A Typical Day in the Life Of A Foreign Nurse in the USA

Many years ago you started wishing for change.

Changes in lifestyle, change in workplace, environment, attitude, anything. But most of all, you wanted a change in your wages; you longed to practice nursing in a country where registered nurses earned higher incomes.

You also tried your very best to not scoff at the medical resources and healthcare facilities at your disposal when treating patients, especially after reading about the latest developments around the world in medical news. You wanted to be somewhere where you’d have immediate access to cutting edge research, knowledge, experience, and technology.

So you made the effort to emigrate to the United States to make a living. You pass your NCLEX, obtain your TOEFL results, and finish up a Foreign-Educated Nurse (FEN) course. You apply with a recruitment agency and they managed to get you a job as a staff nurse over there. The hospital assisted you with visa application, and after less than a year, you flew off to the States.

ANA

Today you roll out of bed to get ready for your shift at the hospital. After a quick breakfast you drive over to your hospital. Owning a car in the US is pretty cheap: you could find decent used cars for less than USD2000. Infrastructure in the US is the epitome of a developed nation: world-class, extensive, and complete.

Upon reaching the hospital you sign in on a computer, reviewing doctor’s notes, blood results, and medication lists. Everything is fully digital; no more filling in with pen and paper by hand. Digital notes are easily searchable, indexed by patient or department, and fully shareable with colleagues at any time. Very different than most hospitals back home.

During break, you talk to your colleagues. Nursing in the US has a very wide demographic: there are many nurses from Asian countries like India and the Philippines, so you get to feel the homely vibe. Many of your colleagues take up nursing as their second career due to the pay. Also, lately there has been more and more male nurses, putting a good balance in diversity.

diversity

You carry on with your day: putting a new bag of Normal Saline for a patient, removing catheters, educating patients and their relatives on their treatments, placing others on EKG machines. You also run tests, update charts, change IVs, make some people laugh, allay their concerns, and tried to comfort those who were scared. Some paperwork is done; nothing out of the ordinary. It’s all part and parcel of working as a nurse.

The end of your day comes. American nurses have a two-shift system: an 8-hour shift and a 12-hour shift. You decide to work 12-hour shifts because doing so you only work 3 days a week and every other weekend. Feels like working part time, compared to five days a week with 8-hour shifts. Having four full days away from the job allows you to enjoy your personal life to a greater extent. You even can choose to work part time or volunteer for other causes.

You leave work feeling like you did your best, ready to come back for another successful day.

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  Photo by Rami Al-Zayat  

  1. Note-taking  
 2. Scheduling  
 3. Reading  

 Smartphone as a work assistant 

 Our phones have gone from blocky, awkward devices to sleek, thin machines. It is now 2017, and processing power in smartphones (even in budget ones) have overcome the performance of some computers just ten years ago. 

 With the modern smartphone now more of a pocket computer than a communication device, several apps have been made to make work easier. These apps, when used with a bit of creativity and time, can help you  stay on top of your goals, never miss an important piece of info, track everything that matters to you and increase mental focus.  

 Read on to find out how you can transform your phone from a typical communications device to an indispensable work and life assistant. 

 1. Note-taking 

 Text 

 Take notes with your phone rather than on a piece of paper. Unlike paper, you won’t lose digital notes if you have them backed up to the cloud. Moreover, you can take hundreds of notes with you on your phone without needing to carry thick notebooks everywhere you go. 

 Most note-taking apps are searchable, like a web browser. Retrieve your information quickly and easily, whenever you need it. On Android, the best note-taking app is  Google Keep . Keep allows your to color-code your notes to your fancy. Add them to your home screen as a widget for quick access. You can still view your notes on any computer with an internet connection. Simply go over to the  Google Keep  site, log in with your Google account, and browse through your notes. 

   

  source  

   

  source  

 On iOS, we recommend the default Notes app. It’s beautifully designed, clean, and robust. Write notes on the fly, and format your text in  bold ,  italics , or underlined. Much like Google Keep, you can attach photos on to your notes. You can also organize them in folders, for easy retrieval. 

   

  source  

  Bonus tip : You can create a note with your voice! Activate Siri by long-pressing the home button, and say “ Make a note “. Siri will ask you what to write about, and it will write whatever you just said. 

