Hit, bitten, spat on

SINGAPORE - Drug addicts and suicidal teens have taken turns to bite, hit, spit at and verbally abuse Madam Doreen Chow.

One even left her mark, literally, on the 53-year-old nurse. Madam Chow has a scar the size of a 10-cent coin on her right arm.

"The woman, in her 20s, had been admitted for eating disorders. She was strapped down and fighting everyone trying to help her. Since her hands were pinned down, she used her teeth," Madam Chow recalled.

Three years on, the scar is still visible.

But such occupational hazards don't scare the enrolled nurse.

Yesterday, her dedication and people skills netted Madam Chow the fifth Tan Chin Tuan Nursing Award. She received a gold medallion and $2,000 cash from Health Minister Gan Kim Yong.

Madam Chow, who has more than 30 years of experience, has spent the last eight years tending to those with mental disorders at Mount Elizabeth Hospital's Behavioural Unit.

Many are unwilling patients, admitted at their family's insistence. So they vent their frustration on the medical team.

Drug addicts are among the most challenging.

"Because their problems have stretched over the years, there's a lot of denial. They tend to be very agitated and resistant," Madam Chow said.

"When their withdrawal hits, especially during night duty, it can be quite bad."

Some end up vomiting or having severe diarrhoea. Others insist on doing what they want and mutilate themselves.

A hostile patient once taunted her: "I'm a gang leader. Who are you to stop me?"

With just another female colleague around then, Madam Chow had to mask her fear: "We have to go into their world.

"To calm them down, we usually find common topics of interest or talk about their family members."

The encounters helped Madam Chow, who has a daughter, 23, and a son, 18, develop her confidence.

"I realised there is hope, even in what some think are impossible cases," she added.

In April this year, Madam Chow and a staff nurse spearheaded the hospital's contraband project.

Nurses screened patients' belongings and kept harmful items like pen knives and scissors during the admission period.

Even cosmetics and CDs are removed - out of fear that patients would break the items and use the shards to cut themselves.

Madam Chow is the first from a private hospital to win the Tan Chin Tuan Nursing Award, said MsTang Yuet Lan, Mount Elizabeth's assistant director of nursing, who nominated her.

Enrolled nurses like Madam Chow hold certificates in nursing and help registered nurses - the diploma or degree holders - with tasks such as dressing wounds.

Among Madam Chow's most unforgettable patients: a young woman who would eat tissue paper.

As the eldest child, the woman, now in her 20s, felt she had to live up to her parents' expectations. After her businessman father became paralysed in an accident, she could not cope.

When stressed, she released tension by cutting her wrist or used a pillowcase to strangle herself. After repeated visits to different doctors, the woman was admitted.

"It's very sad to see a young lady with so much potential like this. She was crying for help, it was a way of communicating her pain," Madam Chow added.

Ate tissue paper

Sometimes, the woman would eat tissue paper and tell the nurses afterwards. So staff had to remove the paper in the room. They also constantly encouraged the woman's housewife mother to be strong. Luckily, the woman's condition improved and she is now studying overseas.

Said Madam Chow: "It's important to build rapport with patients. The approach and choice of words are crucial."

That means knowing when to be there and when to back off. At first, some patients open up more easily and talk to motherly figures. Later during the recovery process, they may find it easier to communicate with younger staff in the same peer group.

Given the different patient demands, how does Madam Chow cope?

Her faith and inner reflection come in handy, she said. She has a notebook of motivational sayings which she reads before going to work.

"I keep myself strong because patients need us."

Top nurses

The award, set up in memory of the late banker-philanthropist Tan Sri (Dr) Tan Chin Tuan, is the highest honour for enrolled nurses.

Top Three Winners:

1st: Doreen Chow Yuet Kuen, enrolled nurse, Mount Elizabeth Hospital

2nd: Leow Siew Tin, principal enrolled nurse, Singapore General Hospital

3rd: Neng Noorliza, senior assistant nurse, National University Hospital

This article was first published in The New Paper.