This 26-year-old respiratory therapist brings comfort to patients with breathing difficulties

When patients enter a hospital ward, who they most expect to see might be doctors and nurses.

But on many occasions, especially for those critically ill, alongside them are respiratory therapists like Victoria Kwong, ready with a ventilator to support their breathing.

At Tan Tock Seng Hospital (TTSH), where she works, respiratory therapists provide around the clock services to intensive care units, high dependency units and general wards, catering to the respiratory and emergency requirements of patients.

The 26-year-old found her calling as a junior college student through a short attachment at Singapore General Hospital, where she was introduced to the work environment and duties of respiratory therapists.

Later on, at a career fair held at her junior college, she applied for one of many scholarships the Ministry of Health Holdings was handing out for different allied health professions. 

Victoria says: “I was drawn to respiratory therapy because we worked in an environment that’s fast-paced and was very critical.

“I really enjoy helping people and making a difference in their lives, so the healthcare industry was definitely a place I wanted to be in.”

Since assuming her post in TTSH three years ago, she does daily assessments on patients who are critically ill in the intensive care unit (ICU) or those more stable in wards.

“Apart from that, we also take part in the doctors’ rounds to help decide what are the care plans for the day,” she says. 

Alongside a team of specialists like her, Victoria provides an array of services, the most common procedures being non-invasive and invasive ventilations.

For invasive ventilation, a breathing tube is inserted down the throat, while non-invasive is carried out through a mask.

The non-invasive procedure is more often used to help patients with their sleep apnea (serious sleep disorder), while the invasive procedure will be carried out on critically ill patients.

However, for those critically ill and with prolonged intubation complications, a procedure known as tracheostomy will be carried out, in which a breathing tube is inserted through the patient’s neck.

Another dire situation Victoria would be involved in is the intubation portion of Code Blue, a hospital emergency whereby the patient has a cardiac arrest and requires cardiopulmonary resuscitation (CPR). 

In both aforementioned situations, respiratory therapists like her will work with doctors to perform the procedures.

Aside from the day-to-day tasks, Victoria also highlighted more time-consuming procedures such as proning, a procedure to flip the patient to lie on their stomach, and high flow nasal therapies.

She says: “For those critically ill patients, their lung reserves aren’t the best. So by proning, this will help buy them time for medication to treat their lung condition.”

Since the COVID-19 pandemic hit in 2020, the hospital saw an increasing number of patients who required such time-consuming procedures, Victoria says.

“At that point of time, a lot of new policies and changes were being pushed out every other week, and these new situations actually added a lot of stress on us.

“We worked with the doctors and the nurses to come up with a policy to help prone patients in a more systematic and efficient way, including showing them how to use the ventilator.”

Victoria’s day-to-day work was also affected by the pandemic; not only could she no longer have meals with her coworkers, more equipment also had to be worn such as N95 masks and goggles even on daily rounds in the wards. 

“However, I also understand that it’s a pandemic and there’s always a need for us to prevent the transmission of this virus,” she says.

Despite the slew of challenges she faces daily, of which some are due to the pandemic, Victoria finds motivation in knowing that her work brings comfort and relief to her patients. 

She says: “What I love most about my job is actually to see my patients recover, and eventually breathe off the ventilator.”

Victoria tells of her encounter with one of her patients, who was ventilator-dependent for over nine months and on the brink of death. 

“He didn’t think he could make it,” she recalls,” But the day he managed to breathe off the ventilator and could speak to us, hearing his voice after a long time was a very memorable moment for me.”

Even as Singapore moves towards a post-pandemic future, she believes that her role in healthcare will remain critical.

“As we are a society with an ageing population, I anticipate there will also be more people needing the ventilators,” she says.

In considering a profession in the allied health sphere, which includes physiotherapists as well as occupational therapists, passion was an important factor for Victoria.

“Most other allied health professions work in a stable rehabilitative environment, but respiratory therapy deals with more inpatient and more critically ill patients. So that’s how it led me to choose this over other options,” she says. 

Aside from working within hospitals, respiratory therapists would also be deployed to visit homes and clinics to assess and perform procedures on patients who require continuous ventilation.

“In this job, we deal with a lot of death as critically ill patients most likely would not survive in spite of the team’s best efforts,” Victoria says, “It’s easy to get numb and immune, so being compassionate is important.”

Acknowledging the stresses on the job, Victoria adds: “If you do have the passion to help others and help them breathe better, I really suggest that you join this career because it will definitely not be a boring one.”