Career Highlight: Palliative Care

Palliative care is a multidisciplinary approach to specialized medical care for people with life-limiting illnesses. It focuses on providing people with relief from the symptoms, pain, physical and mental stresses of the terminal diagnosis. The goal of such therapy is to improve quality of life for both the person and their family.

Palliative care is provided by a team of physicians, nurses, physiotherapists, occupational therapists and other health professionals who work together with the primary care doctors and referred specialists. It is appropriate at any age and at any stage in a serious illness and can be provided as the main goal of care of along with curative treatment.

Although it is an important part of end-of-life care, it is not limited to that stage. Palliative care can be provided across multiple settings including in hospitals, in the patient’s home, as part of the community palliative care programs, and in nursing facilities. Spiritual support is often provided in more interdisciplinary teams.

When a medicine or treatment relieves symptoms, but has no curative properties, it is said to be palliative. The word noncurative is sometimes paired with palliative for clarification purposes.

Scope

Palliative care is for patients with any serious illness and who have a physical or mental distress as a result of the treatment they are undergoing. Palliative care increases comfort by reducing pain, alleviating symptoms, and lessening stress for the patient and family. It is mutually beneficial for both patient and caregiver.

Emergency care nurses and doctors have a critical role to begin discussions with patients and their families regarding palliative care as they see them go through difficult times in life.

Paediatric palliative care is a rapidly growing subset of this field, and services directed specifically for children with serious illness are in dire need of this.

Responsibilities

Assessment of symptoms

A method fr the assessment of symptoms in patients admitted to palliative care is the Edmonton Symptoms Assessment Scare, in which there are eight visual analog scales of 0 to 10, indicating the levels of pain, activity, nausea, depression, anxiety, drowsiness, appetite and sensation of well-being. On the scale, 0 means absent, and 10 means the worst imaginable possible. Medications are often managed at home by family or nursing support.

Further actions

Effective methods to ensuring successful palliative care is to provide a safe way for the individual to address their physical and psychological distress, that is to say their total suffering.

Dealing with total suffering involves addressing a wide range of concerns, starting with treating physical symptoms such as pain, nausea, and breathlessness. The palliative care teams have become very skillful in prescribing drugs for physical symptoms, and have been instrumental in showing how drugs such as morphine can be used safely while maintaining a patient’s full functions.

Importance of counselling

Usually, a palliative care patient’s concerns are pain, fears of the future, uncertainties, and worries of their family and feeling like a burden. There are counselling, visual methods, cognitive therapy, and relaxation therapy to deal with it.

Pallliative care sees an increasingly wide range of conditions in patients at varying stage of their illness it follows that palliative care teams offer a range of care. This may range form managing the physical symptoms in patients receiving treatment for cancer, to treating depression in patients with advanced disease, to the care of patients in their last days and hours.

Training

In most countries hospice and palliative care is provided by an interdisciplinary team consisting of physicians, pharmacists, registered nurses, nursing assistant, social workers, and others. The focus on the team is to optimize the patient’s comfort.

Nurses in palliative care are given extensive training in counselling, medication dispensing, and support. The aim is about relieving distressing symptoms for the patient. Nurses are also part of the management of the imminently dying patient, more so than the physicians or doctors themselves.

Work Opportunities

The work opportunities that we get is aplenty. Palliative care is often used interchageably as a term with hospice care, albeit some slight differences. They share some similar goals of providing symptom relief and pain management. Palliative care services can be offered to any patient without restriction to disease or prognosis, and can be appropriate for anyone with a serious, complex illness, whether they are expected to recover fully or not.

Hospice is a type of care involving palliation without curative intent. usually it is used for people with no further options for curing their disease or in people who have decided to not pursue treatment that is hard on them.

Typically hospice and palliative care nurses work in non-hospital settings.



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 As incidences of chronic kidney disease and other related renal issues continue to rise, the need for adequately trained nurses in those fields continue to grow. Similar conditions are seen in various parts of the world. In 1999, the incidence of patients with kidney conditions requiring long-term care is 340,261. In 2010 it is over 600,000.  

 The diagnosis of renal conditions can be done with a primary care doctor. However, treatment and care of those patients require an understanding of risks, comorbid conditions, complications, and probabilities for loss of kidneys by both physicians and nurses. 

 For nurses, a post-basic renal course can open the doors to working in this area which is sorely lacking in manpower. Here are the reasons why you should consider pursuing a renal post-basic certification. 

 From bedside to business 

 There are a lot of CKD (chronic kidney disease) clinics opening up. Having a renal certification enables you to work at these clinics as your training is aligned with what they have to offer their patients.  

  Pusat Hemodialisis Mawar  is one of them. They are the largest private charity haemodialysis organization in the country. They have 13 centres spread throughout the country. 

 A short search on Google Maps also reveals a lot of haemodialysis centres in Klang Valley. 

 Being a nurse at institutions like those will train your patient management skills as you run the day-to-day administrative tasks in parallel with your nursing duties. 

 Better work setting 

 You’ll have a less erratic schedule than your peers. Dialysis patients require a regular timing on their treatment. Your shifts would be on more regular hours. A more fixed routine can be better for your health and well-being. 

