Career Highlight: Intensive/Critical Care Nursing

Intensive care nursing

Intensive care nursing or critical care nursing is a branch of medicine concerned with the diagnosis and management of life-threatening conditions requiring sophisticated organ support and invasive monitoring.

Overview

Patients requiring intensive care may require support for instability, airway or respiratory compromise, acute renal failure, potentially lethal cardiac arrhythmias, or the cumulative effects of multiple organ failure. It is also commonly known now as multiple organ dysfunction syndrome. They may also be admitted for intensive or invasive monitoring, such as the crucial hours after major surgery when deemed too unstable to transfer to a less intenseively monitored unit.

Intensive care is usually only offered to those whose condition is potentially reversible and who have a good chance of surviving with intensive care support. A prime requisite for admission to an intensive care unit is that the underlying condition can be overcome. Patients with a non-overcomeable condition are not admitted into intensive care units (ICU).

ICUs are the most expensive area of nursing or medical care. It is also the most technologically advanced, requiring nurses with a higher level of qualifications and education than most. Telemetry, data-analysis, and surgical procedures are all part and parcel of the ICU nurse’s daily responsibilities.

Work Location


ICU or Critical Care nurses are provisioned in a specialized unit of a hospital called the intensive care unit (ICU) or critical care unit (CCU). Many hospitals have also designated intensive care areas for certain specialties of medicine, such as:

The terminologies and nomenclature of these units may vary from hospital to hospital. They are also subject to funding, research capability, and availability of trained medical staff.

Equipment and systems in unit

In the ICU/CCU nurses are required to fundamentally understand and able to operate certain equipment and systems that are critical to the survival of the patient admitted. Common equipment in the unit includes mechanical ventilation to assist breathing through an endotracheal tube or a tracheotomy; hemofiltration equipment for acute renal failure; monitoring equipment; intravenous lines for drug insusions or total parenteral nutrition.

A wide array of drugs are also kept in the ICU/CCU, such as inotropes, sedatives, broad spectrum antibiotics and analgesics.

Work staff

Intensive care/critical care medicine is a relatively new but increasingly important medical specialty. The ICU/CCU is staffed by multidisciplinary and multiprofessional teams including nurses, respiratory therapists, physicians and critical care pharmacists. Doctors with training in intensive care are called intensivists; ICU/CCU nurses are a major form of support for this group.

Training

ICU nurses will have completed a minimum of three years as a registered nurse following their nursing diploma or degree. Depending on the hospital, ICU nurses may have opted to do a BSN or MSN in order to develop the critical thinking skills required of medical staff in a such a high dependency ward.

A post-basic certification in ICU care is commonly around the duration of 12-24 months, where nurses in training will cover internal medicine, pediatrics, anesthesiology, surgery, and emergency medicine.

Nurses may also pursue additional education and training in critical care medicine leading to certification by bodies such as the American Association of Critical Care Nurses. This certification carries a lot of weight in terms of qualification for those seeking career advancement.

ICU/CCU nurses choose to specialize in one or more of the nine key systems, which are:

Work Conditions

Common tasks and responsibilities

Hypoxemic Respiratory Failure

The primary aim in treatment of this kind of failure is maintenance of adequate oxygenation, while limiting ventilator-induced lung injury and oxygen toxicity.

Assist Patients to Wean Off Mechanical Ventilation

Weaning is the process of gradual withdrawal of mechanical ventilation. The process is uneventful in most patients, but may take up half the time on a ventilator in problematic patients. Nurses are to assess the readiness of patient to wean using clinical and objective measures, and moderate weaning failure on difficult-to-wean patients.

Inotropic and Vasopressor Support for Hypotensive Patients

This treatment aims to maintain a perfusion pressure necessary for tissue oxygenation in patients with hypotension and inadequate tissue perfusion. Tasks are to correct hypovolemia, titrate doses of inotropes and vasopressors to targeted levels, monitoring of blood pressure via the arterial line, and prevent septic shock.

