St Luke’s Hospital: Bringing back the heart of healthcare
by Tan Huey Ying // September 24, 2018, 3:13 pm
Advance Practice Nurse Tan Mui Lan (left) giving wound care information to a patient who underwent surgery at St Luke's Hospital. Photo courtesy of St Luke's Hospital.
“Everybody can do a good job, but at St Luke’s, we must do an excellent job,” says Susie Goh, 62, Director of Nursing at St Luke’s Hospital.
It is a statement that gels well with the no-nonsense manner with which Sister Susie, as she is affectionately addressed, carries herself.
Nor is it just lip service.
Ask medical professionals in Singapore to name the Goldman Sachs, Google or Deloitte equivalent of hospitals, and community hospitals may not make the list of prestigious employers.
Community hospitals provide medical services for patients who require a short-term continuation of care for recovery and rehabilitation, so the work may be perceived as less challenging and of lesser value.
But Sister Susie thought otherwise.
In 1997, one year after St Luke’s opened its doors, Sister Susie took a drastic pay cut and joined the hospital.
She is determined to provide excellent long-term care to the elderly.
“Step-down care does not mean that the standard of care has been ‘stepped-down’!” she quipped.
Fourteen years after she joined, in 2011, Sister Susie was honoured with the President’s Award for Nurses, Singapore’s highest accolade for the profession.
She was the first nurse from a community hospital to receive the award since its inception in 2001, and today, she is one of the leading voices in the field of wound management in Singapore.
When St Luke’s Hospital for the Elderly commenced operations in 1996, it was one of the three community hospitals in existence, and the only one dedicated to providing step-down care for elderly.
“The aim at St Luke’s is to help patients and family reframe their hope. This is really, the heart of healthcare.”
Dr Tan Boon Yeow, who has been with St Luke’s since 1999 and is the current CEO of St Luke’s, explains: “Twenty years ago, this was a new concept. There wasn’t a facility in Singapore that provided services between an acute hospital and a nursing home for the elderly, so three doctors from the Graduate Christian Fellowship (GCF) decided to start one.”
The mission-based hospital was renamed in 2004 to St Luke’s Hospital to better reflect the wider range of patients they served, not just the elderly. That year, there were only two other community hospitals run by the Thye Hua Kwan Moral Society and St Andrew’s Mission.
It was only in 2011 that the first public community hospital, Bright Vision Hospital, started. Since then, two others have opened, with two more operationally ready by 2020.
What sets St Luke’s apart, however, is the holistic care that it gives patients.
There are different aspects to health: Emotional, psycho-social and even spiritual.
“It is not just physical,” says Dr Tan. “Clinical care is usually the emphasis, but not many provide social care, and few can give pastoral care.”
At St Luke’s, a group of chaplains offers pastoral care to patients regardless of religious affiliations, and conducts chapel services within the hospital regularly.
St Luke’s focuses on a “person-centred” care system, where they treat not just the physical symptoms, but also address other issues such as managing the medical condition (so that it does not flare up and require long-term hospitalisation), pre-emptive and preventive care, and even caregiver education.
St Luke’s is a mission-based hospital founded on and operating with Christian values. But, like mission schools, they take in patients and staff of all faiths.
“Pastoral care is more than religion. It is helping patients to see meaning in life.”
“Pastoral care is more than religion. It is helping patients to see meaning in life, to make sense of the situation and how to find hope,” says Dr Linus Chua, 34, a registrar at St Luke’s.
“At its best, it is a journey that we go through with our patients, helping them to understand and strengthen their resilience so that they can carry on living. There are people of other faiths whom we are also able to journey with.”
Dr Chua says that, in community hospitals, patients are admitted when there is a drop in their functional status.
“Something has happened to them and the status quo is no more. Many are faced with their mortality.
“We do not hold back the truth of the reality – for example, if they have lost the use of a leg. We tell them what is possible, and we answer their questions. That helps.”
And when patients start to search for the meaning of life, as some do, Dr Chua says: “We talk and listen to patients, and we are able to facilitate that process of searching.”
Because the patients have a longer stay than mainstream hospitals, Dr Chua has the time to connect with patients relationally, help address their questions and set realistic expectations.
A family of caregivers
It is this commitment to “person-centred” care that is the difference between community hospitals and large, institutional hospitals.
“I trust the organisation enough to let my own family stay here.”
Tan Mui Lan, 43, is an Advanced Practice Nurse at St Luke’s whose father and brother have both personally experienced that level of care at St Luke’s.
When her father was warded at St Luke’s, Sister Mui Lan noticed how empathetic the caregivers were – towards both her father and her family as caregivers.
She says: “I trust the organisation enough to let my own family stay here.”
Sister Mui Lan’s statement says a lot. Especially in a profession like nursing, which affords the nurse an intimate knowledge of ground-level operations amidst a perpetual manpower shortage.
No Monday blues
But amongst a multi-religious, multi-racial staff team, Sister Mui Lan notes: “We have different beliefs but we are very motivated, and we are able to look beyond the patients’ needs, to look out for the whole well-being of the family.”
“Our patients are precious human beings – they are not just ‘the patient in bed six with a stroke’.”
Because of this like-mindedness amongst the staff, Monday blues are not a regular part of Sister Mui Lan’s work life. “I’m very happy to come to work!”
“The aim at St Luke’s,” says Dr Chua, “is to help patients and family reframe their hope. This is really, the heart of healthcare.”
In a culture where the dignity and value of patients are championed by staff across the ranks, Dr Tan adds that part of St Luke’s mission is to transform communities in a “positive, God-led way”.
He says: “Our patients are precious human beings – they are not just ‘the patient in bed six with a stroke’.”
Sister Susie who heads the nursing department, sets the standard. She says that she expects nurses to address every patient by name as a form of respect. (By default, many hospitals use bed numbers to reference patients internally.)
“God is the Great Healer, we are merely His instruments to comfort and encourage those in this hospital.”
However, Sister Susie leads by example – she knows and addresses all her nurses by name, all 233 of them.
The importance of recognising the dignity of patients and according them respect, is a way of meeting the most basic needs of every individual in their care.
Sister Mui Lan reflects that “sometimes this is more relational in nature than expected. Just being present, listening to them”.
For Sister Mui Lan, one important belief that summarises her conduct as a nurse is this: “God is the Great Healer, we are merely His instruments to comfort and encourage those in this hospital.”
That is just another way to phrase St Luke’s motto: Serving the community from the heart. Loving all without discrimination. Healing the body and the soul.