SINGAPORE — The breaking point for Lena, a nurse in her 30s who works at a hospital under the SingHealth group, was when she was recalled to work on her 13-year-old son’s birthday weekend because the Covid-19 ward where she is deployed was heavily understaffed.

One nurse had been infected with Covid-19 and two others had to be put in quarantine.

Lena, who had planned a family staycation three months before, said: “I broke down that day. It was, like, I had to choose between the patients at the hospital and my family.”

She was recalled on the day her family was to start their staycation.

Despite her reluctance, Lena said that she still turned up for work; she joined her family on the second day.

As the number of Covid-19 cases in the community stabilised and it appears that the caseload has gone down as compared to a month ago, healthcare workers interviewed by TODAY said that the manpower crunch is still keenly felt on the ground.

And though they have been allowed to take leave to rest and recharge, many said that they have been recalled to work on their days off and leave days — which has become one of the triggers for some to quit the profession. 

Public hospital clusters approached by TODAY said that they have provided counselling services, helplines for employees and peer support programmes, among others, to support healthcare workers and look after their well-being.

And while the workers are aware of these programmes, many have not taken them up.

One of them is Amy, a nurse who works under the National University Health System (NUHS), who said succinctly: “Who has the time? We are too tired to even talk to a professional.”

DIFFICULTY TAKING BREAKS

Healthcare workers who spoke to TODAY did not want to be identified because they were not authorised to speak to the media. They said that the shortage of manpower due to mass resignations is one of the biggest contributors to their burnout.

Last month, Dr Janil Puthucheary, Senior Minister of State for Health, said that resignations among healthcare workers have gone up in the first half of this year under the strain of the Covid-19 pandemic. About 1,500 healthcare workers have quit in the first half of this year alone, compared to about 2,000 yearly before the pandemic.

Foreign healthcare workers have also resigned in bigger numbers. Close to 500 foreign doctors and nurses have left in the first half of this year, compared with around 500 in the whole of 2020 and about 600 in 2019.

The healthcare workers interviewed said that anecdotally, they have seen a range of two to six people resign in their respective departments just this year alone.

Sarah, a junior doctor at a public hospital, said: “Morale was bad (during the surge of Covid-19 cases in October and November). A lot of staff nurses were working overtime because so many nurses had resigned.”

And as healthcare workers quit in droves, those who are left behind are faced with a manpower crunch, causing difficulties when they want to apply for leave, even though they had to plan their leave dates one year before.

Some even got their leave applications cancelled at the last minute and were recalled on their days off. 

Lena said that she was recalled at least three times in the last six months, twice when the Covid-19 cases in the community surged in October, which has affected her family time since she works long hours and gets very little time to spend with her children.

She added that she has raised this to her manager, who understood her concerns. They came to an agreement that Lena would not be recalled during the school holiday period.

Roy, another nurse under the SingHealth public healthcare group who works in a post-surgical ward, said that it is difficult to say "no" when a supervisor recalls him to work. Although he has done so several times, he believes that it is at the expense of his work performance, which in turn affects certain employee benefits granted to him. 

This was why he has decided to resign. 

The 32-year-old said: “If we say 'yes' (to being recalled), we will be seen as a proactive and good team player.

“But if we say no, it will be otherwise. I’ve been graded down and told that I was underperforming just because I insisted on taking my days off and clearing my leave on the specific dates I applied for.”

Agreeing, Anna, a nurse in her 20s who declined to say which hospital she works for, said that although her manager still grants leaves during the Covid-19 period, the nurses still have to give reasons why they needed to take those days off. This would also be subjected to the department having enough manpower.

SOME BREATHING SPACE

As the Covid-19 pandemic reaches its two-year mark, those on the front lines of healthcare are bone-weary and burnt out, though some said that the current workload is better than during the dormitory outbreak last year, the hospital cluster in April, and the surge of Covid-19 cases in the community two months back.

This was the case for Siva, a National Healthcare Group nurse in her late 30s, who works in the pandemic wards.

She said that the number of Covid-19 cases has decreased, but some nurses, especially those who serve a smaller number of inpatients, are redeployed to support other areas in need. 

“So you can’t really catch a break. If you’re not busy, you can be moved to a department that is busier,” she added. 

A junior doctor at National University Hospital said that the lower caseload has given them some breathing space, though there are concerns about whether the Omicron coronavirus variant will put further strain on the healthcare system.

HOSPITALS REMAIN VIGILANT

Public hospital clusters told TODAY that they are staying vigilant to ensure there is enough manpower and capacity for any surges in Covid-19 cases here, especially in light of the new Omicron variant.

Professor Fong Kok Yong, SingHealth’s deputy group chief executive officer of medical and clinical services, said that its institutions have been striving to strike a balance between ensuring sufficient resources for spikes of Covid-19 cases here and a balanced rotation so that employees can go on leave.

Associate Professor Thomas Loh, NUHS’ group chairman of the medical board, said that about 65 per cent of its staff members have applied for and are taking turns to go on leave this year-end as they were advised to plan early with their departments. 

“While the number of new community cases has stabilised and our hospitals are seeing an overall reduction in infection numbers over the past weeks, we continue to closely monitor and evaluate data on the Omicron variant as it emerges, and will stay nimble and adjust measures to meet the changing needs accordingly,” Assoc Prof Loh said. 

Healthcare institutions said that they have also rolled out various initiatives to address the well-being of staff members, especially in the last two years.

Mrs Olivia Tay, the chief human resource officer at the National Healthcare Group, said that such efforts were ramped up during the Covid-19 pandemic, with more emphasis on educating and supporting staff members with regards to mental health.

Earlier this month, the death of a Singapore General Hospital (SGH) nurse sparked discussion on social media on the mental well-being of healthcare workers here.

An obituary of the nurse posted by online activist group Wake Up, Singapore's Facebook and Instagram pages alleged that the nurse took her own life after struggling with mental health problems, aggravated by the difficulties she faced in returning to her home in Malaysia.

It prompted SGH to urge the public not to speculate about the circumstances of the nurse's death.

Over at SingHealth, a task force was established in June to look into ways it can better support employees.

Prof Fong, who is also the co-chair of this task force, said that these included "doing a deep dive into our processes and workflows to study how we can effectively streamline them to reduce workload", and creating new rest areas or spaces where staff members may "take a breather and recharge during work".

WHERE TO GET HELP
National Care Hotline: 1800 202 6868
Fei Yue's Online Counselling Service: eC2.sg website (Mon to Fri, 10am to 12pm, 2pm to 5pm)
Institute of Mental Health's Mental Health Helpline: 6389-2222 (24 hours)
Samaritans of Singapore: 1800-221-4444 (24 hours) / 1-767 (24 hours)
Singapore Association for Mental Health: 1800-283-7019 (Mon to Fri, 9am to 6pm)
Silver Ribbon Singapore: 6386-1928 / 6509-0271 (Mon to Fri, 9am to 6pm)
Tinkle Friend: 1800-274-4788 (Mon to Fri, 2.30pm to 5pm)
Touchline (Counselling): 1800-377-2252 (Mon to Fri, 9am to 6pm)