013 at 8:50:00 AM:

I have a girlfriend whos also bonded to one of these sponsorships at ngee ann polytechnic. As a malaysian, she is bonded for 6 years instead of the standard singaporean 3 years which is kinda unfair. Do u have any idea what should be covered or paid altogether to break the bond after she graduates? Does the bond breaking cost lessens if she works longer in the bond ? I just want to get her out of that hellhole asap.

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My reply to CBF is below:

Reply from Winking Doll on Monday, April 15, 2013 at 3:49:00 PM:

Hi Anonymous at Monday, April 15, 2013 8:50:00 AM, 

> Do u have any idea what should be covered or paid altogether to break the bond after she graduates? Does the bond breaking cost lessens if she works longer in the bond ? 

You have to read your girlfriend's specific contract very carefully to determine the answer to your questions. I honestly cannot know because even amongst my classmates, each of us had different bond contracts with different terms-and-conditions. Be very careful of the difference between the "norms" and the "actual signed-contract". 

That said, whatever the contract says, IMHO, chances are that the paper-pushers will try to make things difficult for your girlfriend to leave. Your girlfriend has to be cunning and emotionally strong to withstand the pressure given. 

Just to share with you my experience. My HR manager informed me that a WDA staff told my HR manager (an out-right lie) that I had signed a contract with WDA which stated that I have to repay the full 100% regardless of the time-served (which also contradicted what they "advertised" during their recruitment talks and my HR's understanding based on past practice). I pointed out to my HR manager that I never signed any contract with WDA, the only contract that I signed was with my hospital which clearly stated that the amount was to be pro-rated based on the time-served per the schedule of bond depreciation given to me earlier by my HR. Thereafter, my HR manager alleged that the WDA staff "blackmailed" my HR to "persuade/pressurize" me to write-and-sign a letter "asking for understanding for my special case" (i.e. covering their ass by implying that they WDA had the right to determine the T&C's of my bond termination) and also demanding a slightly higher repayment than what my hospital's schedule of bond-depreciation indicated contractually. After discussing with my HR manager, I wrote and signed such a letter as I just wanted to tie-up the loose-ends as soon as possible. According to my HR manager, instead of following through with the agreement, the WDA staff refused to reply to confirm or refuse acceptance of my resignation. Long story short, from what I understand, in the end my *HR manager* pressurized WDA to accept the slightly higher payment because I threatened to abscond. Note: I already had Confirmation Of Canadian PR and was preparing to leave Singapore.

http://winkingdoll.blogspot.ca/2012/11/questions-about-pcp-nursing-in-singapore.html 

[Extract of the original COPR sticker on my passport]

That was how bad things were for me. So in your case, please tell your girlfriend to tread carefully and be strong mentally. You don't want her to end-it-all in an unfortunate manner.

http://winkingdoll.blogspot.ca/2009/03/value-of-human-life.html 

> As a malaysian, she is bonded for 6 years instead of the standard singaporean 3 years which is kinda unfair. 

I disagree with you on that. If you want to argue, we the *CITIZENS* of Singapore can even say that the government of Singapore should not even offer to sponsor non-citizens, such as your girlfriend, for the nursing course. Instead the sponsorship/academic-opportunity should only be given to Singapore-citizens interested in pursuing nursing. Fair? If you're not a citizen, you have *no right* to any *entitlement mentality*.

That said, I think it is unfair if your girlfriend was paid more/less than her colleagues with the same education, training, skills, experience and job performance on the basis of her Malaysian passport alone. Meritocracy requires that workers be paid equitably, something which Singapore claims to be but really isn't. 

> I just want to get her out of that hellhole asap. 

I agree with you that it can be a hellhole. I suggest the following so that your girlfriend will retain her licence to pursue nursing overseas if she is interested. Go apply overseas for nursing licence first before quitting Singapore nursing. E.g. Australia recognizes Singapore-educated/trained nurses. Please google the internet for details, since I did not take the Australian route. 

Cheers, WD.

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Just some additional notes:

[Extract from the Official Receipt for my bond re-payment]

Firstly, I doubt that CBF's girlfriend is on the same scholarship/bond scheme as me.

• I was from the WDA Professional Conversion Programme for Registered Nurses (PCP-RN) Programme. [Albeit it was known as the Strategic Manpower Conversion Programme (SMCP) during my time.] For that WDA sponsorship, the bond period is 3 years regardless whether the applicant is a Singapore Citizen or a Singapore Permanent Resident. [Those who are neither citizens nor PRs are not eligible for the scheme.] In my case, WDA mis-represented their bond depreciation scheme in the recruitment talk (i.e. their staff said that it would be depreciated for each full-month of employment completed) and thereafter (according to my HR manager) outright lied to my HR manager about my bond "contract agreement" with them. In other words, WDA had no legal case against me (personally) for pro-rating the bond instead of paying up 100% of the (full, un-depreciated) bond amount. To quote my HR manager, "They (the WDA staff) are giving us shit, let's give them shit back!"