 Scan documents 

 What if you had access to all the paper receipts, documents, letters, and notes; any time, anywhere? You can! Your smartphone has a camera. The best scanner is the scanner you always have with you! 

 Simply point your phone towards a paper document and take a photo. Make sure you adjust the focus a bit so text is clear on your phone’s screen. Then, simply create a photo album in your phone’s photos gallery, label it  SCANS  and move the photos of your documents there. 

 Evernote ( iOS ,  Android ) is a multi-platform note-taking app that has a really cool scanning function. When you scan documents with Evernote, the app will brighten the document, making it seem like it was really scanned using a proper scanner. In dark environments, the app will automatically activate your phone’s flash to brighten up the image. Even when taking scans of the document at an angle, Evernote will modify the image to make it seem like you took it straight down! 

   

  source  

 Evernote has OCR (Optical Character Recognition); meaning that words in the document scans are searchable in the app. It even works for handwriting! 

 Other alternatives to Evernote include  Scanbot ,  PDF Scanner + OCR Free , and  Scanner Pro . 

 Draw sketches 

 Sometimes text just doesn’t cut it. What if you need to draw something? It happens a lot, especially in nursing and medical work. 

 Both Google Keep and iOS notes have the ability to create drawings. Unlike pen and paper, you’ll never run out of ink! 

   

  Android Police  

   

  How to make a drawing in Notes iOS  

 2. Scheduling 

 Calendar 

 Schedule events or tasks that you can’t do today. Any calendar app works well; but we recommend Google Calendar ( iOS ,  Android ). It has natural language text-parsing, meaning you simply type your event into the app like how you’d say it. For example, typing: 

 
 Midwifery refresher seminar 8pm Sunday at UMMC 
 

 Will add a calendar entry  Midwifery refresher seminar , dated on Sunday at 8PM, and location at UMMC. The app can take the information of the location of the event from Google Maps. So on that day, it notifies you what time you should leave to arrive on time! 

   

  Macworld  

 3. Reading 

 Books 

 Why bring your whole bookshelf when you can just carry your phone with you? Many textbook publishers also offer ebook versions of their textbooks. With an ebook reader app, you can read books you’ve saved on your phone. Now you can refer your favorite 900-page physiology textbook anywhere without needing to break your back. 

 The Kindle ( iOS , Android ) app allows you to buy ebooks from Amazon and you can read them anytime you like. Check out their selection of  nursing textbooks  that you can get cheaper than the physical copies. Even if you delete the ebooks off your phone, you can still re-download them from Kindle. 

   

  Play Store  

 3. Task Management 

 Todoist (iOS, Android) 

 Putting tasks out of your head and into a system that you trust is one of the best ways to prevent information overload. This enables you to have less mental distractions as you only focus on the task you are currently doing, rather than having other future tasks nagging in your mind. 

 Using task management apps can seem complicated, but it actually is not. The end goal is to spend less time doing the things you want to do, so that you have more time to do the things you want to do. 

 Having a to-do list makes it easy for you to see what you have right now, and what actions are up next.  Todoist  is a great app for this. It’s available on all platforms: iOS, Android, Windows, and Chrome. 

   

  Todoist  

 Start by listing down tasks in your Inbox. As your task list grows, you might start to see some tasks are related to each other. Create projects in Todoist to group these tasks and sort them. 

 Some tasks are more complicated than other tasks. You can break down these tasks into a series of sub-tasks, allowing you to focus on tackling one thing at a time in pursuit of a larger goal. Remember, to eat an elephant, you need to take one bite at a time. 

   

  Todoist  

 Also, just like Google Calendar, Todoist accepts natural language input; set tasks to recur daily, monthly, every two weeks, or even something complicated such as “ Every third Saturday of the month “. Todoist will understand you. See  here  for the complete guide. 

 Todoist is free to use, but with a small subscription fee, premium features such as location-based reminders, file attachments, and tagging are unlocked. 

 
 The modern smartphone is a great tool for self-improvement, organization, and productivity. In such a small device, you can read books, take notes, and stay on top of your work any time, any day. As nurses’ work become more and more complex, we need better tools to help us keep track of daily life. Hopefully you have gained insight into using this great tool, and help you take on challenges that will advance your career as a nurse. 

