​Discover our WOW Factors

In a fast evolving healthcare ecosystem, nurses face increasing challenges in their clinical practice, workplace conditions, as well as finding work-life harmony to pursue their passion in career and life. NHG Nursing strives to be the thought-leader and pace-setter in building a progressive practice environment for nurses to grow, realise its professional potential, and shine. Look out for our upcoming initiatives to help our nurses discover their WOW factors.

Our commitment to avoid scheduling PAPA shift pattern (effective August 2023)

Our latest endeavour in building a positive practice work environment is to enable more rest between shifts, particularly between consecutive shifts. One way of doing so is to avoid planning/scheduling PAPA shift pattern for nurses on two- or three-shift rosters. The PAPA shift pattern, which involves working on shifts of “afternoon(P)-morning(A)-afternoon-morning" over four consecutive days, has led to common feedback among nurses of inadequate rest between afternoon and morning shifts, as nurses can often reach home after 10pm on an afternoon shift, and then having to leave home as early as 6am the next day for the morning shift.

Due to the need to ensure adequate manning for a 24-hour health care service, it has become a common and longstanding experience for nurses. While many have grown used to it over time, quite a number have also found it particularly energy-sapping. One of our NHG institutions, Khoo Teck Puat Hospital, did a pilot within an inpatient unit in 2022 to avoid scheduling PAPA shift pattern and monitor its impact in manpower manning. With the introduction of new roster rules, which was collectively agreed by the nursing teams on the pilot unit, the pilot was a success. The NHG Nursing Council has since studied the pilot results and decided to adopt this commitment in all NHG institutions (where relevant) from August 2023.

There are, expectedly, conditions to this initiative, and they are broadly as follows:

1. As a default rule, roster planner will avoid scheduling PAPA pattern for all staff on two- or three-shift rosters, unless staff specifically requests to opt 'out' i.e. he/she prefers to perform PAPA roster as per normal.

2. If PAPA pattern has to be set for any staff due to exigency of services, roster planner would pre-inform staff to seek understanding and support.

3. Collectively, unit supervisors and staff can set additional 'ground rules' to support this initiative e.g. staff can swap roster with one another based on pre-determined criteria.


'PAPA' and 'PA' shift patterns are different; this initiative excludes 'PA' shift pattern and is specifically targeted at scheduling 'PAPA' shift pattern, which was found to have a higher adverse effect on rest than PA shift pattern, and also because of the need to maintain manpower manning. ​