Feeding via Enteral or Parenteral Methods

In ICU care, nutritional therapy is plays an important part. The goal is to provide adequate calories and protein to keep up with ongoing losses, prevent or correct nutrient deficiencies and promote wound healing and immune function.

Work Opportunities

Search for high-paying ICU/CCU nursing jobs on MIMS Career. Browse, save, and apply for nursing jobs, all in one-click. Take the opportunity for higher pay and better work locations. Our pages are all mobile-responsive, allowing you to take that leap for a better job whenever, wherever you are. All our job postings are heavily screened to prevent scams and mistrustful behavior.

Think About These 5 Things Before You Decide On A Specialization

5 Things Nurses Need To Know To Be Paid More

10 Ways Malaysian Nurses Can Increase Their Income



Other Articles




 Technological developments continue to improve well into the 21st century, bringing in advancements in surgical care. By extension, the responsibilities of the registered nurse that assists in patient care in the operating room/theater need to keep up with the times. 



 Definition: 

 These nurses who have more specialized duties in the OT/OR are called perioperative nurses. The word “peri-” is Greek for “about”, or “around”, “enclosing.” Just think of the word “perimeter. Hence, “perioperative nursing” means the care of a patient before, during, and after a surgical procedure. 



 Duties: 

 Typically, perioperative nurses fall into two categories: 

  Scrub nurse  - These nurses select and pass surgical instruments to the surgeon during the operation. He/she might also assist in the procedure. 

  Circulating nurse  - This kind of nurse manages the operating room. She ensures the place is safe for the patient and operating staff. 

  Anaesthetic nurse  - Provides support to the anaesthetist during or before the procedure. Duties include preparing the equipment, and administering anaesthesia to the patient in a safe manner. 

  Holding bay nurse  - this term might be called differently in other countries. The holding bay nurse is responsible to bring the patient up to speed in the pre-perioperative environment. She is also responsible for all the information to be correct prior to procedure, such as fasting status, reports, and medication. 

  Post-surgery Recovery Nurse  - As the name indicates, this nurse cares for the patient immediately after surgery. Tasks such as ensuring patient’s airways are open, recording results, are the norm. 

  It is common for a single perioperative nurse to carry two or three of the aforementioned duties during a patient’s course of the surgery.  



 Education: 

 A post-basic certification is needed in order to qualify one to take up perioperative duties. The duration of the post-basic training might be within 1-2 years. Nurses undergoing training are exposed to surgical care, intensive care, and treatment of critically ill patients.  

 Most post-basic programs require 3-4 years of work experience as a registered nurse beforehand.  



 Workload and Working Conditions: 

 Surgical procedures can be very long. Moreover, complications can sometimes occur, further delaying the endpoint of the surgery. 

 Perioperative nurses are expected to be alert of the patients’ vitals during the post-surgical state to monitor any signs of abnormalities. 

 Working hours may differ across institutions. A small clinic specializing in aesthetic surgery might have more regular hours, compared to a teaching hospital that has multiple wards. 

 Work conditions and intensity also depend on the severity and complexity of the patient’s surgery. 



 Opportunities in Perioperative Nursing 

 Like most areas of nursing, job opportunities continue to grow. This specialization is expected to grow at a high rate as more institutions begin to provide surgical procedures. 

 The additional training provided to nurses with perioperative backgrounds can open many career doors. In the future, they will be able to function as OT directors, handle fiscal matters, and other managerial aspects of the operating theater. 

 With some more experience, nurses can proceed to becoming academicians or educators, as well as go into research. 

  Read more on advancing your nursing career into nursing education HERE.  

 Salary and income  
Nurses with specialization (such as perioperative nursing) stand to earn higher than the national average of nurses’ income. However, it is subject to location and healthcare institution facilities. 

 For those in the public sector, you have a high chance of being put in a higher grade. 

  Read more on how nurses can increase their income HERE.  