 Head over to  MIMS Career  and discover our wide range of nurse jobs. All of our pages are mobile-responsive; browse jobs, sign up, and apply are all doable on your smartphone. Make your next career move, with  MIMS Career . 
   

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You Should Be Using These Apps On Your Phone

Photo by Rami Al-Zayat 1. Note-taking 2. Scheduling 3. Reading Smartphone as a work assistant Our phones have gone from blocky, awkward devices to sleek, thin machines. It is now 2017, and processing power in...

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  1. Start high  
 2. Look for an agreeable outcome  
 3. Be aware of supply in the area  
 4. Rates are not permanent  
 5. Negotiate other aspects of your rates  

 Locum Jobs 

 An advantage of taking up locum jobs to boost your income is that you have some flexibility to work. You choose the schedule that you are available to fit into. Also, it can  improve your CV  for future job applications at other institutions by showing that you have a diverse set of employers. 

 For new nurses, doing locum allows you extra time and exposure to choose how you want to plan out your nursing career. Like selecting a specialization. You can read more on the  advantages of doing locum to increase your income here . 

 People seem to be paralyzed into inaction when it comes to setting rates, simply accepting whatever the clinic offers to pay you. While this article focuses on nurses doing locum jobs at private practices, we hope that these points will still be able to help doctors, pharmacists, dentists, and other healthcare practitioners as well. 

 1. Start high 

   

  source: @dan_carl5on  

 Start out by always proposing a rate higher than you would. It doesn’t have to be a lot. 

 Say your desired rate is RM20 an hour. Just mention RM25 as your starting rate. You can slowly reduce it to the price that you sought out initially when discussing with the clinic or institution. 

 You don’t want to be working with people who feel like they have to squeeze the most out of their budget to accommodate you. Such scenarios do not lead to healthy long-term relationships. It’s better to make them feel like they’ve got a good deal. 

 2. Look for an agreeable outcome 

   

  source: pixabay  

 Remember, the owner of the clinic wants to fill some gaps in his workforce, and you want to get paid. Think of it as a bridge. Both of you are on either side. The best outcome is if you both meet in the middle. 

 Don’t rip people off. Good negotiation is about both parties walking away feeling like they both got a good deal. If you think that milking out money from people to the point where they are reluctantly agreeing to your prices, think again. That relationship isn’t going to last very long. 

 The best employer (whether they employ you full-time or otherwise) is one that continuously offers you work. They can’t do that if they don’t like you. 

 3. Be aware of supply in the area 

   

  source: pixabay  

 A lot of nurses doing locum jobs in the area? That might affect your locum fees. Try to look for clinics or institutions that have an under-supply of part-time nurses. The main reason why your locum employer is paying you below average is probably because a replacement for you is so easy to find. 

 Price is a reflection of the demand for the locum jobs and the supply of those capable of doing it in the area. This is commonly known as the law of supply and demand in economics. It applies here as well. 

 4. Rates are not permanent 

   

  source: here  

 Rates are not set in stone. Even if you’ve negotiated quite a while ago, you can still make some changes if you approach the employer tactfully. 

 Explain that you’ve been here for a while, and that you haven’t let him/her down. So you’d like an increase in your rates. 

 The worst thing that can happen is they say no. Don’t worry. It’s not the end of the world. At least you tried. 

 5. Negotiate other aspects of your rates 

   

  source: pixabay  

 While there is a fixed rate for your schedule, try to consider other aspects as well. Things like emergency calls, or last-minute requests to come in for locum. 

 Make it clear to the employer that these are out-of-the-norm occurrences, and that you would like to be compensated accordingly. 

 6. Losing locum jobs is not necessarily a bad thing 

   

  source: blupics  

 When increasing your rates, this isn’t necessarily a bad thing. Doubling your rates but losing half of locum opportunities is great. You get the same amount at the end, but work half as much, which frees up your time. 

 Plus, sometimes someone who charges RM40 per hour looks more professional and qualified than someone who charges RM20 per hour. 

 Conclusion 

 Don’t just look at financial rates; benefits are important as well. Is the job good for your reputation? Are they likely to recommend you to others? 

