How I became a “certified” swabber in 8 hours
Update 16/6/20: Thank you to Yahoo News for featuring my experiences from the swab training in a story on the SG Healthcare Corps. 🙂
As my Ryde made its way across the island to Nanyang Polytechnic, I was feeling rather smug over how well-prepared I was.
Mentally, I went through what was in my bag – hand sanitiser, alcohol swabs, back-up surgical mask, lunch box, water bottle, cardigan and even a Dettol solution along with a rag (to wipe down any surfaces).
In my phone, I’ve got both the authorisation letter and the certificate from the online PPE (Personal Protective Equipment) course downloaded.
Crap, where is my IC? I need it for verification!
I’d left my wallet at home. So much for being ready. I’ve been staying at home for so long that I’ve forgotten what REALLY needs to be in my bag when I actually go beyond my neighbourhood.
Volunteering to poke noses
When it was announced three weeks ago that the SG Healthcare Corps would be expanded to include non-healthcare professionals in the fight against coronavirus, I volunteered immediately for swabs and phlebotomy (blood tests). Apparently there were 11,000 sign-ups as of May 4.
My one big regret in life was not keeping to my triple science combination past the first three months of junior college, though one could argue that’s no guarantee of a medical career.
Still, this was going to be the closest I would get to “healthcare” in any case. So, as instructed, I headed to the School of Health & Social Sciences for an eight-hour course on Nasopharyngeal Swab & PPE.
There were about 70 of us in the lecture theatre, with slightly more women than men. The majority were in their late 20s to mid-30s.
The lecturer, formerly an A&E nurse of 14 years, began by asking if we remembered Sars. I do.
In the early days before Sars even had a name, I was roaming the hallways of Tan Tock Seng Hospital trying to find out more about this “mysterious flu that was making people very ill” as my editor had said I was not to return to the newsroom until I had a story.
The lecturer continued on a sobering note – two of his colleagues died from Sars. Singapore is a lot more prepared now, he said, but you’re still putting yourself out there.
“It’s gone into the brain!”
Post-lecture, we were divided into smaller groups to learn and practise how to swab the nose (nasal), throat (oropharyngeal) and back of the nose (nasopharyngeal) on a mannequin head, not on one another thankfully!
We pushed the mannequin’s hardened tongue down so we could get the swab stick in and out of the back of his throat without touching anything else. “Say ahhhh please.”
We learnt to visually estimate how much of the stick should be left protruding outside the nose for a nasopharyngeal swab. “You’ve gone too far, and your stick is now in the brain stem.”
We had so many questions and the instructors answered them with such good humour.
“What if our hand is shaking when doing the swab?”
“Ask the patient to close his eyes, so he can’t see you shaking and you won’t have to be staring into his eyes.”
“What if the patient sneezes when the swab stick is in his nose?”
“Let go of the stick and step away quickly. You don’t want to bring something free home right?”
But more than the technical skills, the instructors also showed us the importance of empathy.
Be patient if the person gets grumpy at being asked his name and IC number because he might have already repeated it six times that day. Be sympathetic because the nasopharyngeal swab is “really quite uncomfortable”. Be kind and explain the procedure because “they have a right to know if we’re putting something into their nose”.
I don’t think I’ve washed my hands as much in a day as I did today. There are 5 moments when we have to “practise hand hygiene” – before and after you touch a patient, before and after a procedure, and when you leave the patient’s environment. And each time you do a hand wash (water and soap) or a hand rub (sanitiser), you have to go through all the seven steps. Now where’s my hand cream?
Learning to put on the PPE was another exercise in remembering the order of donning the various items – mask, goggles, cap, gown, gloves. For the vertically challenged like me, by the time I unfurled the gown, the straps had brushed the floor and I didn’t even realise. Darn, no longer “clean”.
Also, can someone redesign the gown so that we can tie it in front instead of at the back. Because short arms. In any case, I brought my home to practise untying it with one hand without strangling myself.
We finished the day with “mask-fitting”. We were given an N95 mask each based on our face shape. The instructor put a hood over our head and sprayed a bitter-tasting agent into the hood. If our mask fit well, and we wore it correctly, then we wouldn’t taste it.
My first mask – a regular 3M one – failed the test twice despite my best efforts to press the metal bits onto my face (now I know why healthcare professionals have such deep grooves on their face after a day of wearing PPE).
The second one – a Halyard one that looks like a duck bill – finally passed. And so did I, with my certificate.
I came home to the news that the Government is recruiting full-time swabbers and since I’m a volunteer, I’m not sure if or when I’ll be deployed for swabbing (my phone auto corrects it to stabbing, quite apt I thought).
During the PPE session, the instructor asked: “Now that you’re ready, fully gowned and gloved, where do you place your hands while waiting?“
You clasp your hands in front of you, as though in hope.
And that’s where my hands are now.