International Nurses Day Special: Angels in White Who Are Guardians of Palliative Patients
published by 8 World News on May 12, 2020今天（12日）是国际护士节。2019冠状病毒疫情期间，许多人都聚焦照料冠病病患的医护人员，不过还有许多护士默默耕耘，尽心尽力地守护着其他病患。
居家临终护理护士周珮君就是其中之一。37岁的周珮君在雅西西慈怀病院担任护士已有四年，她的工作包括到绝症患者的家中，为他们提供疗护，以及教导病患家属如何在家里照料病患等。
居家临终病患有所增加
雅西西慈怀病院和HCA 慈怀护理是本地其中两家提供居家护理的慈怀组织。疫情期间，重组医院和社区医院为了避免绝症病患受冠病感染，会尽量安排他们提早出院，加上更多绝症病患选择在家安宁，都推高了雅西西慈怀病院和HCA慈怀护理接收的病患人数。
HCA慈怀护理今年4月接收的居家护理病患比去年同期多出逾90%；雅西西慈怀病院今年1月到3月间接收的居家护理病患，也比去年同期增加了42%。
雅西西慈怀病院共有14名居家护理护士，周珮君是其中一员，他们负责照料550名病患。为了协助护士们更好的照料他们的病患，院方也在国际护士节设立了筹款平台。
虽然阻断措施期间，周珮君每天探访的病患从之前的四五人，减少到当前的三四人，但她并没有因此松懈下来。不断更新的防疫措施以及需要面对高风险病患，都增加了她的挑战。尽管如此，她却认为这份工作在疫情期间更具意义。
“为了防止病毒传播，疫情期间，慈怀病院有很严格的访客限制，我们只让两名访客探望病患。看到许多病人无法和以往一样与亲人在一起，让我感到很难过。在这样的时刻，当居家护士对我来说有特别的意义，因为我能帮助病人在家里接受治疗，他们也能与亲人有多一点时间相处。
全身防护满身汗 在外用餐是挑战
周珮君每天早上8点开工。第一件事就是致电她照料的病患，慰问他们的身体状况，再决定是否需要登门探访。由于临终病患的免疫力较差，感染病毒的风险较高，因此雅西西慈怀病院规定所有居家护理护士都必须遵守严格的防疫措施，包括进入病患家之前先消毒、穿戴防护衣、手套、脚套和口罩。
由于我国天气炎热，披甲上阵的周珮君每探访一名病患后，就全身是汗。“要穿上这些装备进行我们的工作，其实是非常有挑战性的。很多时候我们照顾的病人的家里没有风扇，所有我们觉得非常不舒服，满身大汗。”
此外，吃饭也是一个大问题。由于找不到地方坐下用餐，她只好等回到办公处后，才吃正餐。
“咖啡店和小贩中心的位子都被封了。虽然国家环境局通知我们可以在小贩中心吃东西，也通知了摊主，不过摊主们都很担心，不让我们这样做。我们只好不吃午餐，先吃点心或面包。”
临终护理护士承受身心煎熬
除了体力上的消耗，身为临终护理护士的周珮君也免不了得承受目睹病患病逝的悲痛。这段非常时期，她更深切体会到不能给予病患肢体关怀是多么揪心的一件事。
周珮君表示，疫情结束后，她最希望能做的，是给她的病患一个拥抱。“平常我们当成理所当然的东西，比如一个拥抱、一个握手，现在疫情期间我们都不能做了，觉得非常难过。”
和其他医护人员一样，周珮君一回到家，会立刻冲凉。她也会把外出衣物和家人的衣物分开，并减少与家人的接触，包括不跟他们一起进餐等。
“我大部分时间会在自己的房间，也不能拥抱我的家人。虽然对我来说很辛苦，不过为了大家的安危，这一切都是值得的。”
尽管疫情期间出外工作和病患接触，周珮君的家人却十分谅解她的工作，但她仍不时要安慰母亲。“我必须时常安抚我的母亲，确保她我们都做足了防疫措施。”
疫情当前，前线医护人员面对巨大压力在所难免。适逢国际护士节，周珮君希望借此机会鼓励所有护士和医护人员，不要忘了照顾好自己的身心健康，在适当的时候学会放松心情和解压。
“惟有这么做，我们才能扮演好我们的角色，照顾好我们的病患。”
8视界新闻为全天下的护士们加油打气，你们都是最美丽的白衣天使。
Click Here to view full article and video
Translation of article:
International Nurses Day Special: Angels in White Who Are Guardians of Palliative Patients
“Who says we are not at frontline, I feel that we are the ‘front frontline staff’. We enter their houses even before they step into the hospital. We are facing the risks ahead of others.”