 Is the work consistent and secure? Do you trust the employer? 

 Remember these 6 steps when negotiating your fees.  If you don’t value your time, no one else will.  

 Browse through  MIMS Career  for an easy way to find locum or part-time jobs in your area.  MIMS Career  is a premier, healthcare-focused job portal site for Malaysia, Singapore, the Philippines and Indonesia. Our simple sign-up process allows you to easily apply for jobs you might be interested in with a single click. Job locations include hospitals, nursing homes, and private practices. It’s free, easy to use, and safe. 

 Can’t find what you’re looking for? Set up a job alert and we’ll notify you by email whenever positions that suit your preferences are available. All of our pages are mobile-responsive, so you can take your applications with you on the go. 
   

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1. Start high 2. Look for an agreeable outcome 3. Be aware of supply in the area 4. Rates are not permanent 5. Negotiate other aspects of your rates Locum Jobs An advantage of taking up locum jobs to boost your...

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 Introduction 

 Community health is the focus of the health of a population of a community group, rather than on individuals. It is a very distinct field of medicine and nursing, and therefore must be taught in a separate school of public or community health. 

 The health of a community in the current socio-economic climate poses many challenges that need to be overcome. There are many work opportunities that offer different kinds of responsibilities and skills that healthcare professionals are encouraged to look into. 

   

 In history, there are a few diseases that have caused a big impact to the world; such diseases include smallpox, polio, measles and mumps. Whilst largely eradicated today, these were debilitating diseases that caused the death of millions, often in a very short span of time. Their eradication is due to large movements by governing bodies to curb these diseases by education and clinical methods to promote mass immunities. More recently, outbreaks like dengue, malaria, and HIV/AIDS continue to pose a threat to the health and well-being of local communities. 

 Community health has caused a lot of good even in non-medical sectors. Mandatory schooling was put into place after it was found that the industrial revolution workplace was detrimental to their well-being. The science of epidemiology (the study of diseases) came about after efforts to understand cholera were being propagated by the British. Also, stronger health and safety standards for foods brought about a remarked interest in wholesome foods for the European population. 

 Why is it important? 

 Herd immunity contains the spread of contagious diseases. It is the basis on which community health (or public health, depending on which region of the world you’re from) is formed upon. 

 Herd immunity is a concept in which most members of the community are protected against that disease because there is little opportunity for an outbreak. 

 Vaccines are used extensively in this; influenza, measles, mumps, rotavirus, and several dangerous pneumococcal strains are kept at bay due to herd immunizations. These debilitating diseases are extremely dangerous when left to infect a large community. It can cause losses of life, economic downturns, and even social upheaval. 

   

 There is a growing anti-science and anti-vaccination movement that is seriously undoing all the work physicians, researchers, and epidemiologists have done. These people are averse to any form of scientific and health information that they put their communities at risk because they shun vaccinations and community health practices. 

 A major part of community health lies in the communication of healthcare. When the anti-vaccine crowd refuse to immunize their children, it puts their children and the children of others at risk of conntagions that would normally be of no issue. This fracture in the community is enough to bring back long-eradicated bugs into modern society. It is a major issue to address amongst community health practitioners, doctors, and nurses. 

 How does the work look like? 

 Community health is divided into three: primary, secondary, and tertiary. While loosely related, they all have differing lines of work, responsibility, and career progression. 

 Primary 

 Primary community healthcare focuses on the individual. These are interventions like  hand-washing, personal hygiene, immunization, circumcision, diet , and so on. 

 Health communication is key in this area. One can be a nurse, but when working in primary he/she can be a speaker to communicate these practices to the public. 

 Secondary 

 This concerns the  environment . The draining of puddles to prevent mosquito breeding, spraying of insecticides to avoid disease vectors like cockroaches , and clearing of rubbish to address rat populations are all part of this. 

 Tertiary 

 Tertiary healthcare consists of  clinical interventions . Things like rehydration, surgery, and so on. 

 How to work in community health? 

 Your options are pretty wide. You can check out the public, education, private, and non-profit sectors. 