 Source: 

  https://healthtimes.com.au/hub/perioperative/46/guidance/nc1/perioperative-nursing/563/  

  http://www.mayo.edu/mayo-clinic-school-of-health-sciences/careers/perioperative-nursing  

 Search for high-paying perioperative nursing jobs here at  MIMS Career . Sign up and apply today with our safe, secure, and free site. MIMS Career is an extensive job portal for healthcare practitioners such as nurses, doctors, and dentists throught Malaysia, Singapore, Indonesia and the Philippines. 

 Browse through our vast directory of job vacancies by top healthcare employers. See any jobs you like? Apply with one click, or save it for later if you need some time to think about it.  

 Can’t find what you’re looking for? Set up an email alert, and we’ll notify you when a job vacancy that meets your desired criteria becomes available.

Career Highlight: Perioperative Nursing

Technological developments continue to improve well into the 21st century, bringing in advancements in surgical care. By extension, the responsibilities of the registered nurse that assists in patient care in the operating room/theater need...

Read More




 Some of you might wonder: is it possible to practice my profession overseas?  

 Fortunately, the answer is yes. Working overseas provides many benefits. Among them is the experience that you’ll get. Moving to a foreign country will expose you to experiences that not many would have. 

 It will expand your perceptions on the profession as you go through the day-to-day challenges. Depending on the country, you get higher wages. A registered nurse in Australia typically gets paid around AUD 53,900 to AUD 75,000. This results in a high quality of life for your family. You can see similar numbers for Singapore, Canada, and the Gulf countries. 

 There are plenty of opportunities overseas. It takes a bit of creativity and resourcefulness to find them, but it’s worth it for all the benefits. It is a must-do for those of you who feel you need a change of pace in life. 

 Opportunities in: 

 
	   Specialize in a field of choice   
	   Locum jobs in free time   
	   Advance in your Career   
	   Work Overseas   
	   Ask for additional shifts from your employer   
	   Take up health writing jobs   
	   Medical Communicator   
	   Tutor (University or school)   
	   Become a field nurse at community events   
	   Something non-nursing, like passion or interest   
 



 Singapore 

   



 Home Care 

 Many foreign nurses are being hired to provide home care for the elderly in the city-state of Singapore. 

 They enter with the same work pass as a maid; and live in with the patients that they care for. 

 There is a genuine demand for nurses who are willing to work in these conditions in Singapore. Compared to sending their aging relatives to nursing homes, Singaporeans now prefer them to stay at home, where they are familiar and can be comfortable.  

 You would not need to spend on food and lodging. Also, if not working at the patient’s home, you have more time and freedom on your hands, as compared to working in a hospital. 

 The disadvantage is that your pay is only slightly more than a domestic helper. On average, home care nurses get only about SGD600-SGD1000 a month. 

 Check out Active Global Caregiver, Optinuum Health Services and Homage if you’d like to find out more about this kind of work. 



 Private Practices 

 Many clinics in Singapore are actively seeking out Malaysian Nurses; they even list it out in their job descriptions. 

 The pay is higher compared to working in Malaysian private practices: about SGD2000-SGD3000 per month on average. 

 Regular hours for these institutions means you can opt to live in Johor Bahru, while commuting to work in Singapore. You earn in a stronger currency but live in a more affordable area. 

 However the commute can be really tiring, and it can take hours to travel to and fro across the Johor Straits. 



 Public Hospitals 

 As mentioned, the Singaporean government is investing in a lot of foreign nurses. According to sources, the country is investing SGD 24million to help fill out 9000 jobs in healthcare. 

 They even have overseas nursing graduate programs and scholarships to woo over those from overseas, even if from a different career. 

 Job prospects looks bright. With all the government actions, its a clear indication that foreign nurses are very much needed in years to come. 

 However, it can create high levels of stress to work in such conditions. Short of manpower, it creates a large amount of workload. Singaporean nurses cite great demands at work, and internal conflicts. According to a study, affected nurses cope better when with friends and family. 

 Working overseas normally means leaving friends and family behind, therefore leaving you with a lesser safety net for your mental fortitude. 

 You can check out how non-Singaporean registered nurses can work in Singapore here. 



 Australia 

   



 Hospitals 

 Also facing a shortage in nurses, they seek to hire foreigners to meet demands. Some will even sponsor you. 