• I believe CBF's girlfriend's scholarship was for nursing as her first tertiary education, e.g. Nursing Sponsorship for Diploma in Nursing for which the bond is 3 years for Singapore Citizens and up to 6 years for non-citizens. This discrepancy in bond period between Singapore citizens and non-citizens under that scheme is an open and well-known fact -- something that CBF's girlfriend would probably have known before she signed on the dotted lines of her contractual bond. Please don't turn around and say "unfair" if one willingly signed up and took advantage of a scholarship which may otherwise have gone to someone else.

Secondly, don't believe that all Singapore civil servants are "just follow law" type (see movie trailer below). IMHO, my experience (as above) clearly shows that some civil servants would play dirty to pressurize (those whom they consider) "minions" to toe-the-lie. Thus, please be careful if one is planning something that may upset these paper-pushers, e.g. by breaking one's bond. IMHO, you can afford to retaliate with equally dirty-play only if you have your escape hatch planned out. [E.g. my Canadian PR status.]

"Just Follow Law" Movie Trailer

Thirdly, CBF, I am sorry for your girlfriend's situation. As you've stated, you feel that your girlfriend is in a "hellhole" because of her Singapore nursing job. 

• That said, unless you (CBF) are willing and able to support your girlfriend for the rest of her life, I believe that she has to plan strategically and not act on impulse. Lay out one's long-term career plan and escape hatch carefully before launching into action. [E.g. I tolerated the Singapore nursing crap for 1+ years before leaving.]
• When they cannot touch one anymore, be sure to spread the message. [Click here, here, here, here, here or here for Singapore nursing news outlets.] Tell others about one's experience of the Singapore nursing culture and/or the potential flip-side of being bonded (i.e. being stuck in an unhealthy workplace). I believe that if everyone does his/her part, the truth about nursing in Singapore will emerge and actions will be taken to improve the situation when they hit recruitment issues and/or widespread public pressure.

[Image source: 04-Apr-2013 Singapore Nurses United Facebook page.

Original online article: 04-Apr-2013 ST Premium - Forum Letters.]

Lastly, a cautionary tale for CBF's girlfriend. Unless she is able to pay up the notice-in-lieu and quit on-the-spot, she has to be careful of bitchy attacks/bullying from some colleagues upon making known her intent to resign. My Singapore nursing lecturer warned me about some people who will "react strangely" (perhaps out of jealousy) when one has an opportunity for brighter career prospects (and leaving the crap behind, whereas they remain stuck in it). And indeed, it happened to me.

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[Addendum on 19-Apr-2013, extracted from the comments section of my previous blog post.]

Reply from Winking Doll on Friday, April 19, 2013 at 3:38:00 PM:
Hi Concerned Boyfriend,

Below is a comment from someone who completed a similar bond (as the one your girlfriend has) with "the aforesaid hospital". Do excuse her language as she did not have a pleasant work experience there either. [Note: I have edited her message slightly for clarity only.]

Firstly, a DECLARATION AND DISCLAIMER: The following are personal opinions from me and the aforementioned person. Neither of us is a Human Resource personnel, nor are we in any way trained in the matters of handling termination of scholarship bonds. Thus any content from us shall be construed as a sharing of personal opinions, not career nor legal advice. We do not guarantee the accuracy, completeness, or usefulness of any information provided by us. Under no circumstances will we or anyone related to this content be responsible for any loss or damage resulting from any reliance on the information or other content posted or linked herewith.

Ex-staff wrote: "Wtf, it's pro rated. It's written in the contract -- which year, u pay how much. If that's the case*, just leave without notifying them. My friend did that as she had depression n just left. It costs too much for moh pursue lawsuit, more than the amt she owes (to them). But I'm so sure the breeching (i.e. bond-breaking) contract fee decreases each year."

*Note: By "if that's the case", she was referring to any threat/suggestion that your girlfriend has to pay up the full bond amount.

Please be aware that the above person left "the aforesaid hospital" years ago, so no one knows for sure if the above will apply to your girlfriend as well. Also be prepared that the paper-pushers may suddenly unveil their iron-fists under their gloves as they did in my case.
http://winkingdoll.blogspot.ca/2013/04/the-art-of-bond-breaking.html

Good luck.

Cheers, WD.

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Read also "The Suay Kuan" -- a real-life story of his/her Singapore nursing and bond-breaking experience as shared by an anonymous reader of this blog.

Medicalization of health issues

The video below is a humorous look at the medicalization of health issues in developed nations. The song is based on USA. Nevertheless, similar issues abound in Singapore and Canada.

"Take Ten Pills and You're Fine"

IMHO, the best solution is to educate healthcare users. E.g. The video below on opioid medication by Dr Mike Evans (with support from MyFavouriteMedicine.com, Centre for Addiction and Mental Health and Canada Health Infoway).

"Best Advice for People Taking Opioid Medication"

Note from 7:18 to 7:30 where Dr Mike Evans says, 

"My sense is that many patients who are taking opioids for pain are painted with this wider brush of suspicion, which is unfortunate."