 In the public sector, institutes like IMR (Institute of Medical Research) work closely with the Ministry of Health (KKM) to deploy methods in increasing the health and wellness of Malaysians as a population. Recently they are doing extensive work combating childhood obesity with they  myBFF (My Body is Fit and Fabulous) program . 

 The education sector will be rife of opportunities for clinicians who wish to work in a non-clinical setting. Universities, schools and colleges are potential work areas. 

 The private sector has a lot of companies waiting to get into the healthcare industry as a business. Our company  MIMS  provides timely information to educate the public and healthcare professionals on latest issues on healthcare. Also we provide a drug information service that physicians and consumers can search any time, anywhere. 

 Non-profit organizations like MAKNA (National Cancer Council Malaysia), or NKF (National Kidney Foundation) hire employees with a clinical background to help them raise awareness of the diseases or patients that they focus on. They constantly look out for people to help them with communication, treatments, and financing. 

 Career Progression 

 Search about these points below to know more about your potential career paths: 

 
	 Biostatistics programs 
	 Environmental health and science programs 
	 Social behavioral programs 
	 Epidemiology programs 
	 health services and administration programs 
 

 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.

Career Highlight: Community Health

Introduction Community health is the focus of the health of a population of a community group, rather than on individuals. It is a very distinct field of medicine and nursing, and therefore must be taught in a separate school of public or...

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 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...

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 Gynaecology is the medical practice of dealing with the health of the female reproductive system and the breasts. Literally the term gynaecology means “the study of women.” The opposite of gynaecology is andrology, which deals in male-specific medical issues. 

  Almost all modern gynaecologists are obstetricians : physicians who deal in the branch of medicine and surgery of childbirth and labor. These two fields overlap in many areas, therefore in many institutions Obstetrics and Gynaecology are lumped together as O&G. 

 Gynaecology is concerned with the health of the female reproductive organs and the ability to reproduce. It also encompasses paediatric and adolescent problems to post-menopausal ages. 

 History 

 From ancient Egypt circa 1800 BC, the Kahun Gynaecological Papyrus is the oldest known medical text of any kind. It writes about women’s complaints; gynaecological diseases, fertility, pregnancy, contraception, etc. In the 4th century BC Hippocrates wrote texts about gynaecological diseases that were common afflictions to Greek women at the time. 

 J Marion Sims is widely considered to be the father of gynaecology. He operated during the 19th century at Jefferson Medical College, New York. However the title is now being scrutinized due to his unethical development of his surgical techniques. He operated a lot on slaves, many of whom were not given anaesthesia. 

 Training 

 Post-basic courses on midwifery, gynaecology, and obstetrics are considered to be part of gynaecological training. If desired, a nurse can opt to pursue a Masters in order to carry out research work in the field, and proceed to doctorate studies. 

 Training is given out to encourage the study and advancement of the practice of gynaecology. It is also done by the publication of clinical guidelines and reports on aspects of the specialty and service provision. 

 Gynaecology is a vast field. Nurses who work in this area have sub-specialties in high-risk obstetrics, fertility care, or minimal access surgery. The job most deals with healthy women, where unexpected challenges can present themselves on a daily basis. Work includes a large number of hands-on procedures, and training reflects that. 

 Common Cases 

 Patients range from those who have chronic disorders which are not life threatening, to those who require immediate acute emergency treatment. 

 Nurses in this field are often required to provide assistance during operative procedures. Some of the common procedures a gynaecological nurse with oversee include: 

 
	 dilation and curettage 
	 Oophorectomy 
	 Exploratory laparotomy 
	 Treatments for urinary incontinence 
	 Cervical excision procedures 
	 treatment of polyps 
	 surgery for cancers 
 

 A major part of a gynaecology nurse is the delivery of infants. Their work includes: 

 
	 assist delivery using instruments (forceps or vacuum) 
	 C-sections 
	 Foetal health 
 

 Career Opportunities 

 
	 Independent Nurse Consultant 
	 Educator 
	 Training programme director for gynaecology nursing 
	 
	 Research in public and private sectors 
	 
	 - 
 
   

 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: Gynaecology Nursing

Gynaecology is the medical practice of dealing with the health of the female reproductive system and the breasts. Literally the term gynaecology means “the study of women.” The opposite of gynaecology is andrology, which deals in...

Read More