Rozana Bte Abdul Rashid
Assistant Nurse Clinician
Case Management
Changi General Hospital

On 13 July 2015, Mr I*, a 57-year-old married school bus driver was admitted to Changi General Hospital for a persistent cough without relief for breathlessness even with the use of a Ventolin inhaler. It soon came to light that Mr I had developed chronic obstructive pulmonary disease (COPD) due to his long-standing history of smoking.

During my first encounter with the father of five, he shared that he had been unemployed for the last three months as a result of his medical condition. As such, he was very worried about not being able to finance his HDB housing loan as he could hardly make ends meet despite contribution from his children and the Community Social Service Office. Spurred on by his plight, I contacted the Medical Social Service (MSS) to check if there was anything they could do to help Mr I. I was informed that MSS’ assistance could only come in after Mr I’s condition had stabilised.

After a few more interactions with him, it became evident that Mr I did not fully comprehend the severity of his medical condition. It took a few hours of education, training and reiteration for Mr I to have a clear picture of what having COPD entailed, and managing his symptoms with the use of his inhaler. To further lend Mr I ownership of his condition, I included goal setting exercises in our sessions together.

Mr I had being smoking four cigarettes daily for the past 40 years. It was not surprising that he was resistant to the idea of abstaining from smoking. In order to achieve his compliance, I enlisted the help of his youngest son whom he shared a close bond with. Eventually, his wife and youngest son played pivotal roles in motivating and supporting Mr I in his journey towards successful smoking cessation. This led to an improvement in his condition post-discharge.

Mr I continues to show improvements in the Outpatient Pulmonary Rehabilitation Programme despite his initial hesitation. I was very touched when he expressed his gratitude for my care and support of him throughout his journey. I was also very heartened by his determination to get back on his feet again and re-enter the workforce.

Upon reflection, caring for a patient with COPD is a challenging yet extremely rewarding experience. A great deal of care, patience and time needs to be invested in walking the patient through the education process in order to equip them with a thorough understanding of their own condition. I am glad that I had the chance to make a difference in Mr I’s life so that he is able to manage his symptoms effectively and continue leading a fulfilling life.

Key Learning Points:

  1. Educating patients’ on their conditions and teaching them how to manage their symptoms requires patience, time and effort.
  2. Include family members and loved ones in the recovery process as they provide invaluable moral and emotional support to the patient.
  3. Caring for a patient with sincerity can impact a patient’s life profoundly.