#AskOurNurses is an initiative where we invite nurses from various hospital departments to share more about the department, and what it is like to be a nurse in their respective departments.
We have Mr Yuri also known as @the.unconventional.nurse on Instagram, to share his unconventional nursing journey and address some of the questions you have posted on our IG story. The following are the questions that our guest speaker have answered.
________________________________________________________________________________
Question: Share with us about your nursing career, how you started and where you are now.
Yuri:
Yeah sure. My nursing career is probably like any other nurses out there. Nothing amazing, nothing interesting. So I graduated in 2010 from NYP (Nanyang Polytechnic with Diploma in Nursing). Then I served 2 years of NS (National Service). After that, i straightaway joined Tan Tock Seng Hospital (TTSH) in Neruo-Medical ward, a paying class ward. To be honest, when I first heard it was a paying-class ward, I was quite scared as paying-class people can be demanding. But it turned out to be the best 10 months I had in TTSH, in Neuro ward, 10A. Ward 10A, if you are listening to this, I miss you. So 10 months in, they asked me.
“Yuri, you are staying in Jurong right? So there is a hospital opening in Jurong. So you want to transfer?”
Back then, I did not have a mode of transport and Grab was not available yet. So I figured, since it is near my house, I opted for the transfer. I did not go to Ng Teng Fong yet, I went to Alexandra Hospital. I was there in the general ward, Acute Medical ward for close to 2 years. After 2 years, I felt I needed a change in my environment. So that was when I asked my Nursing Manager if I could be transferred to the Emergency Department (ED). I managed to be transferred but it took me about another year before the physical transfer was made.
When I finally got transferred to ED, my life totally changed for the better. That was the best decision i ever made. I was in the ED for about 6 years plus, did my advanced diploma and moved to the new Ng Teng Fong Hospital, all of us from Alexandra Hospital ED migrated over.
So after 6 years plus there, and in between i got married and shifted to the east. So i needed a change in my environment again. Traveling from east to west on a daily basis is not sustainable for me.
So i looked through Job Ads, and i saw this job title “Coordinating Nurse” by a company called International SOS. It seemed interesting, and i read through the job description, but i still did not understand. But regardless, i still went to apply for the job. They called me for an interview. During the interview, it was a totally different vibe. It was very corporate-ish. They asked me what my working culture like, what is my working habit like so on and so forth. I then accepted the job as a coordinating nurse. What we do is essentially triaging cases through phone calls, and at the same time we are a case manager. So when a call comes in, we will triage the case and refer the case to either a doctor or a hospital, and we do follow up on the patient’s care, and all of these are done remotely. So technically, you talk to a lot of patients, but you do not see them, but you know them because you read all their case notes and you talk to them on occasional basis.
In this company, it was quite an eye-opening experience for me. I was so used to bedside care and i had the opportunity to do medical evacuation flights as well. The journey did not end here.
I joined an insurance company as a clinical case manager. So, essentially i did somewhat similar thing (as my prev company), but for now for an insurance company. I do not sell insurance, but i review the medical reports to ensure that whatever care that patient has gotten is up to standard and they do not deviate from the typical treatment decisions. Because in the outside world, some companies have the tendency of overtreating the problems.
And then during the 9 months, my old boss from the previous company called and offered me a job as a Programme Manager. Again, i did not read the job description thoroughly. The fact that it sounded interesting and i liked my previous working culture, i took up the offer. Essentially, i do a lot of mental wealth and wellness projects for different clients around Asia, particularly Singapore. Essentially these clients will engage my company for these services, and i will ensure that programmes will run smoothly and the clients get what they paid for. That’s my journey up to date.
If an opportunity rise, do not be afraid to seize it
Question: In your career, have you encountered any inspirational figures?
Yuri:
So my biggest inspiration till date is Brother Wahab. I got to know him in AH, i think he was an ADON/SNM in ICU. He came down to the ward, and i was very lost. Like how some specialties view other departments differently, and that was how i felt when he came to my ward, as i felt inferior. Less than one year in AH, Brother Wahab came to me and asked if i would want to do advanced diploma.
I was very shocked as i have not even reached 1 year mark. And he said “why not? Just go for it. You can earn some money and learn something new.”
He also told me, “why should you be worried about going to advanced diploma? Why should you be scared about going for a course that you do not have much exposure in? At the end of the day, you go there to learn something new. If you already everything, i wouldn’t send you.”