When nurses hurt nurses

Since I get some hits from Singapore and Canada regarding nursing (e.g. search on the "Nursing in Singapore" blog category or Goggle for "IEN SEC"), I would like to share about relational aggression in nursing and an article on how to deal with bullies in the workplace.

I have recently finished reading a book, "When nurses hurt nurses - Recognizing and Overcoming the Cycle of Bullying" by Cheryl Dellasega. IMHO, it gives a good overview of relational aggression that was (and still is) so commonplace in nursing (especially in Singapore) such that it contributes to common refrains like "nurses eat their young".

About the author: Cheryl Dellasega, PhD, CRNP, works clinically as a nurse practitioner and researches extensively on relational aggression. Her published books include "Surviving Ophelia" and "Mean Girls Grown Up".

IMHO, ultimately the patients suffer when relational aggression in nursing is not addressed. At least in B.C., Canada, there are laws and organizations (e.g. nurses union) that push for and support policy changes to reduce systemic factors. In Singapore, with labour policies that supports discrimination and suppression of labour rights, one can't help but to ask, "What has changed? What will change?" My hopes are not high.

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[Extracted from Appendix F - Nurse-to-nurse bullying: the RN way of RA]

Some examples [of relational aggression] include the following:

• Giving another nurse "the silent treatment" [Example here is from my own experience, not nurse-on-nurse; but I have seen it happening nurse-on-nurse.]
• Spreading rumours throughout the unit, hospital, or organization
• Humiliating or putting down another nurse, usually with regard to his or her nursing skills or abilities
• Failing to support another nurse because you don't like him or her (this could be anything from failure to help with care to disagreeing with decisions the nurse made) [Or working new staff like slaves, e.g. see the block quote in this blog post on "Pneumonia".]
• Failing to come to another nurse's assistance because you don't like him or her (a particular problem in EDs [Emergency Departments] and psychiatric units)
• Refusing to share information with another nurse or otherwise setting him or her up for failure [Click here or here.]
• Excluding another nurse from on- or off-the-job socializing
• Repeating information shared by one nurse out of context so it reflects badly on him or her
• Running a smear campaign or otherwise trying to get others to turn against another nurse
• Sharing a confidence you were asked to keep private, and perhaps twisting it a bit out of context
• Making fun of another nurse's appearance, demeanour, or other trait. [E.g. I have noticed this behaviour occasionally from a few Filipino GNIE classmates; I am not proud that I was a silent observer.]
• Manipulating or intimidating another nurse into doing something for you
• Using body language (such as eye rolling or head tossing) to convey an unfavourable opinion of someone. [This happens a lot in Singapore wards.]
• Saying something unfavourable, then pretending you were joking. [E.g. I have noticed this behaviour occasionally from a few Filipino GNIE classmates; I am not proud that I was sometimes the victim and more often a silent observer. If the victim reacts negatively and/or calls out their uncivil behaviour, they would gossip amongst the Filipino group that the victim was "too stressed, and needs a good fuck."]
• Name-calling
• Making a nurse look bad in front of patients, other nurses, or supervisors. [E.g. Read the comments in this blog entry or here.]
• Teasing another nurse for his or her lack of skill or knowledge

The Joint Commission for Accreditation of Healthcare Organization (JCAHO), which is responsible for regulating acute care organizations, takes this issue so seriously that as of January, 2009, they require policies to be in place that will help detect and address relationally aggressive behaviours.

[Unfortunately in a really bad environment, the nurse manager may well be the bully himself/herself. Extracted from page 134 "How Managers Bully" - Nurse-to-nurse bullying: the RN way of RA]

These (managers' bullying tactics) include behaviours such as the following (to name a few):

• Publicly discipling nurses who have made mistakes
• Threatening consequences if nurses don't do what the manager wants
• Playing favourites
• Setting up certain workers to fail by withholding information

[Dellasega, C. (2011). When nurses hurt nurses - Recognizing and Overcoming the Cycle of Bullying. Indianapolis, IN: Sigma Theta Tau International Honor Society of Nursing]

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I have seen a lot of ugly behaviours while nursing in Singapore -- the stuff that I wrote in my blog about workplace bullying is just the tip of the iceberg; i.e. stuff that won't get me or my previous employer (hospital) into legal trouble. I recognize that I have occasionally behaved as a bully too while surviving as a nurse in Singapore; and I am not proud of myself for that.

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What should one do when one finds oneself working amongst these sharks dressed as angels-in-white? Barbara A. Broome, PhD, RN, wrote an interesting article of practical advice - "Dealing with Sharks and Bullies in the Workplace". Here's an extract of her advice.