 As a rapidly developing country, Australia has very high standards of nursing care that we can learn from. A job stint there will expose you to cases or methods that you would not normally have the opportunity to see here. 

 A major advantage of being a nurse in an Australian hospital is that it is one of the highest paying countries for nurses. However, the process for Malaysians to immigrate and practice nursing there can be lengthy. First you have to register with the NMBA. Then register with ANMAC, complete training with AHPRA, pass ANMAC skills assessment, obtain placement in an institution, and then only finally migrate. 

 You can check out our article on how to become a nurse in Australia for more detailed info. 



 Nursing Homes 

 As Australian society continues surging onward with better healthcare delivery, life expectancies have increased, leading to a ballooning population of geriatrics. Australian hospitals tend to want to discharge patients as fast as they can, resulting in more patients being put into extended or long term care centers. 

 These care centers are sprouting up in all Australian states. They even have one specifically to cater to those of Chinese ethnicity. Malaysians of ethnic Chinese parentage would do well here. 

 Advantages of working here include flexible hours, and locations you can choose. The work experience you gain from here can set you up for specialization in Geriatrics, an increasingly valuable specialty. 

 However, like any business, nursing homes can close down due to lack of funding, or if investor money runs out, like this nursing home in Walcall.  

 You can check out how non-Australian registered nurses can work in Australia here. 



 Saudi Arabia 

   



 Hospitals 

 The Royal House of Saud is aggressively developing their healthcare system, capacities and how they deliver it to their citizens, according to this report. 

 Nurses from Malaysia get drafted into 1st Grade, which has a salary of RM14,000/month. The Saudis are comfortable with Malaysian nurses because of our proficiency in English.   

 You get to live a very comfortable life as a nurse here. Lodging and food are often prepared by the employer to make it easier on foreign nurses coming into work. This gives a leg up for those unsure how to begin life in a new country. 

 Many Malaysian nurses are already working there. You would have a strong support system for hard times from the community. 

 Not only is the pay very attractive, the extremely low tax rates imposed on you would result in a much higher net income. The healthcare is advanced, even if the Kingdom is struggling to deliver its healthcare to its citizens because of the large country size. Also, since it is home to the two holiest sites in Islam, it is a great opportunity to be closer to one’s faith for Muslims. 

 Unfortunately, Arabs can be culturally more aggressive compared to mild-mannered, timid South East Asians. Also, the Kingdom is a bit further away compared to working in other ASEAN countries. 



 United States and Europe 

   

 There is currently an extreme shortage of nurses going on in the States. By 2022, it is estimated that the total number of nursing vacancies is projected to be more than a million. 

 According to the latest numbers from the American Census Bureau, the 76-million strong baby boomer generation will triple the number of over-65 population in 2030. This can strain the nursing workforce. 

 It has even come to a point where American institutions are now promoting nursing as a second career. They are even helping to promote the profession to men, who have traditionally shied away from nursing. 

 Working in the United States as a nurse nets you a good pay, and a high standard of living.  

 A similar situation to the USA is also happening in Europe. A lack of interest in nursing amongst the young have pushed several European countries to act by employing foreign nurses to meet demand. 



 Conclusion 

 Moving overseas can be scary. The adjustment phase can be difficult, even to the most open-minded of all migrants. But, like all difficult things, the end result is fruitful. In an increasingly globalized world, more international experiences lead to better global ties, and a more peaceful society overall. 

 One easy way to apply for a job overseas is by MIMS Career. Signup and input your resume details with us, and you can enjoy our fast, secure, and easy 1-click application process to many healthcare employers. Find nursing work that you would get excited about in Malaysia, Philippines, Indonesia, or Singapore. You can also save jobs to view later, or create email alerts to notify you of new positions you might be interested in.

10 Ways Malaysian Nurses Can Increase Their Income

Some of you might wonder: is it possible to practice my profession overseas? Fortunately, the answer is yes. Working overseas provides many benefits. Among them is the experience that you’ll get. Moving to a foreign country will...

