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.



Other Articles



  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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The Complete Guide to Negotiating Locum Rates

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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 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.

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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...

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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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 For those nurses serving with  Kementrian Kesihatan Malaysia  (KKM), the start of your work life will present you with one of the toughest choices you’ll make: 

 
 EPF (Employees’ Provident Fund, also known as KWSP), or choose the pension fund? 
 

 Both are viable options in securing your financial health after you retire. Although retirement might seem like ages away, a good amount of planning and successful investments can mean the difference between being able to live comfortably in your golden years, or struggle with daily or medical expenses. 

 So which to choose? We’ll break down the points below. 

 Pension fund 

  What is it?  
It’s a monthly stipend of a set amount, provided by the Public Services Department upon your retirement. In addition to that, you also receive a  gratuity  payment, and medical/health benefits. 

  Calculation  
Here we will be assuming that you start work at 20 years old, with a starting salary of RM2,000, and continue working until you retire at 55 with a salary of RM5,600 (3% annual pay increase). 

 Your monthly pension will be your last drawn salary, divided by two. For example, if your base salary is RM5,000 when you retire, your monthly stipend will be RM2,800/mo. 

 In addition to that, you will receive gratuity payment, which is calculated as such: 

 
 gratuity = 7.5% x 35yrs x 12 months x RM5,600 (final drawn salary) 
= RM 176,400. 
 

 RM176,400 will be given as a lump sum, while RM2,800 will be given per month. Again, this is all assuming you retire at 55, with a final salary of RM5,600. 

  Benefits  

 
	 No subtraction from base pay. 
 

 Unlike EPF, as we will see later, there is no subtraction from your base salary. 

 
	 Guaranteed monthly retirement funding 
 

 Again, unlike EPF, where your money can be withdrawn for other uses, pension takers are guaranteed to have a monthly source of income. 

  Disadvantages  

 
	 You have to start and end your service in the public/government sector. It might hamper your ability to seek work overseas, better base salaries, or even some chances to study. 
 

 EPF or Employees Provident Fund (KWSP - Kumpulan Simpanan Wang Pekerja) 

  What is it?  
EPF is the accumulation of savings generated from deductions of your base salary. Currently, you can choose either 11%, or 8%, as  recently announced . 

 This accumulation of money is further grown by annual dividends. On average the dividend is around 6%, depending on the GDP (gross domestic product) of the country. 

 What makes EPF great as long term savings is due to the magic of  compound interest. . Your employer also contributes to your fund (12% of your pay). These two things make an EPF account grow substantially when properly managed. 

  2 accounts  

 Your EPF savings are divided into two accounts. 70% goes into account 1, and the rest to account 2. Account 1 is your retirement funds. Account 2 is withdrawable, under a few conditions: 

 
	 more than 50 years old 
	 Housing downpayment for your 1st house 
	 housing loan payment 
	 education 
	 medical costs 
	 Hajj pilgrimage 
 

 Upon reaching the age of 55, you will be able to withdraw from account 1. You will have to choose to withdraw one lump sum, or as a monthly stipend like a pension. 

  Calculation  

 Let’s take the same example as just now. Start work at 20, salary RM2,000, retire at 55, salary RM5,000. 

 
 Deduction from pay = 11% = RM220 
Employer contribution = 12% = RM240 
 We will assume no withdrawals are made over entire working period  
EPF annual dividend = 6% 
 

 The interest adds up year over year, and with the help of EPF’s  online calculator , 

 Total EPF savings at 55 years old = RM461,900 

 It is a marginally higher amount than RM176,400 gratuity you will receive from a pension. 

  Benefits  

 
	 Flexibility. At the age of 55, you can withdraw that money and invest in another scheme, venture, or fund that offers greater returns. 
	 Faster growth. As shown, even with a contribution of 11% of your pay, over the course of 35 years it balloons into a large amount of money. 
	 Freedom of employment. You no longer have to work within the constraints of the government or public service. You are free to pursue study or work opportunities as you wish. 
 

  Disadvantages  

 
	 Sometimes things don’t go as planned. You might hit a financial roadblock that forces you to withdraw from your EPF fund. An example of this is a medical emergency. 
	 It subtracts 11% of your base salary. 11% might not seem like much, but for people who live paycheck to paycheck, it can be a bitter pill to swallow. 
	 Annual dividend from EPF can decrease, depending on economic climate. 
 

 Making a comparison 

 Monthly funds 

 Assuming that you live until the mean life expectancy age in Malaysia, which is 76 years old. 

 
 Years to live off retirement fund (pension) = 76-55 = 21 years 
 

 To make a fair comparison, let’s subtract the gratuity amount of a pension scheme from the lump sum of EPF savings. 

 
 EPF at 55 years old - gratuity of pension at 55 years old = RM461,900 - RM176,400 = RM285,500 

 Stipend per month that EPF provides = RM285,500 / 21 years / 12 months = RM1,132.94/month 
 

 Even if we did not subtract the gratuity value, it would be: 

 
 RM461,900 / 21 years / 12 months = RM1,832.94/ month 
 

  It is far less than RM2,600/month from a pension scheme . 

 What if we invest all of EPF savings? 

 Say at the age of 55, you embark on another investment with better returns. We will assume 8%. You pile up all your savings into it. 

 Investment return x EPF savings = 8% x RM 461,900 = RM36,952/year or RM3,079.33/month. 

  It is more than what you’ll obtain from a pension.  However you’ll need to ensure that the second investment has better returns than EPF dividends. That in itself can sometimes be a challenge. 

 Conclusion 

 They both have their advantages and drawbacks. It seems like it is up to you to play it well, to ensure you can lead a comfortable life upon retirement. 

 However the main question of choosing either EPF or pension as retirement savings often boils down to your choice of employer. 

 Will you stay with the government sector for another 30+ years? You don’t want to end up with no retirement fund… No EPF or no pension. That’d be the worst. 

 If yes, go for the pension scheme. It is safe, guaranteed, and offers great peace of mind in your golden years. 

 However, with EPF, you are free to take up opportunities that come your way. Countries like Saudi Arabia, Singapore, and Australia are actively seeking out Malaysian nurses with extremely attractive pay. Opportunities for post-graduate education are more limited in the government sector; if in private, you get to choose when you want to do it. You can also fund it with your EPF savings, something you can’t do on a pension. 

 Choose the freedom of choice. Search for high-paying nursing jobs, and overseas 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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EPF (KWSP), or Pension? Which to choose?

For those nurses serving with Kementrian Kesihatan Malaysia (KKM), the start of your work life will present you with one of the toughest choices you’ll make: EPF (Employees’ Provident Fund, also known as KWSP), or choose...

Read More