1. Assume all unidentified fish are sharks. ... In other words, you don't really know who or what you are dealing with, so be on guard.
2. Do not bleed. ... In the case of bullying, remove yourself from their presence. Giving way to crying, using defensive behaviour or trying to provide an explanation only provides more opportunities for aggression.
3. Those who cannot learn to control their bleeding should not attempt to swim with sharks for the peril is too great. When attacked, control your anger and state only the facts. Controlling your anger changes the power of the bully. The bully will be confused as to whether or not the attack has injured you and will be unsure of their advantage. ... Always document the interaction.
4. Counter any aggression promptly. Sharks and bullies rarely attack without warning. Usually there is some tentative, exploratory aggressive action. It is important that one recognizes that this behaviour is a prelude to an attack and take prompt and vigorous remedial action. The appropriate countermove is a direct discourse about the inappropriate behaviour.
5. Avoid ingratiating behaviour. One may mistakenly believe that an ingratiating attitude will dispel an attack. This is not correct; such a response provokes a shark attack.
6. Use anticipatory retaliation. One needs to develop the skill to counteract inappropriate behaviour. A constant issue is that the bully will forget and may attack in error. ... This memory loss can be prevented by a program of anticipatory retaliation. ... Your response to inappropriate behaviours is unexpected and serves to remind the bully that you are both alert and unafraid.
7. Identify disorganized and organized attack. There may be more than one bully acting in concert. ... It is essential that one know how to handle an organized attack. Confront the behaviour. Make it known that the behaviour is unacceptable and will not be tolerated. If the behaviour continues, a written complaint should be filed in human resources with the dates, times an details of each event. If there are witnesses to the event, their names should be included. A copy of all written communications should always be kept as a record of filing of the complaint and actions. As a last resort, legal action may be necessary. [IMHO, I am sorry to say that "legal action" is unlikely to work in Singapore, no thanks to its labour policies that supports discrimination and suppression of labour rights.]

[Broome, B.A. Dealing with Sharks and Bullies in the Workplace. ABNF Journal, Winter2008, Vol. 19 Issue 1, p28-30, 3p]

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Mean Girls: Four Ways to Respond - by Susan Fee

Singapore's union says no to equal pay for all nationalities

I am referring to this report from the Business Times dated 15-Dec-2012.

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[Extracted report from The Business Times dated 15-Dec-2012.]

NTUC says 'no' to equal pay for all nationalities

'Same job-equal pay' rule will put local workers and families at a disadvantage

BY ONG CHOR HAO

THE labour movement has rejected a call for workers of all nationalities to get the same pay for the same job, and recommended instead "fair and reasonable wages" for all.

Labour chief Lim Swee Say, addressing a range of labour issues at a press conference, said: "We are highly uncomfortable with this idea of 'same job-equal pay', because we feel that this will actually disadvantage our local workers and their families, and we think this is not the way to go."

The "same job-equal pay" clamour arose when a group of SMRT bus drivers from China held an illegal strike last month to signal their unhappiness about their pay being lower than that of their Malaysian counterparts, among other things.

Mr Lim, the secretary-general of the National Trades Union Congress (NTUC), said it was a sensitive, complicated issue but noted the issues to consider.

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See what Lucky Tan and Kristen Han (#spuddings) wrote about why that million-dollar minister's logic is flawed. IMHO, even an 18 year-old A-levels economics student would probably have a better grasp of basic economic principles of running a business than that million-dollar minister.

On other note, I am glad my foreign-talent friends ZS and JX (both from PRC and worked in Singapore for years) decided to give up their Singapore PR. They are indeed better off in Canada, given such government-endorsed discrimination in Singapore. In other words, with such government-backed discrimination, the kind of foreign workers that Singapore would attract and retain in the long-term are the rejects (at the bottom of the barrel) rather than the crème de la crème.

As for the nurses in Singapore, brace yourself that relational aggression resulting from such inequity will continue within the multi-national nursing workforce -- either until you retire/quit from nursing in Singapore or there is political change in Singapore.

Equal pay for equal work in Singapore?

Equal pay for equal work in Singapore? [Click here, here, here and here for online commentary arguing for it.] Here's the caveat: IMHO, this nationality-driven discrimination has become so widespread in Singapore that the bus drivers' situation is merely the tip of the iceberg. Are we ready to bite the bullet and do a throughout spring-cleaning?

Take a look at the healthcare sector in Singapore for example. Even nurses in Singapore are discriminated in their pay based on their passports. If you don't believe, just go check with the Human Resource departments of the various restructured and private hospitals. [I know about it personally from working at one such private hospital lodged upon a certain "mount", and heard about similar HR practices at another private hospital from an ex-colleague who transferred from there.]

Even monkeys know to reject unequal pay.

How do you expect nurses from various countries behave when they learn of the discriminatory pay in Singapore? Ever heard of "relational aggression" in nursing? [Click here for an example. In the example, SSN Y is a Malaysian who lived in Singapore for many years. SN J, SEN M and EN IV are non-Singaporeans. SSN R, SN SB, SN RB, SN M, PCA M and I are all Singapore citizens. I cannot recall if SSN L and SSN R are Malaysians or Singaporeans.]