Read More

 Recently there’s been talk about the Malaysian Nursing Board phasing out the Diploma in Nursing programme. As a result, soon all future nursing students that want to practice the profession in the country has to complete a four-year degree (Bachelor of Science in Nursing). 

 Many parties have been very vocal about this, citing that many nurses cannot afford the extra costs it takes to study for four years instead of the usual two for a diploma. Some students get into nursing for that reason; it offers a quick pathway to work in a respectable profession, without the added burden of a pre-university programme after completion of secondary school. 

 While I understand that some nurses have to support their families ASAP, I’m here to argue that there is a hidden benefit to all nurses being required to do their degree in order to be registered practitioners. 

 That benefit is the extra 2-4 years of age that nurses have upon graduation. 

 Older… Wiser? 

 A few days ago there was news of a 19-year old girl who will become the  youngest medical doctor in Malaysia  this year. The prodigy completed her secondary education at the age of 14, enrolling straight into an Australian pre-U programme, followed by medical school. 

 While I applaud her achievements (it is nothing to make light of), for the rest of us entering the healthcare workforce at 19 is not the best of ideas. 

 A doctor fresh out of medical school at the age of 25 is six years older than 19, and will have six years of extra life experiences that will make him or her relate better to patients. 

 The healthcare line, as we all know, is riddled with a lot of challenges and difficulties that are difficult to teach in training colleges. There are unexpected obstacles from patients, their relatives, and colleagues that are difficult to circumnavigate without emotional maturity. When these are not handled well they lead to burnouts and depression. 

 Forcing the degree programme for nurses rather than diploma grants student nurses extra time to prepare themselves. Most of the time, maturity comes with age. Being a nurse (or a doctor for that matter) is an arduous endeavor in itself. There will be times when you have to react to difficult situations requiring you to make a choice. Maturity grants the wisdom to make the right ones. 

 
 The healthcare line, as we all know, is riddled with a lot of challenges and difficulties that are difficult to teach in training colleges. 
 

 Being sure about oneself 

 As a patient, you would want nurses or doctors who are sure of themselves for your treatment. You want those who believe in what they do and believe in the importance of their work. Not the reluctant ones. 

 It is common for healthcare practitioners to leave the profession within the first 5 years of working. An extra few years of study provides the extra time to contemplate on whether this career path is really for them or not. This creates better rounded nurses and doctors. 

 Better clinicians 

 Better rounded nurses and doctors, who can find the balance between their personal growth and career, make for better clinicians. They are more likely to innovate and push medicine forward. This is why countries like the US and Sweden require prospective medical school students to have a Bachelor’s degree beforehand. These countries have the most number of medical innovations in history. 

 Removal of bad habits 

 
 Better rounded nurses and doctors make for better clinicians. 
 

 For nurses, making BSN degrees mandatory in order to be registered means an addition 4-5 years of study; 1-2 years for a pre-university course (like STPM) and another 4 years for the degree. Contrast this with immediately hopping on the diploma programme for two years after school. 

 The work involved to obtain a degree is very hard. It can only be done by being mentally sound, organized, and effective. These habits are not necessarily attained in school. 

 An older nursing graduate has more time to become a better, organized person; to know her strong points, faults, breaking points, things she cannot do, and learn how to deal with them knowing that a harder road lies ahead.

Making The Case For Longer Studies

Recently there’s been talk about the Malaysian Nursing Board phasing out the Diploma in Nursing programme. As a result, soon all future nursing students that want to practice the profession in the country has to complete a four-year...

Read More


 Emergency Nursing 

 Emergency medicine, formerly known in some countries as accident and emergency medicine (A&E), is the medical specialty involving care for  undifferentiated and unscheduled patients with illnesses or injuries requiring immediate medical attention.  

 Overview 

 As first-line providers, emergency nurses and doctors are responsible for: 

 
	 initiating investigations and interventions to diagnose and/or treat patients in the acute phase 
	 coordinating care with doctors from other specialties 
	 making decisions regarding a patient’s need for hospital admission, observation, or discharge. 
 

