SINGAPORE – Two nurse leaders have risen through the ranks to reach C-suite posts that now see them in leading positions running public hospitals.

Adjunct Associate Professor Yong Keng Kwang was appointed assistant chief executive of the Institute of Mental Health (IMH) on April 15.

Three months later, Ms Margaret Lee, the chief nurse of Alexandra Hospital (AH), became the hospital’s deputy CEO on July 1.

Both positions are new.

Prior to these appointments, Yishun Community Hospital’s CEO Pauline Tan was reported to be the first nurse to have attained the position in 2015.

Dr Catherine Koh, group chief nurse of the National University Health System, said it is relatively rare for a nurse to ascend to these C-suite positions.

The traditional career pathways for nurses are in nursing management, clinical work and education, with the new career tracks being research and informatics.

Prof Yong received the President’s Award for Nurses in 2014 and Ms Lee in 2021.

Raring to go

Ms Lee’s appointment comes as AH gears up to serve more patients. By 2028, it will be redeveloped into a 1,300-bed integrated general hospital.

Plans are afoot to significantly ramp up manpower in the light of the expansion.

But the nursing shortage is a worldwide issue that will not go away, and one of Ms Lee’s challenges lies in managing manpower requirements, particularly as healthcare needs here rise with a rapidly ageing population.

Currently, nurses make up 43 per cent of AH’s headcount.

“I know that we will not have enough (nurses). So, what can we do to ensure that we have a better future, not just for the people we care for, but also the people providing the care?” said Ms Lee, 48.

One solution for AH is a virtual nursing model, where experienced nurses are tapped to support bedside care by monitoring patients virtually, which helps to relieve the mental fatigue of bedside nurses, she said.

During the Covid-19 pandemic, Ms Lee, whose three children are now aged 19, 17 and 14, told her husband that if she had to choose between the hospital and home, she would choose the hospital.

“My reason is very clear – you’re safe at home... It’s the other people who needed care,” she said.

Ms Lee views the journey she has been on so far as a privilege and it has helped her uncover many opportunities amid the challenges, she said.

“We are hampered by a lot of difficulties every day, but for me, it’s all about perspective,” she added.

“The more challenging it is, the more it’s worth doing, because the very fact that it’s challenging means it is complex.

“As long as there is a good reason to solve a problem for the greater good of people, then it is worth doing.”

When asked how she feels about the challenges ahead of her, she said: “Don’t think so much, just do (the work), stay humble, keep learning. I do not focus on myself.”

Associate Professor Jason Phua, AH’s CEO, who is also deputy CEO for clinical transformation at the National University Health System, said the hospital was looking for someone who could look far into the horizon, imagine the possibilities for patients and staff, and rally the team towards achieving them.

“Time and again, through thick and thin, and across the years, whether we were fighting Covid-19 or planning for the redeveloped hospital, Margaret (Lee) did not just steady, but also uplifted our team,” he said.

“She is an inspiring mix of courage and kindness, of energy and calmness.”

Ms Lee, who is an adjunct assistant professor, has also been tasked with strengthening AH’s culture as its chief culture officer.

The irony is that she had not planned on becoming a nurse. She pursued a diploma in nursing at Nanyang Polytechnic only because she did not do well enough to get into the graphic design course she had wanted.

“Perhaps the way I started, not being a superstar, being extremely ordinary... kind of has a place in what is important to me now...

“I never want to lose the sense of what really matters to people on the ground, especially when I’m in a privileged position where I really can help to make a big impact.”

Wearing three hats

IMH’s Prof Yong, 53, has a triple role, as he is also chief wellness officer and group chief nurse at the National Healthcare Group (NHG).

In the latter capacity, he oversees the development and practice of more than 9,000 nurses in the cluster.

“The cluster decided to deploy somebody who has networks and access to cluster resources to come and support IMH in a closer way,” he said.

Apart from helping to expand the scope of IMH’s outreach work, he will also be facilitating the development of capacity to manage psychiatric patients at the group’s restructured hospitals, among other work.

“Other than the level of complexity, I would say that I am not a fish out of water,” said Prof Yong.

NHG’s chief human resource officer Khoo Swee Lan said it had identified the need for a pivotal leadership role to augment IMH’s existing leadership team, and complement its efforts to transform IMH into an even stronger institution to lead key mental health initiatives in Singapore. 

She said Prof Yong was chosen for his extensive and diverse experience and expertise beyond nursing, and for being a long-time champion of staff well-being.

Prof Yong, who became NHG’s group chief nurse in October 2020, said his eldest daughter wanted to follow in his footsteps but chose to study linguistics as she did not get into the nursing course at the National University of Singapore. He has three children aged 23, 19 and 17. His wife is trained in physiotherapy.

“Nurse leaders (are very capable) but because of our nature, our attributes, we prefer to stay in the same (role), and are happy to retire as a nurse,” said Prof Yong.

He said he can already identify one or two staff in his nurse leader groups who can take on more leadership responsibilities.

“We all worry about being impostors, (asking ourselves) can we really do it? Hopefully, this will be a good sign to show others that nurse leaders can do it.”