Reading Vincent Wijeysingha's post on The Online Citizen, citing what he considered bad HR policies that risks passengers' and road-users' safety made me laugh -- cynically. My ex-colleagues and I have gone through similar (mis-)treatment as nurses at a certain private hospital in Singapore.

> "their six day work week did not mean working Days 1 to 6 and then resting on the seventh. It meant being allocated a rest day at any time during each seven day period: Thus they could be off on Monday, work twelve days straight and then be off next on the Sunday of the second week."

• Checked. I have been through that. Even pressurized to take up double-shifts, sometimes in the midst of 12 consecutive workdays, and in the midst of it, getting crap from my management. In addition, being pressurized to return to work even when I am sick with medical certificate from the doctor (click here and here) or on my "once-in-seven-days" day-off.

> "This did not include the already existing practice of not paying the drivers for the time it takes to prepare their vehicles prior to starting their first run of the day and servicing their vehicles after the end of each shift. Workers estimated that SMRT sucked at least one hour of unpaid work per shift from each driver"

• Checked. We were expected to arrive prior to the shift reporting time to complete various safety checks prior to the start of our shifts. Ditto to stay behind after the end of our shifts for various admin and add-on work. [Click here and here for examples.]

> "Constraints precisely designed to neutralise anyone who dares to ask for respect and dignity. ... Are told to go and join another company if they are unhappy with their pay and conditions?"

• Checked. I have personally witnessed a foreign-trained nurse secretly crying as she was forced to return to work at a ward where she was being abused by the "senior" (i.e. long-service) staff. The bullying is real. My nursing buddy who was sent to that same ward earlier became physically unwell after undergoing the stress from the collegial abuse. My buddy threatened to break her bond with the hospital if she was not re-deployed to another unit. Fortunately for my buddy, the management believed that she could afford to pay up the bond, and thus she was quickly re-shuffled to another unit to retain her services. When I asked the foreign nurse why she didn't she try to speak to the management like my buddy did, she told me that she did. The management told the foreign nurse that if she could not take the abuse, she could quit if she paid-up her bond. [Note: Being newly recruited from overseas, the management knew that the foreign nurse did not have the savings to pay up her bond.]

Consider how such labour abuses compromise not only the nurses' physical, mental and emotional health but also patients' safety. [Click here and here for examples.] How safe do you feel if the nurses caring for you and/or your loved ones are all-smiles in-your-face but actually breaking-down or burnt-out inside? How many nurses left the Singapore healthcare system in disgust? [Some of these left comments in my blog.] Unless you have personally suffered such systemic labour abuse and are happy to accept it over your entire career, please do not chide me for leaving Singapore. Do not chide me for breaking my bond in favour of my physical (click here and here), mental and emotional health. Do not chide me for choosing to work in a country where having real unions and enforcement of workplace safety laws meant that labour is treated with dignity and respect. [Click here, here and here.]

Other industries in Singapore that I came across with similar discriminatory practices and/or labour abuses include: construction, hospitality (hotels), information technology (including banking and financial services sectors), food and beverage / restaurants, etc. IMHO, anyone game enough to hunt for discriminatory practices and/or labour abuse just have to close his/her eyes and pick any industry, ANY industry in Singapore -- dig a little deeper and one will open a Pandora's box of filthy discriminatory HR practices and labour abuses.

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[Update Dec-25, 2014] Click here to read a blog post from "The Slim Rolly Polly Wannabe", another ex-Singapore nurse (now nursing in Aussie).

Questions about PCP Nursing in Singapore

In my previous (unrelated) blog entry, I received some questions from a reader Sue regarding the Singapore government WDA's PCP (Professional Conversion Programme, a.k.a. Accelerated Diploma) Nursing programme in Singapore. [Note: The PCP programme was previously known as the "Strategic Manpower Conversion Programme" (SMCP).] Since there may be other readers who may be interested in the programme, I shall post her original questions and my replies here.

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Anonymous wrote on Monday, November 19, 2012 3:58:00 AM:

Hi, I just came across your blog and would like to know a few things, hope you can help me with it.

For your PcP Nursing programme, did you get to choose your specialisation? Which is the specialisation that requires the least physical strength? What is the dropout rate for the programme?

Thank you (Sue)

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Winking Doll replied on Tuesday, November 20, 2012 1:22:00 AM:

Hi Sue, 

Thanks for visiting my blog. 

> For your PcP Nursing programme, did you get to choose your specialisation? 

Just to confirm, are you are referring to the Singapore WDA PCP Nursing Conversion Program? If so, during my time, the determination of one's specialization depends on one's sponsoring agency and its procedure. E.g. Some classmates are sponsored by nursing homes, and thus their specialty is already fixed (i.e. long-term care facility). E.g. In my hospital, my buddy stated clearly during her sponsorship interview that she is only interested in O&G, so they arranged for her to be interviewed by the O&G ADON. In my case, during the sponsorship interview, I stated that I had no particular preference (since I truly knew very little about nursing at that point). It was only near the end of the course that I played some politics and pulled some strings to get me transferred from Med/Surg to Paeds. E.g. My classmates at a restructured hospital received a form towards the end of the PCP course asking them to list their 1st to 5th preferred choice of specialization. That said, I don't know if the system has been changed since our time, it's been 5 years now. 

