As healthcare evolves, nursing is set to transform with advanced roles, new technologies, and a focus on holistic and compassionate care. Adjunct Professor Tracy Carol Ayre, Group Chief Nurse, SingHealth, explores these exciting changes and the critical skills nurses will need to thrive.

Tracy Carol Ayre, Group Chief Nurse, SingHealth

The future of nursing is exciting, to say the least. A few major trends will shape the nursing profession. Care models are shifting and will continue to evolve due to a rapidly ageing population, greater emphasis on preventive care and population health, and shifting of care to the community and homes. To support this shift, nurses will take on expanded roles with greater autonomy. They will need generalist skills and knowledge in order to provide holistic care across the lifespan — from pre-conception to the dying.

But we will also continue to develop nurses in specialised and advanced roles, including developing Advanced Practice Nurses for the community. Essential skills like communications, interprofessional collaboration, and speaking up for safety will continue to be important, but nurses will need to learn future-ready skills like innovation, data analytics, and process reengineering. Technology like robotics, artificial intelligence, and smart wearables will augment their work.

I have often been asked whether technology will replace nurses in the future. No, because nurses are valued for the human touch they provide, and they will need to learn how to maximise the use of technology in order to have more time providing direct patient-centric care with compassion and empathy.

The world of nursing education will continue to evolve, given these shifts in patient care. The use of technology to augment clinical training and competency building will proliferate. Schools will work more closely with the healthcare systems to develop practice-ready nurses who are resilient and can contribute to the agenda of building tomorrow’s healthcare.

Nursing leaders will continue to prioritise fostering healthy and supportive work environments where everyone will thrive. The COVID-19 pandemic was a wake-up call for us to focus on nurses’ well-being and retention factors such as burnout, flexible work arrangements, and staff safety.

On the global front, there is greater recognition of the importance of sustainability, diversity, inclusivity and equity within healthcare and nursing. Nurses have a huge potential to contribute to global health initiatives like building capacity and capability of nurses in our regional countries to address health disparities and promote healthcare access. The establishment of the Centre for Global Nursing (p13) is just one of the many new developments that nursing is carving out, reflecting a dynamic and impactful future for the profession. As the profession evolves, nurses will continue to play a pivotal role in shaping healthcare and defining tomorrow’s medicine.

Innovating paediatric nursing with technology

Kam Wee Fang, Senior Nurse Manager, KK Women’s and Children’s Hospital

Senior Nurse Manager Kam Wee Fang is transforming paediatric nursing with her innovative approach to technology at KK Women’s and Children’s Hospital (KKH). Leading the Nursing Software Suite (NuRSS) project in 2019, Wee Fang and her team rolled out a bedside iPad system with a user-friendly interface at most wards across SingHealth hospitals. The team has progressively released three applications — Mycare, Myedu, and Food In & Out, and a medical knowledge resource — to date.

The Food In & Out app allows caregivers to chart a patient’s food intake and output, as well as basic information such as bowel movements, into the iPad before the information is verified by nurses. This reduces the need for nurses to constantly check on the patients, allowing them to focus on more crucial tasks.

During the trial period, Wee Fang led her team to trial the app, ensuring that it remains user-friendly for patients of all ages. She put herself in the shoes of patients young and old to pre-empt potential difficulties and conveyed her team’s concerns to the app’s vendors through a series of feedback sessions. There were many rounds of tweaks before Food In & Out was officially launched.

Since its roll-out, the app has received plenty of positive feedback from nurses, patients and caregivers. The mother of one of her paediatric patients hailed the app as “a good initiative” and felt “empowered and happy to be part of her daughter’s care team”. The proud mum even taught her nineyear- old to input her own information so that both of them could work together to monitor her health, even after leaving the hospital.

Food In & Out represents a step towards the healthcare setup of tomorrow. With a growing patient population, Wee Fang believes in the constant need to innovate and harness technology to create the smart hospital wards of the future, and enable future nurses to deliver a higher quality of care, ensuring that all patients are well taken care of.

Known for being a people’s person, Wee Fang currently oversees the Medical Paediatric Wards at KKH, and is just as passionate about her job as the day she started in 1982. “Nursing is very interesting because you get to interact and learn from people from different walks of life,” she said.

With 34 years of paediatric nursing experience, the Master of Science (Clinical Leadership) holder has engaged with patients and caregivers in KKH’s Paediatric Intensive Care Unit, High Dependency, and Haematology/Oncology Wards. Her peoplecentred approach led her to this realisation: “You have to listen to patients and caregivers attentively, try to put yourself in their situation, and understand what they’re going through.”

She makes it her mission to deliver personalised care by spending more time with patients and exploring new ways to streamline work processes. Together with her team members, she harnesses technological innovations to manage administrative tasks for greater efficiency. “Technology allows nurses to focus on true patient care,” she asserted.

Pioneering hands-free solutions

Deng Shubin, Assistant Nurse Clinician, SingHealth Polyclinics - Eunos

The SingHealth Polyclinics (SHP) Nursing Innovation Workgroup Committee comprises nurses from various polyclinics, including Assistant Nurse Clinician Deng Shubin. The committee meets regularly to discuss common problems that they encounter and how these challenges can be met.

In one such meeting, the nurses noted that many patients often struggle to hold the hand-held eye occluder during visual acuity screenings. The hand-held Lorgnette Spectacle Occluder is challenging for patients with weakened motor strength to hold, creating inefficiencies as administering nurses spend more time on the test when a patient is struggling. “A hands-free occluder will reduce the time spent and enhance the patient and staff experience,” said Shubin.

In 2023, Shubin formed a team with three other senior staff nurses — Stella Sim, Zarina Binte Yusoff and Lim Cheau Yee — to develop a hands-free solution. Enlisting guidance from the Alice Lee Innovation Centre of Excellence (A.L.I.C.E), Shubin led her team to survey 100 patients and 77 nurses on their experience with the vision test at four polyclinics. They found that 25 per cent of the patients surveyed could not hold on to the hand-held occluder due to shaky hands, while 71 per cent of the surveyed nurses encountered patients requiring assistance around one to three times a month.

The survey findings prompted Shubin and her team to conceptualise a flexible wearable solution. “It can be like a pair of spectacles worn by the patient, so we’ll also be able to flip on the pinhole and opaque attachment on the mechanism,” she explained. At the same time, patients can undergo the vision test without having to hold the occluder, making the examination less stressful for them.

Unable to find an existing solution or product, they approached A.L.I.C.E. for assistance to develop a prototype. They participated in the SingHealth Nursing Innovation Challenge 2023 and were awarded a $5,000 grant last November to craft and trial their prototype. Although the prototype is now ready, it will be a while before it is adopted for general use. Going forward, she and her team will undertake Quality Improvement trials of their handsfree prototype with patients and nurses before developing a functional prototype.

Shubin’s passion for nursing stems from her upbringing. Inspired by her parents, she goes about her duties at SHP - Eunos with a generous spirit. “My parents are my pillars of strength. They’ve given their very best to me without expecting anything in return,” she shared. The 35-year-old believes in providing comprehensive care and health education to patients through innovative approaches. “I strive to deliver the highest quality of care to meet my patients’ needs,” Shubin said with pride.

A Master of Science (Applied Gerontology) degree holder, Shubin was recently promoted to a Nurse Clinician role. Her knowledge of available community resources allows her to better advise patients on preventive screening. She is convinced that innovations are essential for the future of healthcare as they benefit not only the patient but also nurses.

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