Reflections from a Visiting Nurse

Hannah Luah, a recent nursing graduate from the National University of Singapore came to visit us in August 2018. All our staff tremendously enjoyed her visit, and the gentle, genuine way she fit into our nursing and hospital community. We were impressed with how quickly she picked up Thai as well: I remember one evening in the operating room when someone asked for the vital signs of the patient, and the answer came back in perfect Thai – in Hannah’s voice! Hannah, we wish you all the best in your next steps in your journey and hope you will visit us again soon. 

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Kwai River Christian Hospital in the Rainy Season (August 2018)

The Kwai River Christian Hospital (KRCH) is a hospital located in Village Huay Malai near Sangklaburi, within the Kanchanaburi province of Thailand. Its cosy compounds comprise an inpatient ward, outpatient facilities, one ED, 1 OT and 1 delivery room. There are also lab, pharmacy, radiology and physiotherapy services.

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The Pharmacy, bill payment counter and hallway to the X Ray Room and Operating Room

The hospital staff are a warm, close-knit community of Thais and foreign missionaries who live within the adjacent hospital housing, or around the village. Located near the Thai-Myanmar border, they provide care to the Thai, Karen, Mon and Burmese people who live around the region, including refugees. Sometimes, patients are referred from Sangklaburi Hospital or Myanmar as well.

A day usually starts with worship, prayer and morning devotions in Thai before most work begins. As a freshly graduated nursing student, I followed the nurses closely throughout my 1 month there. Coming from Singapore’s specialty-based system, I was amazed to see the breadth of responsibilities the nurses there had. Sometimes, we would start the day with a delivery, then go back to inpatient ward duties, and assist in surgery in the afternoon. Being mainly trained to function in the inpatient ward setting, I learnt a lot from observing deliveries and surgeries, and eventually circulating in the OT. That same nurses could efficiently run the inpatient ward, operating theatre, and delivery room all in the same day really blew me away. The next week, they would rotate to the outpatient department/ED, and then back again. It was eye-opening to see such flexibility and capability, which I never would have seen in Singapore. I also learnt a lot from visiting doctors and teams who came from many different backgrounds, and brought with them expertise in pediatrics, A&E, anaesthesia and internal medicine.

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A quiet moment in the Emergency Room
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A view from the Inpatient Ward nurses counter
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In the Operating Room

I also appreciated the autonomy and independence the nurses were granted, a sign of the good rapport and trust built among the team. Apart from confidence in each other’s abilities and intentions, I feel these relationships were augmented by the interactions out of work that arose from many staff being neighbours in the hospital-provided housing as well. In Singapore we are often taught about teamwork through inter-professional education (IPE). However, IPE had always seemed limited in my opinion until I saw how the relationships in and outside of this hospital led to a close-knit community pursuing the best interest of the patient.

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A teaching moment in the Operating Room seen from the scrub station

I will always remember KRCH for the people and the warmth the community gave off. It has all been very inspiring to me and though I know that we rarely have the luxury of such a convenient setting in Singapore, it motivates me to try my best not just with my patients, but with my fellow healthcare providers as well.

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Celebrating Dr Thew’s Birthday
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A touristy moment on the Sapan Mon-Thai Friendship Bridge in Sangklaburi

– Hannah Luah, 2018

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