> Which is the specialisation that requires the least physical strength? 

Well, if you can get into Nurse Informatics, that ought to require the least physical strength. I wonder if my reader CK can help on this, since he is in the Nurse Informatics specialization. But then, there wasn't anyone in my cohort who ended up in that specialty. At one point, the Institute of Mental Health was looking for someone to go into that area. That said, I am not sure if how often such opportunities present itself in Singapore. 

Other areas that usually doesn't require much strength would be Neonatal Intensive Care Unit, Polyclinic nurse, Day Surgery, Endoscopy Centre (e.g. TTSH), and School Health Nurse. Avoid the Intensive Care Unit, Neurology Unit, and similar such areas where the patient is likely to be too sick to help you with their care by bearing/lifting some of their own weight.

I wonder how little physical strength you are expecting to put in. After all, the PCP training requires you to undergo Medical, Surgical, O&G, Paeds, Mental Health, OT and Emergency Dept clinical, so some physical strength is required to complete the training. That said, I think most able-bodied persons would meet the physical strength requirement. E.g. I was an underweight 40-43kg at height 155cm -- petite even for Asian females. Yet I managed to survived through Med/Surg, etc through "teamwork". IMHO, the killer isn't the physical work per se, but the bitchy female-dominated environment (especially of nursing in Singapore).

http://winkingdoll.blogspot.ca/2012/04/nursing-in-singapore-what-did-you-learn.html

http://winkingdoll.blogspot.ca/search/label/Nursing%20in%20Singapore 

> What is the dropout rate for the programme? 

My cohort started with 28. After the 1st test, 2 dropped out. After 2nd semester, another 1 dropped out. At the last semester, 2 deferred and another 2 did not complete the course (if I remember correctly). Amongst those that deferred, I heard that only 1 of the 2 returned to complete the program in the end. There were others from previous batches who joined our class along the way, so the ending numbers don't quiet synch. If you were to strictly count amongst the 28 who were at the same starting line, how many of those completed within the expected (scheduled) 2 years time-frame, then the answer for my cohort is that 21/28 or 75% completed as per original schedule. 

I think you have asked good questions. As I have mentioned above, I don't know if the system has been changed since my time. I think that it is best that you raise your questions at the WDA PCP talks promoting the conversion training. 

Cheers, WD.

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Just FYI for those who are interested. 3 (including me) of the 21 in my cohort mentioned above migrated to Canada. Note: That said, I did not do the nursing conversion programme to qualify for immigration to Canada. I already qualified for Canadian permanent residency based on my previous career and the Canadian immigration point system back in end-2006. I believe the same is true for my 2 other classmates who immigrated to Canada as well, for they too had submitted their PR application around the same time, before/near the start of our nursing programme.

IMHO, the WDA staff did their best to give me trouble when I tendered my resignation before completing my bond. Please read your contract carefully if your true intention is to leave Singapore with your newly acquired nursing qualifications. In addition, please be careful not to leak to others about your emigration plans, unless it is someone you can trust 100% to be on your side and who would be discrete about not accidentally leaking your plans to your workplace management and/or to WDA. Finally, be prepared to face "friends" who turn into jerks just because you choose to leave the little red dot.

p.s. Also do consider if you can put-up with and survive a potentially bullying/abusive environment long enough to earn your wings as a nurse.

The nurse-nun's story

I watched "The Nun's Story" on DVD yesterday. According to Wikipedia, the film is based on a novel with the same title written by Kathryn Hulme. It is a fictionalized story based on the real-life experience of Kathryn's partner Marie Louise Habets, who was a Belgian nurse and a former Religious Sister (i.e. Catholic nun).

As I watched the movie, I recognize the bullying (by some senior Religious Sisters) on the pretext of training "obedience" and "humility" in their younger nun (acted by Audrey Hepburn) training to be a nurse. [See also here.]

Now if one traces the history of female nurses in Singapore, one would learn that the first female nurses in Singapore were Catholic nuns from the Society of St Vincent de Paul assigned to (the Singapore) General Hospital. If you want to find out more juicy stories of struggles for power, accusations of bullying and discrimination, I recommend that you read "The Origins of Nursing in Singapore" from the Singapore Medical Journal.

[Note: According to a hospital's website, another group of Catholic nuns were serving as nurses in Singapore even earlier than the St Vincent de Paul group.]

I am generalizing here, but apparently the nursing culture in Singapore started out on the wrong foot and has continued to this present age. E.g. I am so sorry that even a lay-Catholic ADON subscribed to such out-dated ideas of how a nurse should behave -- i.e. accept all "shit", shut up and serve humanity with humility. Sorry, madam, we join nursing to be professionals (not to be exploited), and we certainly did not take any vow of "chastity, humility and poverty" that your nuns did.