 Emergency nurses generally practice in hospital emergency departments, wards, units or intensive care units. They may also be working at pre-hospital settings via emergency medical services, such as in the event of a calamity like a road accident. Moreover, emergency nurses also may work in primary care, such as urgent care clinics. 

 History 

 During the 18th century the French Revolution brought upon the development of the ambulance. After seeing the speed with which the carriages f the French flying artillery maneuvered across the battlefields, French military surgeon Dominique Jean Larrey applied the idea for rapid transport of wounded soldiers to a central place where healthcare was accessible. 

 Emergency medicine and nursing is a relatively new field. It was only in 1979 that a vote by the American Board of Medical Specialties that emergency medicine became a recognized medical specialty in the United States. Other countries followed suit soon thereafter. 

 Scope of Work 

 Emergency nursing is a specialization based on the knowledge and skills for the prevention, diagnosis and management of acute and urgent aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioral disorders. 

 It further encompasses an understanding of the development of pre-hospital and in-hospital emergency medical systems and the skills necessary for this development. 

 Common Tasks 

 
	 Triaging of patients 
	 Suture complex lacerations 
	 reduce a fractured bone or dislocated joint 
	 treat a heart attack 
	 manage strokes 
	 stop severe nosebleeds 
	 placing a chest tube 
	 conducting emergency tracheostomy 
 

 Work location 

 Emergency nurses are tasked to provide the acute care of internal medical and surgical conditions. In many emergency departments, nurses are tasked with seeing an alarmingly large number of patients, treating their illnesses and arranging their next steps. 

 Training 

 There are a variety of models for emergency nursing training across the globe. In some countries the emergency nurse rides in the ambulance to and fro the scene of emergency. This is done to provide stabilizing care to the affected patient. 

 Nurses in emergency departments require a broad field of knowledge and advanced procedural skills of many nursing fields. They must know how to: 

 
	 Resuscitate a patient 
	 Carry out surgical procedures 
	 provide cardiac life support 
	 Manage patients’ airways 
 

 Specialization for emergency nursing often happens after a post-basic certification proceeding three years of service as a registered nurse. 

 Required skillset 

 Emergency nurses require an extensive amount of cool-headedness to handle the oncoming onslaught of daily tasks that present themselves. A great number of emergency ward cases are urgent and time-sensitive in nature, therefore the nurse needs to exercise great caution and patient, while being curt and efficient at the same time. 

 Good teamworking skills is essential. The role of an emergency nurse also involves proper triaging of patients into in- or out-patient services, and work with various specialists or fields to determine the best course of action following prognosis. A positive, proactive, and supportive nurse is beneficial in any emergency setting. 

 Clear communication skills are required in order to convey the correct information to emergency dispatchers or hospital emergency personnel. Failure in conveying correct medical info will prove to be disastrous for the patient, incur financial losses, and increase chances of litigation due to malpractice. 

 Career opportunities 

 Emergency nurses can work in a wide variety of settings, and they include: 

 
	 First aid volunteers 
	 Emergency medical services (BOMBA, paramedics) 
	 paediatric emergency medicine 
	 rescue squads 
	 emergency medical technician 
	 traumatology 
 

 It is not uncommon for nurses to leave clinical work in order to focus on research, especially at the post-graduate levels of study. 

 Search for high-paying nursing jobs on  MIMS Career . Browse, save, and apply for nursing jobs, all in one-click. Take the opportunity for higher pay and better work locations. Our pages are all mobile-responsive, allowing you to take that leap for a better job whenever, wherever you are. All our job postings are  heavily screened to prevent scams and mistrustful behavior.  
   

 Our Most Popular Articles 

  Think About These 5 Things Before You Decide On A Specialization  

  5 Things Nurses Need To Know To Be Paid More  

  10 Ways Malaysian Nurses Can Increase Their Income

Career Highlight: Emergency Nursing

Emergency Nursing Emergency medicine, formerly known in some countries as accident and emergency medicine (A&E), is the medical specialty involving care for undifferentiated and unscheduled patients with illnesses or injuries...

Read More