I have worked in Singapore in the past for 5years as a Staff Nurse. I was in Emergency Medicine Department. It was tough to adjust at first, considering I came from a small hospital with only two years hemodialysis experience back in the Philippines. I was determined to cope though. Their culture and religion plays a big part in their health care system and as a nurse, we must be vigilant to their needs. Aside from this, the influx of the patients are just so overwhelming---they don't have a system whereby they can re-route ambulances to other hospitals if our hospital has no available beds in the wards. So with this, all we have to do is to keep on accepting incoming patients and in times that the wards are full, they will have to wait for as long as 24hours in ED just to wait to be admitted. I find this very difficult for our nurses, especially that the nurse-patient ratio goes out of control. Its crazy. We had no choice but to put trolleys side-by-side with no space in between just to accommodate more patients. If one elderly woman wants to pee, we have to find a corner and push the trolley to help them relieve their bladder. If I would put myself in the shoes of other patients, I wouldn't like it if I am lying down next to somebody whom I've got no idea what disease they might be having. It's disgusting, but of course, saving lives comes first. A lot of our nurses recently resigned, which makes the workload in our department much more difficult. We had 11 staff resigned just for the month of August, and more is rumoured to follow in September. I am writing this because I am concerned to those staff left in ED, as well as to those patients who will more likely to receive a lesser quality of care under staffs who were overwhelmed with patients to take care of, with medicines to serve, and with procedures to do. I hope this will be resolved soon, especially that they plan to expand ED early next year. I guess, employing new staffs will help, but not right away since it will take time for them to actually function without being supervised.