Not a typical Singaporean

After meeting with the team for our GNIE school project today, AP, PY and I adjourned for a gossip break before continuing with our part of the project work.

PY is a PRC who was recruited from China by the Singapore government to study nursing in a Singapore polytechnic and had worked in Singapore for some years to fulfil her bond obligations. She has a negative impression of Singaporeans. E.g. not smart* (see below), kiasu (competitive), selfish, and so on.

I realized on our first day at school that PY did not liked being associated with anyone/anything Singaporean. I introduced myself as a Singaporean in class. When PY later introduced that she graduated from XYZ Polytechnic in Singapore, I remarked enthusiastically, "Hey, we were from the same school!" but PY's response was muted. So I asked her which hospital she was from, and when she replied, I mentioned that I had a friend was working there and asked her which department she was from. She snubbed me. Since she did not seem friendly at all, I hung out with the relatively easy-going young Filipinos (like AP) instead.

Towards the end of the 1st semester, after about 4 months of school together, one day during lab, PY suddenly remarked to me, "You seem smart, not like my schoolmates in Singapore. Why?" I just smiled. IMHO, PY, like many of the PRC students recruited/sponsored by the Singapore government, forgot to take into account that she has gone through a selection process, a filtration which (hopefully) ensures that she has some "quality" that would put her head-and-shoulders above the average Singaporean student. [Otherwise, how can the Singapore government justify spending money on foreigners instead of its own citizens?] However, she was comparing herself against the average Singaporean polytechnic student -- no, make that the "bottom of the barrel" of Singaporean polytechnic students because nursing was (still is?) one of the easiest faculty to qualify for in the Singapore polytechnics. [Note: Nursing, despite its "noble" job nature, does not generally attract the crème de la crème students because of its pathetic pay and work conditions in Singapore.] Thus, I was not surprised that PY had assumed that I was like her typical Singaporean peers back in her polytechnic days and snubbed me initially. [Not that it was fair/right for her to snub her peers, but it is understandable given the superiority complex common amongst PRC "scholars" on Singapore government sponsorships and the typical Singaporean's prejudice against PRCs. Click here and here for examples.]

In addition, PY did not think highly of her Singapore nursing education. E.g. Whenever I remarked that we are both "well-trained by the Singapore system", PY would reject my suggestion and countered that it boils down to the individual. Admittedly, she was under the 3-year diploma in nursing programme with mostly teenage-students, so her teachers were stricter (i.e. more disciplinary/punitive) in their approach. I was from the 2-year accelerated programme with fabulous teachers who treated us as motivated matured learners. In fact, PY looked surprised today when I told her that my (main) nursing lecturers were UK-trained and trained us based on UK standards. That is, they trained us to function as critical-thinking RNs who assess patients independently and advocate for our patients, much like RNs in Canada.

Anyway, time flies and we have been in school for almost 9 months. During this time, although we have had some classroom interactions, PY and I generally moved amongst different circles. After all, we were not in the same clinical groups. Over the months, PY heard feedback from the other classmates about me -- "WD did this...", "WD did that..." (generally positive feedback). In fact, one Korean classmate SS even went so far as to say, "I want to migrate to Singapore. Singapore is such a good country! Clean, strong economy, good education, good government. Even the people are nice, look at WD..." At which point, PY told SS, "You cannot judge like that, WD is not a typical Singaporean." [I learned about all these today straight from the horse's mouth.]

So over gossip break today, PY told me candidly that she did not like me initially because of her negative experiences in Singapore, both in nursing school and at the hospitals. How bad is nursing in Singapore? Well, both of us agreed that we never want to return to nursing in Singapore, ever again. In fact, she has forgotten much about her "Singapore experience" as she let the bad stuff slide off from her memory. She also told me how she came to change her mind about me, a Singaporean (see the preceding paragraph).

AP, PY and I went on to share and discuss our generalizations of the "typical" Filipino, India Indian, Iranian, South Korean, PRC and Singaporean. We recognize that generalizations are just that -- it is not wise to let our initial prejudices get in the way of getting to know an individual. E.g. IMHO, PY and I have more similarities than differences in our approach to work and our attitude towards academic performance.

GNIE: Resume for Practicum and Preceptorship

Today we had to fill-up a template resume for the GNIE course co-ordinator and administrators to arrange for our Practicum and Preceptorship postings.

There was one section where we had to write about our RN experience. I wanted to get the item done quickly, so I listed my experience off the top-of-my-head.

Clinical Experience: Acute Paediatric Unit. In addition, overflow of Obstetrics & Gynecology, Medical & Surgical patients.

