Singapore nurse on how she allays patients' fears of breast cancer

SINGAPORE - At 15, Ms Nagalingam Saraswathi had her heart set on becoming a nurse. As a member of the St John Ambulance uniformed group in school, she helped nurses at Kwong Wai Shiu Hospital with tasks as small as cutting patients' nails or feeding them.

In particular, she was "impressed by a staff nurse who looked very smart in her neatly ironed white uniform and cap" and her gentle approach towards elderly patients.

She herself has donned such uniforms for 41 years since graduating from the now-defunct School of Nursing in 1974.

In 1992, she was selected by SGH to train in breast care nursing at The Royal Marsden in London and Royal South Hants Hospital in Southampton.

Ms Saraswathi may be the first formally trained breast care nurse among the 10 to 12 in Singapore.

Over the years, the 60-year-old has introduced initiatives to help patients, such as group exercise classes to promote movement of the arms post-surgery and the practice of teaching patients to drain their wound, so they can be discharged the day after surgery.

The Senior nurse clinician at Singapore General Hospital (SGH) also works with agencies to organise health screenings for the community.

She is widowed and has a 37-year-old son, who is single and an entrepreneur, and a 35-year-old daughter, who is married.

I specialise in caring for patients who are diagnosed with or suspected to have breast cancer because...

It can be devastating for people who are well and active in life to be told that they have breast cancer.

They have many concerns about the diagnosis and treatment, so I provide the assessment and counselling for physical, psychological, emotional, social, spiritual and sexual concerns, as well as answer any questions on treatment.

Breast care nursing is fascinating because…

The nurses ultimately become friends with the patients, with the first meeting determining the extent of their relationship.

Every patient reacts differently when diagnosed with breast cancer. For the nurses, it takes a lot of patience and compassion to relate to patients and work with them on coping strategies.

Almost all patients have the contact numbers of their breast care nurses whom they can call for assistance and support at all times.

One little known fact about breast cancer patients is that...

Most patients can go home and return to their daily activities the day after surgery. They are not as physically weak as most people think they would be.

If I were to give an analogy for what I do, I would be...

A mother who loves her children. When my children are in trouble, I will counsel, advise and help them move on. I continue to love and care for them although my efforts may go unnoticed. I am very happy when they do well and feel good.

A typical day for me...

Starts at 5am. I visit patients in the short-stay ward - the Ambulatory Surgery Centre - at Singapore General Hospital (SGH) before going to the office at 7am. These are patients who will be discharged the day after surgery.

I see between eight and 10 newly diagnosed patients each week I run the breast clinic on Tuesdays and Fridays. On other days, I have about the same number of patients who come to me for follow-up. I help them with tasks such as removing seroma (accumulation of fluid that leaks from damaged blood and lymphatic vessels), cleaning wounds or fitting a prosthesis onto their chests.

I allocate one Saturday each month for research as I am preoccupied during weekdays with patient counselling, ward visits and training of nurses from schools and around the region.

I usually knock off work after 6pm. My son will then pick me up from work for dinner. I reach home at about 8pm and will watch television or read a book before going to bed at 10pm.

I have come across all types of cases...

Through working with patients as well as their families. About 40 years ago, I attended to a patient who had a wound following a mastectomy.

I helped to dress the wound every day at the SGH clinic and went to her house to do the same on weekends. She was the first patient with a very bad wound whom I attended to.

Both she and her family were very appreciative and came to the airport when I left for my studies in Britain in 1992. I had known them for only two months. I was touched and at a loss for words.

A few years ago, a patient in her 20s underwent surgery and even got married while undergoing chemotherapy.

I love patients who...

Have a positive attitude and appreciate my efforts to help them.

People who get my goat are...

Those who give up on themselves.

Things that put a smile on my face are...

Meeting patients who tell me they are doing fine and seeing they are happy.

It breaks my heart when...

I learn that my patients have a cancer recurrence.

Another thing which saddens me is that women are still coming in with large fungus-like growths even though there is widespread information on breast cancer screening.

This might be due to cultural beliefs or the fact that too many women, such as housewives and the elderly, are ignorant about the importance of breast cancer diagnosis and early treatment.

I would not trade places for the world because...

I have never thought of taking on another job.

I believe that everything happens for a reason and, for me, my passion is in caring for breast cancer patients.

My best tip is...

To be conscious of the changes in one's breasts. Women should do a monthly breast self-examination and go for a mammogram when they reach 40 years old.

Do not delay these checks as they could save your life.

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