LIM SWEE HIA

‘During SARS, I was coordinating all the nursing activities. The biggest lesson [for me] from SARS was this: we must protect our staff and our patients. We must ask ourselves: Where is the weakest link?’

There is a glint in Associate Professor Lim Swee Hia’s eyes. Without hesitation, she provides an example of a loophole during the SARS outbreak in 2003 and how the problem was swiftly fixed: ‘I was doing rounds to see if everything was ok, whether there was enough Personal Protective Equipment (PPE).

That was when I discovered that one of the cleaners was using the vacuum cleaner to suck her mask because it had gotten wet. The cleaners had each been given an N95 mask. When I saw her trying to clean her mask, I realised that the knowledge wasn’t there, so I worked with the housekeeping supervisor to conduct training for this group of people. I got my nurse educators to conduct sessions in Malay and Hokkien.’

Whenever she spots an oversight, she sets her heart and mind to correcting it. Whether it’s to do with maintaining standards of sanitation and infection control at the Hospital, or promoting and improving the prospects of nurses in Singapore, A/Prof Lim is a tireless doer and eager advocate of change.

In person, she is self-effacing and affable. There is a mellow grandmotherly air about her, but when she speaks about nursing or other projects she’s involved in, she brims with enthusiasm and her voice is lively and rings with conviction.

The design of the Tan Chin Tuan Nursing Award medal is based on a much-loved pendant familiar to generations of nurses at the School of Nursing.

When she was 16, her father had tried to stop her several times from pursuing her interest in nursing. ‘ No nursing for you!’ A /Prof L im recalls cheerfully. But in the end, her father could not stop her.

When she recalls her time as a trainee at the School of Nursing (SON) and Preliminary Training School (PTS), A / Prof Lim is all smiles and uses the word ‘enjoy’ repeatedly.

How can a hospital, a place of clinical care and emergency response, be associated with enjoyment?

‘Because of the environment. It’s all about teamwork,’ she says.

During the Hotel New World Collapse, she was a Nurse Manager in the Surgical ICU. She remembers how, after the news of the disaster broke, her staff started calling her, requesting to come back to work. She had to turn many of them down, reminding them: ‘Please don’t come back, because I need staff for the next shift. But still, some came back all dressed up ready for work. They had already arranged for their children [to be cared for]. Their father-in-law, mother-in-law, all came out [to help].’

A/Prof Lim’s initiatives to promote nursing include starting the Senior Enrolled Nurse career path and setting up the Tan Chin Tuan Nursing Award. She had noticed that, unlike the Staff Nurses, the Enrolled Nurses didn’t have as much career progression or recognition.

‘I approached MOH, I went to see the CNO [Chief Nursing Officer] and I said I’m going to start a career path for the Senior Enrolled Nurses to become Principal Enrolled Nurses (PEN). We adjusted their salaries. Some of them don’t want to be Staff Nurses, but they are very experienced. So you move them up, you empower them. After we had PEN, other hospitals in Singapore also started.’

‘The top three Enrolled Nurses are given the Tan Chin Tuan Nursing Award, which was set up after the donor came to me and asked what her donation could be used for. Staff nurses have awards like the President’s Award for Nurses. How about Enrolled Nurses? That was what gave me the idea. And also, I remembered this pendant at the SON in the early 1960s which had an image of Florence Nightingale and a lamp. I decided to use that design for the Tan Chin Tuan Nursing Award medal.’

She remembers how much she had wished she could buy the pendant back when she was a nursing student: ‘It cost $10, which was a lot of money back then when my salary was $210.

I’m very glad we used that design for the Tan Chin Tuan Nursing Award medal and that it was made of gold. You make sure [you give something that] you want. That’s the culture here.’ Her eye for detail comes out in every story she shares.

Large-scale benefits are reaped when the smallest of details are noticed.

For instance, every ward in SGH has a resuscitation trolley. By securing the drawers with numbered cable ties, nurses have been spared the onerous effort of checking the drawers every shift because if anything has been removed from any of the drawers, the number on the cable tie would reflect this change.

This simple procedure of securing resuscitation trolleys with numbered cable ties has been adopted by hospitals in China, Nepal, Myanmar, and Cambodia.

A/Prof Lim shares two other examples: ‘We noticed that the fall rate was highest at night and that the patients were elderly. They were getting up to go to the toilet. We told them, we will come at 2 am, 4 am to give bed pan, why do you still move.

They told us they didn’t know the time because they didn’t have watches. So we put clocks in the wards. The fall rate dropped but we noticed there are still some falls. They said: “Your clock is not luminous! We cannot see!” After that, we bought clocks with luminous numbers. [This was from the time before SGH’s analogue clocks were replaced by digital ones.]

In our patients’ toilets and bathrooms, we put in hooks.

They go in with their drip and drainage tube, so we  hought, let’s position hooks for them so that they can do their business in peace.’

Whether it’s nursing itself, or training and planning, she has felt a tremendous sense of fulfilment. Near the end of the interview, she says, ‘In my next life I will choose nursing again.’ She sounds so happy as she says it and the reason for her happiness is clear.

Associate Professor Lim Swee Hia is the Senior Director, Special Projects, SingHealth. She served in several roles including Group Director of Nursing at SingHealth and Director of Nursing at SGH and National Heart Centre Singapore between 1999 and 2012. She was instrumental in helping SGH obtain the Magnet® Accreditation (2010 to 2014), the highest accolade for nursing excellence and leadership.

She has spearheaded initiatives, training programmes and work redesign projects at institutional and national levels to elevate the nursing profession in Singapore. She was also the President of the Singapore Nurses Association from 2012 to 2020. She received the President’s Award for Nurses in 2002.