It is International Nurses Day today (12 May). During the Covid-19 outbreak, most people are focusing on the healthcare workers who are taking care of Covid-19 patients. However, there are many nurses who are toiling silently and faithfully, doing all they can to be guardians of other patients.
Palliative Home Care nurse Linda Chew is one of them. 37-year-old Linda Chew has been a nurse in Assisi Hospice for four years. Her work includes visiting the homes of terminally ill patients, providing nursing care for them, and educating family members of patients on how to take care of patients at home.
Increase in Palliative Home Care patients
Assisi Hospice and HCA Hospice Care are two palliative organisations that provide palliative home care. During Covid-19, restructured hospitals and community hospitals try to discharge palliative patients as early as possible to prevent them from being infected by Covid-19. Additionally, more patients are choosing to die at home, and these factors have increased the number of Home Care patients for Assisi Hospice and HCA Hospice Care.
The admission number of Home Care patients for HCA Hospice Care in April 2020 has increased by 40% compared to April 2019; the admission number of Home Care patients for Assisi Hospice from January to March 2020 has also increased by 42% compared to the same period last year.
There are 14 Home Care nurses in Assisi Hospice, and Linda Chew is one of them. To support the work of the nurses, Assisi Hospice has started a fundraising campaign on International Nurses Day.
Though the number of home visits has reduced from four to five patients a day to three to four patients a day during the circuit breaker period, she has not relaxed. The ever-evolving preventive measures and having to face patients who may be high risk have added to her challenges. Despite so, she finds the work even more meaningful during this period of the pandemic.
“To prevent the spread of the virus, there has been restriction in the number of visitors in the hospice. We only allow two visitors per patient. It has been a very trying time emotionally for me, witnessing many not being able to spend time with their loved ones like before. Serving as a Home Care nurse in these times is especially meaningful to me, as helping patients stay at home would allow more families to spend more time with their loved ones during the final moments in their lives.”
“For patients near their end of life, they do not have much time left, hence these moments are very precious.”
Sweaty in full gear
Challenge in finding place for a meal
Linda Chew starts work at 8am every day. The first thing she does is to call the patients she cares for, asking how their condition is, before deciding if she needs to visit them. As patients with life-limiting illness are more vulnerable and their risk of infection is higher, hence Assisi Hospice stipulates that all Home Care nurses have to adhere to strict infection control measures, including sanitisation, donning the protection gown, gloves, shoe covers and masks before entering the patients’ homes.
As the weather in Singapore is hot and humid, Linda is usually drenched with sweat after a visit. “It is actually very challenging to be working in this gear. Some homes have no fan and it is very uncomfortable during our visits at times. After our visits, we are usually drenched with sweat.”
Having meals is also a big challenge. As she is unable to find a place to sit down and have her lunch, she usually waits till she is back in office before she has a proper meal.
“Seats in coffee shops and hawker centres are blocked. Even though NEA has told the food stallholders that community healthcare workers can eat in the premises for short while and alone, they are still very fearful and have been disallowing us to do so. We would usually skip lunch, and just eat some snacks or bread first.”
Palliative Care nurses bear with physical and emotional stress
In addition to physical challenges, palliative nurses like Linda Chew experience the grief of witnessing the passing of her patients. During this period, she feels more deeply about the heartache of not being unable to show care for her patients physically.
She said that after the pandemic ends, she hopes to give her patients a big hug. “It’s very sad that now we can’t do what we took for granted, like a hug, a handshake.”
“Our patients are mostly near their end of life, you see them now, but after a few hours or a day, you may not see them anymore. So after the pandemic, what I want to do is to give them a big hug.”
Similar to other healthcare workers, Linda Chew bathes immediately once she reaches home. She will separate her clothes from those of her family members, and minimise contact with them, including not having meals together with them.
“I spend most of the time in my own room, and I can’t hug them too. This is difficult for me, but for the sake of everyone’s safety, it is worth it.”
Even though she needs to go out for work and be in contact with patients during the pandemic, Linda’s family is very understanding of her work. However, she needs to constantly reassure her mother. “I need to reassure my mother and let her know that we do the necessary precautions.”
“My family is very proud of my work, they feel that we are angels in white.”
During the pandemic, frontline workers face enormous pressure. As it is International Nurses Day, Linda Chew wishes to encourage all nurses and healthcare workers to take good care of themselves physically and emotionally and learn to self-care.
“Only then we can play our part well and take good care of our patients.