When the Code Blue emergency code is activated, it means someone’s heart has stopped beating. That is when respiratory therapist Sara Sim rushes to their side to help them breathe again.
“Wherever we are in the hospital, a team of us do our best to get to the patient as soon as possible and try to resuscitate him or her,” says Ms Sim, 30.
Most often, this means getting a breathing tube into the patient, though it can also mean helping with compressions for cardiopulmonary resuscitation (CPR) or giving the patient oxygen using a device. It is a very fast-paced job that requires one to think on one’s feet.
“When things happen, you need to immediately know how to rectify or help with a situation,” says Ms Sim. “You don’t have time to sit down and run through a checklist.”
It can be very fulfilling when she manages to get a patient breathing again, but she points out that it is just the beginning.
“Depending on how long the resuscitation takes, you might have to worry about stuff like brain damage. That’s more important than just focusing on the resuscitation itself,” she explains.
Finding an exciting job
Currently a senior respiratory therapist at Woodlands Health, Ms Sim had been awarded a MOH Holdings (MOHH) Healthcare Merit Award (formerly known as the Health Science and Nursing Scholarship) in 2013 to study respiratory therapy at Ohio State University where she earned a Bachelor of Science in Health and Rehabilitation Sciences.
She decided to become a respiratory therapist after a visit to a scholarship fair. Then a biotechnology student at Temasek Polytechnic, she did not know what kind of career she wanted, only that she did not want a nine-to-five job.
“I like to have an exciting life,” she quips.
Respiratory therapy seemed to fit the bill. It also helped that her older sister, who had told her about the scholarship fair, was going into the same line of work.
When her sister did an attachment at a hospital, Ms Sim tagged along. Her experience there cemented her decision to take up the MOHH scholarship.
Facing death, focusing on life
The job is not without its emotional tolls, Ms Sim warns.
The first time she lost a patient was during her first year on the job in 2017 at Singapore General Hospital. Though she had managed to establish an airway, she had to help squeeze bags of blood into the patient who was bleeding out too quickly during the procedure.
All the while, she could hear the patient’s family crying outside through the double doors.
“That night, I could not sleep. But the reality is that a lot of people who make it to the Intensive Care Unit (ICU) are so sick, the mortality is pretty high. I realised I had to learn to let go,” she says.
That loss hit her badly. Now, she copes by compartmentalising.
“Once I get off work, I try not to think about it anymore so it won’t be stuck in my mind all the time,” she says. “That way, I can carry on and provide better care for my patients.”
What she does let herself take away from her work is the reminder that life is short and unpredictable.
“You should always try to cherish the people around you,” she reflects.
Ms Sim went on to spend five years at Sengkang General Hospital, which she helped set up in 2018. Her role included working on simulations to see if the hospital workflow was viable – for instance, how a patient would be transported from the ICU for a computed tomography scan.
She took with her the lessons she learnt there when she moved to Woodlands Health in 2023, where she is currently helping to set up the respiratory care department.
When the Covid-19 pandemic hit, she felt not fear but calm.
“We had done simulations of pandemic workflows. When it actually happened, we were all quite ready for it,” she says.
Nevertheless, Covid-19 was exhausting for front-line workers like her.
“There was minimal manpower. At times, it was so busy I didn’t even have time to eat lunch,” she recalls.
To do this job, Ms Sim says you have to be someone who does not give up. She advises scholar hopefuls to do an attachment first, so they have some idea of how intense the job can be.
“Just know what you are getting yourself into,” she says. “If you have emotional stress from seeing a lot of death, then maybe you won’t be able to cope very well subsequently.
“But if you love the job, you will enjoy every day at work.”