A Force for Global Health

Reinforcing their belief in the positive impact of cross-border nursing, two healthcare professionals in this space — one from Singapore, one from China — have a lively conversation with each other on this topic. We listen in on their chat.

The future of healthcare is one that increasingly transcends geographical boundaries, and global nursing is at the forefront of this evolution. As healthcare systems worldwide grapple with evolving patient needs while embracing unprecedented opportunities in digital innovation, Professor Jiang Yan, Director of Nursing at West China Hospital of Sichuan University (WCHSCU), and KK Women's and Children's Hospital (KKH) Assistant Nurse Clinician Jasmine Goh share how nurses are defining tomorrow's medicine and healthcare delivery. Their perspectives highlight innovative approaches to strengthen nursing capabilities and build responsive healthcare networks across Asia and beyond.

Professor Jiang Yan and Jasmine on an online chat

The importance of global collaborations

One of the most meaningful cross-border healthcare initiatives Jasmine has been involved in is the Global Nursing Network for Rare Diseases (GNNRD), particularly in the establishment and development of the Asia-Pacific Chapter. “This initiative has deeply resonated with nurses across borders, largely because of our shared commitment to provide culturally responsive support for patients living with rare genetic conditions,” she shared. “What's been especially impactful is our focus on addressing linguistic and cultural differences in practical ways that strengthen cross-border collaboration and mutual learning. These shared efforts have helped amplify the role of nurses in rare disease care, and fostered a growing sense of solidarity across the region.”

The most rewarding outcome has been seeing the impact of these collaborations ripple beyond the Asia-Pacific region. “They've reinforced a global message that nurses are not alone in this work. Together, we can drive sustainable and meaningful improvements, even in the most underserved and complex care environments,” noted Jasmine. “Although healthcare systems around the world may differ, a powerful unifying theme is that nurses, regardless of where they work, consistently serve as advocates and connectors for families navigating the complexities of rare disease care.”

With support from a SingHealth Duke-NUS Global Health Institute (SDGHI) grant, Jasmine has had the privilege to further the work in this area by leading a comprehensive needs assessment across the region. “This assessment is tailored to the diverse contexts of Asia-Pacific, taking into account factors such as culture, language, healthcare infrastructure, and economic variability, ultimately helping us understand how to better support rare disease patients and the nurses who care for them,” said Jasmine.

Jasmine (seated, fourth from the left) at a group workshop for the Asia-Pacific Chapter of the GNNRD

APN development in China

Professor Jiang highlighted the growth of APNs in China. “The APN field is still budding here. Scaling up is challenging due to the lack of international standards, and overseas APN models are not fully adaptable to China,” she commented. “We launched our APN programme in 2021. In the beginning, we partnered with Associate Professor Zhou Wentao from the National University of Singapore to establish our APN training system. Based on the needs of patients, doctors and nurses, we clarified the role of APNs and trained 30 in our first cohort. Currently, we are optimising the APN model through international exchanges. Since last year, we have been collaborating with Clinical Assistant Professor Wai May Ng, National Neuroscience Institute, and other APN teams at SingHealth. We hold online international case discussions on difficult nursing cases every month. We share professional insights from multiple perspectives and different nursing measures within our respective teams. These discussions have enhanced clinical care capabilities for both partners. Recognising that foreign APN guidelines cannot be directly applied in China, we analysed global practices and developed the Expert Consensus on APN Training and Utilisation in China. This pioneering document standardises APN role classification, qualifications, scope, core competencies, education, prescribing rights, and outcome evaluation, providing a roadmap for China's APN development.”

Embracing digital innovation

Technology is revolutionising nursing practice. “Traditional pressure injury assessment relied heavily on visual examination and experience,” Professor Jiang explained. “Working with our engineering team, we developed a Non-invasive Pressure Injury Detection Device‚ which enables nurses to assess skin conditions simply by taking photos with AI-assisted analysis. The system captures micro-motion signals, translating deep- tissue damage into AI-analysable data, and uses algorithms to make preliminary diagnostic recommendations, thus enabling more accurate diagnosis. The prototype is now being used only at WCHSCU, but we envision its broader application across China. It's currently undergoing further refinement and can hopefully be pushed out on an international scale in the future.”