The fact that he wants me to learn and gain knowledge, i was amazed. I was scared to go, because i felt that I was not ready. But the fact that he viewed it as, he wants me to go so that i will be prepared next time. So that saying/perspective resonates with me till now. He has been an inspirational figure, because he is not the kind that is regimented, who will picks on what’s the colour of your socks, why did you not iron your uniform, why is your hair long so on and so forth. But he is very objective, and very caring towards his colleagues.
Question: What other possibilities out there for nurses to venture into?
Yuri:
Yeah, in fact there is a lot of opportunities out there if you are planning to deviate from the normal bedside care. Apart from case coordinating, case management, there are other things out there.
I think we should view it under industries. When we go to the pharmaceutical industries like Terumo, Baxter, GSK and other pharmaceutical industries, you can go there as a clinical specialist. So, Sales Representative is one thing, Clinical specialist is another thing. When you join as a clinical specialist, you are the subject matter specialist of the product. Let’s say you go to Terumo, like terumo pump. Okay so Shulhan, now you are our clinical specialist. So we will teach you the ins and outs of this pump. We are not asking you to sell it, but in any case our Sales representative need a nurse or anyone with a medical background who knows this product in and out, you will go with the Sales rep to the client to sell the product. You do not have to sell it, but you support the Sales rep. Because you are a nurse, you can speak the lingo of the healthcare workers. So if they ask if this medicine is available in the drug library, you can demonstrate to your clients. But if you intend to go through the Sales route, it is possible as well. You can hold two hats, both as Sales Rep and Clinical specialist.
Another one is occupational health, like oil and gas, factories etc. So this factories or site as they were to call it, would require occupational health nurse. They are nurses who manage a clinic in a factory or an industrial area. So this clinics can range from small to big companies. So essentially they manage a clinic, but at the same time, they are equipped with various skills such as BCLS (basic cardiac life support), ACLS (advanced cardiac life support) and ITLS (international trauma life support) and so on and so forth. In worse case scenarios, they would require to attend to cases such as fall from height and trauma.
Question: Are these occupational health nurse attached to a particular company?
Yuri:
So yes, you will attached to one whole company. You are one occupational health nurse, attending to the whole company. So imagine if the whole company falls sick, you would suffer as well.
In corporate side of things, we have school nurse. It is also under the umbrella of occupational health nurse. I feel that it is not as taxing, but then i may be wrong as school students tend to fall ill quite regularly. So the list goes on. So how i go for job shopping is through LinkedIn.
LinkedIn is a place where a lot of professionals, even the Fortune500 Companies list out their job openings, such as Amazon, Meta/Facebook. So i felt that space is a good melting pot of good opportunities. I was quite surprised when recently there was a job opening for environmental health and safety manager for amazon. One of the requirements is to have a health-related background. Nursing is a health-related background. So from there, you study where the ‘lobang’ (opportunities) is, once you know where the ‘lobang’ is, you study the needs and how to get there.
Question: Do you have insights about travel nurse/flight nurse?
Yuri:
Yeah sure, i do have some insights, though i am not the expert in this field.
The travel nurse you mentioned is widely practised in the US, which we do not have in Singapore. They call them the travel nurse because it is to essentially supplement the lack of manpower in different states in the US. So they will employ travel nurses from whichever state to come and support the hospital operational needs. In Singapore we do not have travel nurses, but we call them Locum Nurses.
The other one you mentioned, flight nurse, in my company we call it is Evacuation Nurses. My company is a Medical and Security assistance company, so my company specialise in medical evacuation as well.
Let’s say i have a Singaporean client who fell sick, or injured in the remote area of the Philippines and has to be admitted there. Since he sustained an injury, he will contact us. Since the Philippines does not fall under the category of Country of Medical Excellence, he has to be brought back to Singapore where care is more adequate. So we will send someone there to pick you up and bring you back to Singapore. So this is where the Evacuation Nurses will be deployed out. Depends on the injury sustained and recommendations from our medical director, the person will either fly through a private jet that is fitted with all the stretcher and medical equipments, or fly commercial business class. These nurses usually have an existing role in the current company they work in, either as a case manager or other roles.
Question: So how does the care exactly work as an Evacuation Nurse?
Yuri:
I will share my experience when i paired with another evac nurse who offered me to go on this mission with him in Greece.
So our patient sustained an injury, a cervical fracture in Greece. So he was paralyzed neck below, he had rehab in Greece and the company wanted him back in Singapore since he was away for quite long. It was during the pandemic, Coovid-19, and we were not able to travel. So when we reached Greece, the patient was already waiting for us in a wheelchair. We did not have to disembark and get our passport stamped, so he came in and we received him at the transit area. So imagine, we travel all the to Greece, never stamp out, receive our client and fly back all the way to Singapore. But the good thing was that we flew Business class.
