A nurse who learnt HR from the night roster

The first roster I objected to was my own. In March 1997, eight months after I registered as a nurse, I worked eleven night shifts in one month in the surgical intensive care unit at Kinloch Bay Hospital in Singapore. I was the newest nurse on the unit, so I took the nights that experienced colleagues had declined. On the ninth of them I drew up an infusion at the wrong concentration, and the senior nurse checking it stopped it before it reached the patient. She did not file a report, which today our hospitals would expect her to do as a near miss. Instead she sat me down at four in the morning and asked how many nights I had worked that fortnight. Twenty-five years later that question became a rule for our nurses.

I was born in Surabaya in 1974. My father taught chemistry at a secondary school, and I had a year of college there before I applied, at nineteen, for a hospital-sponsored nursing traineeship in Singapore. Kinloch Bay paid my fees at the Kembangan School of Nursing; in return I owed the hospital three years of service after qualifying. I finished my diploma in 1996, served the bond and stayed. I took an advanced diploma in critical care in 1999, became a nurse clinician in 2001 and finished a part-time nursing degree at Merbau Hill University the following year, mostly after night shifts.

In 2003 I became nurse manager of the unit I had trained in. The hospital had begun recruiting nurses from the Philippines and India, and in 2004 I joined interview panels in Manila and Chennai. Several of the nurses who came to my unit told me, months later, what they had paid to agents before they met us, and one was still repaying a loan from her family. I raised it with the director of nursing, who agreed it was wrong and explained that it happened before the nurse reached our door. In 2006 I moved into HR as the hospital's nursing workforce manager, responsible for rostering rules and recruitment for 640 nurses. I finished a part-time master's degree in human resource management in 2008.

In January 2009 I moved to Kuala Lumpur as general manager of human resources for Seri Andalan Medical Centres, a group of six Malaysian private hospitals. I had spent twelve years on the receiving side of nurse migration; now I was on the losing side. Our Johor hospital lost a quarter of its nurses some years, many to Singapore employers whose dollar was then worth about two and a half ringgit. I also learnt how Malaysian private hospitals work with consultants who are not employees, and built a career structure for the resident medical officers who were. When I left in 2013, group nurse turnover was nine points lower, but Johor's barely moved. I did not understand why until much later.

My next move surprised colleagues. From July 2013 I led HR at the Singapore manufacturing site of Veldane Biologics, a vaccine and biologics producer. The site was hiring 310 people for a second building, most of them operators who had to be qualified before they could work in aseptic areas. In a hospital I had seen nurses rostered on wards where their training was out of date because nobody had checked. In the plant, an operator whose qualification had lapsed could not open the door of the cleanroom. I came back to hospitals convinced that a licence or a competency should be a condition of being rostered, not a line in a file.

I joined Aravelle in April 2019 as chief people officer for our Singapore and Malaysian hospitals. Within a year we were cross-training 610 nurses for intensive and isolation care during the pandemic. In 2020 an audit I had commissioned found eleven nurses who had kept working after their practising certificates lapsed; we built a register that now blocks a lapsed nurse from the roster. The same year we began paying the whole cost of recruiting foreign-trained nurses. In January 2022 I became group chief human resources officer, and in 2023 we acquired Wiralaksa Hospitals in Indonesia, the work that has shaped my last three years.

I am a nurse by training and still think like one about handovers. I want the person taking over a problem to know what the person leaving it knew. In practice that means I write short papers with the dissenting view attached, I ask ward managers what a policy will do on a Sunday night, and I prefer a measure that the people being measured can check for themselves. Colleagues would say I am slow to call a programme a success and quick to say when one of my own rules has gone wrong, which has happened more than once.

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