In genetic nursing, technology is vital. “We use 3D camera technology for genetic assessments,” shared Jasmine. “3D facial scanning captures structures for craniofacial analysis, comparing them to known patterns corresponding to various genetic conditions.”

Innovation extends to patient care solutions. “We're using 3D printing to customise positive pressure respiratory masks for elderly patients,” said Professor Jiang. “By tailoring masks to individual bone structures, we reduce facial pressure injuries from long-term use.” Jasmine noted the potential impact: “This would be invaluable for paediatric patients in Singapore, many of whom struggle with mask comfort and compliance.”

Building future-ready healthcare networks

“The COVID-19 pandemic highlighted critical gaps in nursing resources,” Professor Jiang reflected. “Beyond balancing national and hospital needs, we discovered that effective pandemic response depends on more than just the number of nurses. Their professional knowledge and experience (such as in intensive care and infection control) are even more critical. Nursing competence is of paramount importance, especially in isolation settings. Moreover, the unpredictable nature of pandemics and their associated manpower demands pose significant challenges, making workforce management particularly complex. We need capabilities for prediction and predictive management. Based on the dynamic characteristics of infectious diseases, we established a nursing workforce prediction model that can anticipate the staffing requirements and competency needs at different stages of infectious diseases to enable personnel scheduling and training based on these requirements. In addition, we have developed a shift scheduling decision-making system that provides suggestions from data and functions we input. The insights from this model will strengthen our response to future public health emergencies, enabling more strategic deployment of our nursing workforce.”

Professor Jiang Yan (middle) in a discussion with her nurses

Grooming nurses for the future

“I often ask my nurses, Are we able to change a patient's outcome through our work?‚” Professor Jiang mused. “In reality, not all nurses are able to answer this question with a resounding yes. While it may be unrealistic to focus on elevating the competencies of all 5.5 million nurses in China to the highest level, we can start with 10 or 20 nurses within WCHSCU's nursing team of about 5,000.” She added: “The core principle of nurse training is competency-based. Our goal is to equip nurses with competencies that align with our specific needs. We believe nursing's future will embrace interdisciplinary collaboration. By equipping nurses with foundational knowledge in fields like engineering to drive innovation, this cross- pollination of expertise expands their problem-solving capabilities and ignites breakthrough solutions in patient care.

Using the earlier example of the pressure injury device, collaborations with WCHSCU's engineering team stretched its potential beyond using just an ultrasound imaging technology. With high patient loads, traditional treatment methods often prove to be inefficient and cost-ineffective. This not only negatively impacts patients, but also puts significant strain on nurses. Harnessing new technology developed through interdisciplinary collaboration allows nurses to feel more empowered and elevates their skills. With the growing use of robotics and AI in healthcare, it's crucial that we keep in focus the human element of patient care, which cannot be replaced by robots.

Professor Jiang Yan and her nurses encouraging a patient

What we need are competent yet compassionate nurses. Striking a balance between operating advanced medical technologies and providing empathetic , person-centred care is essential.”

For Jasmine, this balance resonates deeply. “Ultimately, nursing is grounded in genuine care for others. As a nurse with a background in the Children s Intensive Care Unit (CICU) and Neonatal Intensive Care Unit (NICU), my nursing journey has always been rooted in a deep compassion and empathy for children. They are the driving force behind my commitment to provide holistic and family-centred care. My goal is to continue advancing nursing practice through compassionate, evidence-based and culturally sensitive care so that every child, no matter his or her diagnosis, can have the best possible chance at living a fulfilling life.”

Looking back, Jasmine recalled how her transition into genetics nursing marked one of the most transformative moments in her career. “Before this shift, my understanding of rare diseases was limited — I believed that these conditions were incurable, and that those affected would never have a good quality of life. However, once I stepped into the rare disease space, my perspective changed completely,” she said. “I came to see that individuals with rare diseases are not defined by their diagnoses.

They strive to live normal, meaningful lives, and to be fully integrated into their communities. They did not choose to inherit these conditions, but they can choose how they live, and live well if given the right support and opportunities.”