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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 Want to work in the United States? Opportunities are aplenty; the American over-65 population is about to triple by the year 2030.  Most of them will suffer from chronic conditions, be obese, and suffer from arthtritis.  This leads to an overwhelming demand for nurses to assist healthcare institutions in providing care to these aging patients. 

 Living in the United States can be an interesting and rewarding period of time. You get great education, infrastructure, and one of the highest standards of living in the world. The  salary  is great too: the median salary for US registered nurses is $60,616, or about RM250,000 per annum. 

 Here’s what you need to do: 



 1. Ensure your academic requirements are met 

 You need to: 

 
 Graduate from a program with accredited Registered Nursing 
 Have a valid RN license 
 Practiced as an RN for not less than two years  
-Some states (like  Texas  or California, for example), require you to complete a Foreign Educated Nurses (FEN) course. It’s a refresher course consisting of 240 hours divided equally into classroom and clinical practice. You will do it under the supervision of a licensed RN. 
 



 2. Pass English proficiency test 

 You need to do this if: 

 
 You graduated from a school not in the UK, Australia, New Zealand, Canada, or Ireland 
 Your school’s spoken language is anything other than English 
 Your school’s textbooks were written in English 
 

 You can take: 

 
 TOEFL (Test of English as a Foreign Language) 
 TOEIC (Test of English for International Communication) 
 IELTS (International English Language Testing System) 
 

 Send the test results directly to the state board you’re applying to. 



 3. Sit and pass your NCLEX-RN (National Council Licensing Examination - Registered Nurse) 

 To take the exam, you have to register with Pearson VUE. The instructions are all on the website. 



 4. Find an employer, or a recruiting agency based in the US 

 A recruiter can also be your employer. They will help you get your immigrant visa. Not only that, but they will also assist you in finding a job at a hospital or institution that they are partnered with. 



 5. Get an RN immigrant visa/green card 

 You are going to need these documents for your visa: 

 
 Visa Screen Certificate (VSC) 
 Evidence of US-based employer who will petition for your visa. As mentioned, a recruiter can also be your petitioner. 
 



 6. Obtain visa and accept job offer 

 You might have to take a medical exam for this. 



 7. Get certified for Resuscitation courses 

 You’ll need to take (depending on the area that you will practice in): 

 
 Advanced Cardiac Life Support (ACLS) course 
 Paediatric Advanced Life Support (PALS) course[10] 
 

 And there you have it! All you have to do next is to emigrate to the US. We’d like to wish you good luck with your endeavours! 

 Great nurses are always on the lookout for new, exciting, and better opportunities to grow their career. Find out your next employment with MIMS Career, a fast, secure, and convenient portal to connect you to top-class healthcare employers in MY, SG, ID, and PH.

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 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.

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 Geriatrics is the specialty of care of the elderly. The main goal is to assist aging patients to improve their health by preventing or treating illnesses or disabilities. 

 Currently the mean age of the global populace is increasing[1]. Demand for geriatric care has rapidly risen within the past 10, 20 years. This trend is also seen in Malaysia. Unfortunately, it is a profession that not many young nurses or doctors would want to pursue[2]. 



 Definition: 

 The word geriatrics is derived from Greek. “Geron” means “old man.” “Iatros” is defined as “healer.” 

 Gerontology, a word commonly used together with geriatrics, is the study of the aging process itself. 

 Duties: 

 Geriatric nurses assist their patients in their daily life. They help them to live healthily, and improve their independence by treating or staving off disabilities that cause dependency of care. 

 It is not uncommon for geriatric nurses to ensure the comfort of their patients is taken care of as well. They also assist in recognizing and managing syndromes that are common to older adults. 

 Educating the family members of the elderly patient is also a key responsibility in the geriatric nurse. The nurses have to ensure the care provided by the family are only good practices. 

 Ultimately their job scope depends on the institution they work in. 



 Education: 

 The study of geriatrics and gerontology itself is a relatively new branch of medicine. Medical capabilities have progressed to the point where people are now living longer than ever before.  

 The global average life expectancy was at 45[3] years old in 1950-55, and it has now jumped to 76. Recently, the Baby Boomer generation has started to encroach the age of 60-70. As a result there are only a few established centers of learning for the advancement of this field of medicine. 

 Post-basic or advanced diploma courses in geriatrics can also be listed under the name of elderly care[4]. Unfortunately, not many learning institutions or hospitals offer this in Malaysia, as of time of writing. 



 Workload and Working Conditions: 

 It depends on the institution they work in. Geriatric nurses can work in mental health facilities, hospitals, private hospitals, private practices, clinics, and also nursing homes. 

 Some wards may employ geriatric nurses to assist in treatment and recovery of their older patients. For example, renal, cardiology, and neurology all often do this in larger hospitals. 



 Opportunities in Geriatric Nursing 

 As it is a rapidly growing field of high importance, the opportunities for academic study and research are very high. There is a big need for healthcare workers to be trained in the field of gerontology, so local healthcare can keep up with global standards. 

 Some geriatric nurses even can opt to open up their own practices as well. 

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



 Salary and income 

 The median salary of geriatric nurses is higher than that of a registered nurse[5]. However this depends on many factors, such as duties/responsibilities, experience, and work location. 

 This is expected to increase as demand for geriatric nurses continues to grow ever-rapidly. 

  Read more on how nurses can increase their income HERE.  

 Source:  
    1.  http://today.mims.com/topic/what-are-the-options-for-aged-care-in-singapore-?country=Malaysia&channel=GN-Health-Wellness   
    2.  http://today.mims.com/topic/specialist-spotlight–geriatricians   
    3.  https://upload.wikimedia.org/wikipedia/commons/2/29/Life_Expectancy_at_Birth_by_Region_1950-2050.png   
    4.  http://www.imc.edu.my/elderly-care-setting-standards-elderly-care/   
    5.  http://www1.salary.com/Staff-Nurse-RN-Geriatric-Salary.html  

 Search for high-paying geriatric 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 throughout 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: Geriatric Nursing

Geriatrics is the specialty of care of the elderly. The main goal is to assist aging patients to improve their health by preventing or treating illnesses or disabilities. Currently the mean age of the global populace is increasing[1]....

Read More