 Better pay 

  On average, renal nurses with post basic certification get about 10% more pay.  

 Hospital dialysis nurses may be offered more pay, but they may also be required for emergency dialysis treatments, making their schedule less average than others in their field of focus. 

 Adjustable pace 

 You can choose to work in smaller dialysis centres for slower pace, or larger nephrology units in hospitals if you wish for a faster paced working environment. Unlike other specialties, you have a choice to work in the kind of environment that suits your working style. 

 Rapid changes in the field 

 Technological advances in the renal treatment field progresses at a rapid pace. Previously, it was slow. Kidney diseases were complex and difficult to study. Therefore treatments were vaguely ineffective. 

 The 21st century brought in upgraded transplantation technologies with breakthroughs in biocompatible materials. 

 As a renal nurse, you will handle the care of post-transplant patients. The tasks and how you perform your duties to these patients have a high probability of changing with the frenetic pace of research. 

 High Demand 

 Renal nurses have good experience in interpreting telemetric data. This makes them efficient at being support units in surgical wards to ensure successful procedures. 

 Dialysis is expensive, costly, and there’re not enough facilities and manpower in public and private hospitals. 

 Conclusion 

 Pursuing a renal post-basic certification is a solid pathway to consider. Nurses with this certification are more in demand, have better pay, and all the listed advantages above. For people who like clinical challenges, treading this path is for you. 

 Already have a post-basic in renal care? Head over to MIMS Career to search and apply for renal care jobs in your area. Just signup and experience our convenient 1-click application process. It’s fast, safe, and easy. MIMS Career also allows you to search in our huge database of employers seeking new staff. You can also save potential jobs for later viewing, and create your own personalized job alert.

Renal Post-Basic, a certification to consider

As incidences of chronic kidney disease and other related renal issues continue to rise, the need for adequately trained nurses in those fields continue to grow. Similar conditions are seen in various parts of the world. In 1999, the...

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 1. Midwifery 

  What : Interested in obstetrics and gynaecology? Taking up a midwifery course can land you jobs in O&G offices, clinics, or hospitals. In O&G settings, emergencies can arise at any time, so expect some pretty hectic days. You can even open up your private practice as well. 

  How : A lot of teaching institutions offer midwifery courses in Malaysia. You can check out MAHSA, IMC, UKM, and others. Course duration takes about 1-2 years. 

  Why : Nurses with Midwifery skills can earn up to 33% more than normal registered nurses. Search high-paying Midwifery jobs now. 



 2. Administrative Skills 

  What : This is a part of nursing that not many will look at. With good administrative skills, you can take on behind-the-scenes roles and oversee the “business” aspect of nursing. You can review budgets, HR functions, management, and more. 

  How : Take up administrative tasks, or courses. A lot of universities and colleges offer full- and part-time programs that you can fit in your schedule. Otherwise, online courses work as well. You can find more here. 

  Why : Nurse Administrators earn about 30% more than unspecialized nurses. 



 3. Telemetry and Informatics 

  What : As global advances in electronics become more and more sophisticated, technology companies have been producing better instruments to help healthcare workers better understand their patients. Reading these instruments require skill, training, and critical thinking in order to use the data to make decisions on treatments. 

  How : You’d need a Masters in nursing, or computer science and its equivalents. This is an emerging field, so don’t expect it to be so widespread, but you will be in high demand and paid more. 

  Why : The salary ranges from USD58,088 to USD105,034. 



 4. A different language 

  What : The advantages are numerous. You can expose yourself to new settings. New people. Take more opportunities you wouldn’t have done without that third or fourth language. Right now Mandarin is very highly prized in this side of the world. 

 What about Arabic? There’s a huge market for nurses there. Knowing Arabic would create better patient-nurse relationship that’s beneficial to treatment. 

  How : Take up language classes! Learning centers are abundant. Online classes are available here as well. 

  Why : It opens a world of job opportunities, gives your brain a boost, and develop priceless intercultural relationships. 



 5. Use MIMS Career! 

  What : MIMS Career is an effective, one-stop application platform for nurses in Malaysia, Singapore, Indonesia and Philippines. Signup today and enjoy our unique 1-click application process to countless high-paying nursing jobs. 

  How : Signup. Fill in your details and resume. Apply.  

  Why : Find high-paying nursing jobs in the comfort of your home, or wherever you are. Get connected with top healthcare employers in the country, for free, in a safe, secure manner.

5 Things Nurses Need to Know to Be Paid More

1. Midwifery What : Interested in obstetrics and gynaecology? Taking up a midwifery course can land you jobs in O&G offices, clinics, or hospitals. In O&G settings, emergencies can arise at any time, so expect some pretty...

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 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 coronary intensive unit for heart disease 
	 medical intensive care unit 
	 surgical intensive care unit 
	 pediatric intensive care unit 
	 neuroscience critical care unit 
	 overnight intensive recovery unit 
	 shock/trauma intensive care unit 
	 Neonatal 
	 and more 
 

 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: 

 
	 Cardiovascular system 
	 Central nervous system 
	 endocrine system 
	 gastro-intestinal 
	 haematology 
	 microbiology 
	 peripheries 
	 renal 
	 respiratory system 
 

 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.  
   

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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....

Read More