The care in-flight was rather easy, because he was not on any prescribed long term medications. He just had an indwelling catheter, and his elimination needs was something we cared for as well. So we told the hospital to bowel prep the patient prior to the flight, because i cannot imagine myself doing diaper change on an airplane. So in flight, we monitored his vital signs hourly, just to make sure he is fine.
Before this mission, everything has already been planned. We know when to fetch him, we know what time to fetch him, we know what time our flight back to SG, we know where we are landing, we know which hospital to go to. When we touchdown in Singapore, an ambulance was waiting to send us to the hospital. So when we reached the emergency department, they will triage and led us to the ward that has already been prepared.
Then we bring the patient to the ward, and the situation would just be like any other ED to ward transfer.
Question: There might be a misconception that once you leave bedside nursing, you will lose your skills. How true do you think it is?
Yuri: I think there is some truth to it. Like every other thing, if you do not practice, you will lose touch of the skill. Yeah I would have to say, when you leave bedside nursing, you might, not you will, but you might lose your clinical skills. But for me, one of the things that i do to keep myself updated is through teaching. I am a BCLS instructor, and i teach twice or thrice a year. So it gives the chance to be in that environment again. In BCLS, you will also teach bedside AED. You will know what a defibrillator does, you will know what the role of an airway nurse etc. So that kept me in check, and one way how i keep myself with bedside nursing skills.
But essentially, when we talk about bedside nursing, there is more to than just BCLS and AED. There is venepuncture, serving medications and other skills that are important and valuable.
Back when i was doing bedside nursing, i took things for granted. I felt all these small skills are so easy, who would be able to forget it. But after i left bedside nursing, i realise it is very easy to forget. So the possibility of losing your skills is there, but if you make a conscious effort to keep yourself updated through courses, locum, teaching, i dont think you will eventually lose it.
Question: What other skills have you gained after leaving bedside nursing?
Yuri:
One of the biggest skills I have gained is Email writing. I mean in bedside nursing, you do not really write emails to anyone unless you are a nursing manager, or any managerial role then you would require to write emails.
But as a staff nurse, there is no need for email writing. At most, you would tigertext which are informal texts. When i am out of bedside nursing setting, i am required to send in a lot of emails on a daily basis.
So email crafting is an important skill in the corporate setting, or in a clinic. It is actually a pretty tough task for me as i do not have much experience in it. But with practice, it will only get better.
Another thing is speaking to people, speaking to patients and/or stakeholders in a more professional manner. As for me when i was a nurse, i tend to be very laid back and casual with my patients. But now that im out in a more corporate and professional setting, i would need to code switch to fit the environment.
Question: Can you summarise some of the pros and cons of leaving bedside nursing?
Yuri:
I will start with the cons first.
You will need to be prepared to lose that one-to-one contact with your patients. If treating your patients directly, seeing them, and talking to them on a personal level, and that is something that drives you in your day-to-day job, I think you should stick in a hospital setting. When you leave bedside nursing, that kind of interaction is almost zero to none. When you are still in bedside nursing, try and try to maximise this opportunity and interact with them and create an impact in patients’ lives.
Next would be bonus. I’m not sure how well-aware you are, but an average nurse like me, I would get a 2.5x month for my bonus. But when I left to the corporate side of things, my performance was an excellent grade, equivalent to getting a grade A in hospital (highest grade one can achieve), my bonus was basic multiplied by 1.7. But with this performance bonus in the hospital, my basic pay would have been multiplied by 3x. The reality is, though the basics outside of the hospital setting may be higher, the bonus is lower.
Pros:
I can wear whatever i want, whatever colourful socks i wish to,
I am exposed to so many things that I have not been exposed to. Back then I may have heard of industrial nurses, but I have no idea what their jobscope is. When I'm out here, I'm exposed to many new roles. And to me that is the biggest advantage, the knowledge I have attained. This made me want to learn more about the industries. To me, knowledge is my biggest gain.
Question: What is one phrase/piece of advice you have for student nurses?
Yuri:
Actually I have a lot to say to student nurses. Things can be tough for you right now, because things are not like how it used to be back then. I know for a fact things are tougher for nursing students, especially those who went through nursing school during the pandemic. Learning has evolved, and unfortunately, some people in the workforce do not grasp this idea. Do not let that demoralise you, do not feel rejected on how people treat you. Ultimately, you will meet someone who is nice and willing to help you. Do not give and press on, and you will eventually reach a greener place.
Comments