RN responsibilities:

• Patient assessment and charting, 
• Medication administration (PO, IV, SC, IM, PR, Nebulizer, Transdermal), 
• Oxygenation (up to 2L/min initiation by RN), 
• IV NS fluid initiation or termination (based on RN assessment if not pre-ordered, doctor’s order to follow), 
• Blood and blood products (e.g. Immunoglobulin) transfusion, 
• Pre-op care (e.g. bowel prep, pupil dilation, sedation) and post-operative care (e.g. dressing change, 24hr IV narcotic), 
• Witness for pre-operation consent, 
• Care and monitoring of patients’ in’s-and-out’s (e.g. oxygen, IV line, JP drain, urinary catheters, CSF drain, chest tube), 
• Specimen collection, 
• RN initiation of selected treatment (e.g. barrier cream, topical analgesic, ginger water, therapeutic diet), 
• RN initiation/termination of nursing monitoring  and charts (e.g. Intake/Output, Hourly VS, Hourly CWMS, Neuro Chart & GCS, Braden Scale, Morse Fall Scale, Wound/Broken-skin chart), 
• Assist doctors with minor procedures within unit (e.g. CSF extraction, chest tube removal, excision of cyst or small foreign), 
• Assist with venipuncture (by certified RN), 
• Admission assessment, 
• Discharge planning/teaching, 
• Patient/Care-giver education (e.g. incentive spirometer), 
• Multi-disciplinary team collaboration (e.g. Doctor, PT, OT, Speech Therapist, Dietician, Infection Control Officer, Patient/Next-of-kin) [Note: Oops, I've missed out our mutually supportive Pharmacists], 
• Emergency management of patient’s sudden change in status, 
• Dangerous Drug Act locker (i.e. Narcotics locker) shift stock count, weekly order re-order and refill

General nursing duties:

• Arrange and escort patient for inter-unit transfers (within same hospital), 
• Coordinating diagnostic orders, 
• Documentation of specific nursing procedures, 
• Documentation of recommended or template nurse-client communication, 
• Buddy new RN/LPN (i.e. RN/EN in Singapore lingo), 
• General patient hygiene, feeding, ambulation and transfer, 
• Linen change, 
• Prepare isolation room, 
• Co-ordinate post-isolation room disinfection, 
• Emergency equipment check (emergency trolley, defibrillator, Laerdal resuscitators, bedside stock), 
• Patient room assignment, 
• Billing (if needed, explain bill to patient/NOKs), 
• Dietary orders, 
• Unit stock (medication and supplies) check, weekly order re-order and re-stock, 
• Linen order and re-stock, 
• Unit inventory audit, 
• Patient charts documentation audit, 
• Orientate non-nursing students on career exposure

Even though the above is not a comprehensive list, when I looked at it, I suddenly felt a sense of personal achievement and satisfaction. I had only been a Staff Nurse (i.e. RN) for 1+ year, yet I have had exposure to a lot of different cases and situations, including being the most senior staff on the unit during a series of night duties. [Note: That said, I question the wisdom of putting a 1-year experience RN in-charge of the whole acute unit/ward, especially when considering patient safety.]

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During nursing theory today, we discussed Neurological related topics. When IJ saw the worksheet question on "status epilepticus", he immediately commented that the only thing left to do is to prepare for the patient's death. To which I replied, "No" and started recalling from experience how we handled such emergency cases at my Singapore nursing unit.

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Previously I did not think much of my Singapore RN work experience since I had only worked for 1+ year. With today's hindsight, I guess I can mark it with a small "mental milestone" for my humble achievement.

Happy Canada Day!

Happy Canada Day!

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I learned to sing "O, Canada!" before even landing on Canadian soil. It was on my MP3 player (a.k.a. my mobile phone) and cheered me up on the (many) days when I dragged my feet to work as a nurse in Singapore.

[To paraphrase from Amy Fabulous's article on 24h Vancouver dated 29-Jun-2012.] When faced with a problem, there are 3 options to take:

1. Remove yourself from the situation: This is what I did by migrating to Canada. I know that I am probably exchanging one set of problems for another (click here and here), but I'm game to try something different.
2. Change it: You can keep trying different methods of changing the situation. E.g. My friend who is making an appeal regarding her clinical failure.
3. Accept it totally: From April 2007 when I started my nursing training in Singapore until August 2010 when I left my nursing employment in a Singapore hospital, there was so much shit thrown my way that I wished I was Teflon-coated, so that all the shit would slide-off me. [Click here, here, here and here for some examples.] Yet, I sucked it all up and kept my eyes focused on my ultimate goal -- to complete a goal that I've set for myself. Was it tough? Sure as hell! Was it worth it? Well, as I stand today, I think that I have learnt from my experience and (hopefully) it makes me a better person. The bottom line: I have learnt how determined I can be (once I've set my mind on something); and my past experience makes me appreciate the opportunities and privileges that Canada (especially B.C.) offers to me.

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So yeah, I am happy to have moved* from one red-and-white flag to another red-and-white flag. Cheers to the maple leaf!

O Canada (English version)

O CANADA (English rock-and-roll version)

by DAYLIGHT FOR DEADEYES

*Note: By "moved", I mean "reside". I am still a Singapore citizen.