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Emerging Role Of Community Nurses In Singapore During The Pandemic

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What are the community nursing challenges posed by the covid-19 pandemic? Community nurses in Singapore serve in a similar capacity to district nurses in the United Kingdom. They focus on promoting health and wellbeing, preventing illness, and caring for people of all abilities, the sick, and those who require palliative care.

The Covid-19 Pandemic
The COVID-19 scenario poses a long-term public health concern. Community nurses continued to deliver services while taking extra precautions. Before nurse consults, notices were posted at community nursing posts, and triage stations were set up to test for fever and/or respiratory symptoms, as well as travel and contact history. To prepare for home visits and teleconsultations, community nurses analyzed their current workload. In preparation for personnel deployment and reassignment of the caseload, team leaders supported the handover of cases.

Teleconferencing
During the outbreak, teleconsultation has developed as a feasible means of COVID-19 prevention and precaution in Singapore. It has the potential to provide timely information while also assuring users that support is merely a phone call away. It enhances communication with healthcare practitioners while also addressing social distancing issues. 

Moreover, elderly persons with stable health concerns received teleconsultation from community nurses to assess their overall well-being, health, and self-monitoring measures such as blood pressure. Continuous monitoring was essential for targeted therapies and care escalation when medical problems were not well-controlled and/or the patient's medication had recently changed.

Debriefing Program
During the pandemic, palliative care was identified as a special training need for community health workers, with effective education tactics including role-plays and narratives, training the trainer, internet resources, and a continuous educational program. The significance of 'debriefing,' described as a time to discuss the impact of caring for very sick patients, multiple losses, moral distress over ethical dilemmas, and working with limited resources on staff health, was emphasized. To enable family members to have a leadership role in the provision of care, training and debriefing are also essential.

CoPat Program
During the pandemic, the community outpatient parenteral antibiotics therapy (CoPAT) service was maintained. When frail patients with restricted mobility needed prolonged intravenous antibiotics, the CoPAT program provided an alternative to inpatient hospitalization.

Several elderly persons had their medical appointments rescheduled. Some people avoided specialist clinics and did not take their chronic disease medications because they were afraid of developing COVID-19. Community nurses remained on call to guarantee continuity of care and a steady supply of medication via medication delivery services to patients' homes. They helped older people manage their medications at home by providing health coaching, drug consolidation, and short-term medication packing.

Virtual meetings
Community partners launched a virtual 'live' outreach event for senior citizens. Community nurses were invited to provide health talks in Mandarin and a local dialect about how to avoid falling. The audience reacted positively. They stated that the fall prevention data and advice were useful to them at home.

Despite the pandemic, life must carry on. Nurses strive to be as accessible as possible to their patients. Pandemic plans and frameworks have generally focused on surges in demand and sustaining urgent and critical services, public health obligations including infection control and immunization, and providing adequate clinical facilities and equipment.

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Photo Source: Asian nurse photo created by benzoix - www.freepik.com
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