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 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.

insert image old docs

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.

insert image anti vaxxer

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:

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.



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 As productivity writer  Benjamin Hardy  puts it, survival mode is: “ your life being filled to the brim with nonessential and trivial things. You don’t have time to make anything meaningful. ” 

 Do you often feel like this? Crazy shift hours, demanding patients, children to take care and worry about at home… It’s no wonder that  nurses are falling sick because of their stress levels . Your busy life just gnaws at the corners of your mind. It’s difficult to sleep, hard to find time to eat, and care about yourself. As you fend off your exhaustion, you realize at the end of your day the worst thing about your predicament is that you have to face the same thing tomorrow. 

 And the next day. 

 And the next one. 

  So you go through life on autopilot.  

 There is a way to break this cycle, and return your sense of self. You will feel happier, healthier, and achieve your personal and professional goals with these simple daily practices. 

 Re-orient your life 

   

  Take charge of your life . Most importantly, be conscious of your decision to take charge of your life. Decide on a better way of looking at how you live, and decide to act on it. Intention is very important; actions only come after that. 

  A good plan today is better than a perfect plan tomorrow.  

 You have only one life; it would be a shame to live it miserably, because you won’t be getting any of your youth back. 

 Get Good Sleep 

   

 So many things can be attributed to the irregularity of sleep or the lack of it. Your concentration slips out frequently. Your memory is fuzzled. Your body feels tired, and has no energy. These are all detrimental to the patients under your care. Most importantly, it poses a real danger to your health. 

 Those who sleep 7-9 hours a day are proven to be healthier, fitter, and less likely to be obese or suffer from any other health issues. 

  “But wait…” you say. “I can’t do that! I work shifts.”  

 Don’t worry. Remember that you can space out your sleeps into naps if a long period of rest is not available to you. 

 There are so many benefits to getting enough sleep. Some of them are: 

 
	 Increased concentration 
	 Better cognitive abilities 
	 Less risk of cardiovascular diseases 
	 Reduced chances of depression 
 

 And so on. 

 Prayer, or meditation 

   

 Gratitude upon waking up, or when facing a difficult time, is one of the  best  habits you can form. This mindset of abundance primes you to cope better with challenging situations or periods of your life. Because you are always grateful for the things that you currently have, it negates the negative impact of focusing on the things you don’t have, or would like to be better. 

 Prayer and meditation helps you re-orient yourself to set your most important priorities. It also serves as a good “brain detox”. 

 Your life might be busy and hectic. By devoting some time to honing your spiritual center, you will learn to make sense and derive meaning in a chaotic world. 

 If you don’t know how to meditate, here’s the  5-minute meditation trick every nurse needs to know . 

 Exercise in moderation 

   

 At MIMS Career we all know most of you nurses are very tired. However, exercise is something that still should not be neglected. 

 Take walks. Walking can also be a form of meditation. Just walk a few minutes, being mindful of your surroundings and focusing on your surroundings. Try and get into the habit of exercising, too. It has many benefits which I’m sure you’re aware of. If you want a healthy mind, it has to start with care of the body. 

 No gym membership? Try some no-equipment home exercises. 

 Eat Healthy 

   

 Eat small, frequent meals as opposed to large meals in one sitting. 

 Those working shifts have a tendency to grab whatever food is available, and that is unhealthy. Try to prepare healthy snacks that you can bring to workplace, like cut fruits. 

 Pack food to work. Cooking packed lunches are a lot healthier because you are aware of what you put into your body. Experiment with simple 1-dish meals. They are light enough to bring in one container, and can simply be reheated in a microwave. 

 If going home to eat, experiment with freezing your prepared meals, or slow-marinading meat that you can throw in the oven right when you get back home. YouTube channels like Tasty can give you many ideas. 

 Consume Great Content 

   

 Read, even if you can only do it for ten minutes a day. If done every day, you’ll eventually finish many books in a year. 

 Podcasts and audiobooks are good to listen to on your commute.  Here’s a helpful article also written by me about getting started with podcasts.  

 The world’s most successful people all read at least one book a week. You don’t have to do that, but that goes to show how important the value of reading good content is. 

 By “good”, I don’t mean Facebook posts or tweets. I mean real, thought-provoking forms of prose that teach you something new. 

 Over time, just by doing 10 minutes a day, you’ll have more knowledge on different topics. It will make you a better writer, speaker, and you’ll develop a personality that future employers would absolutely love whenever you go for interviews. You will view the world in a different lens. 

  Here’s a great reading list for you to get started if you like.  

 Write down and review your goals every day 

   

 What are your goals? Write them down. Both short and long term. 

 Then do something that gets you closer to your long term goals every day. 

 Getting out of the rut that is your daily grind can be difficult, but very rewarding when done right. The location and working environment you’re in can make or break your learning curve towards attaining your career goals. 

 Which is why you should give MIMS Career a shot. Browse through our extensive directory of nursing jobs across Malaysia, Singapore, Indonesia, Philippines, and more countries coming soon. Upload your resume and be notified of jobs you might be interested in. 

 Sign up for free, and discover the change of pace in life that you need to get out of autopilot today.

How Nurses Can Get Out of "Survival Mode"

As productivity writer Benjamin Hardy puts it, survival mode is: “ your life being filled to the brim with nonessential and trivial things. You don’t have time to make anything meaningful. ” Do you often feel like this?...

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

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

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

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

 Older… Wiser? 

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

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

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

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

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

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

 Being sure about oneself 

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

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

 Better clinicians 

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

 Removal of bad habits 

 
 Better rounded nurses and doctors make for better clinicians. 
 

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

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

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

Making The Case For Longer Studies

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

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 A close relative of mine is a young nurse. Two years ago she started taking care of this nice lady who was partially paralysed; her breathing muscles would no longer function autonomously, hence a tracheostomy was done so she could breathe. The condition left her bed-ridden on bad days, and wheel-chair bound on good ones.   

 She cared for the lady to the best of her abilities, for about 18 months. One day the lady started feeling cold. She was sweating and shivering at the same time. She went unconscious, and had five cardiac arrests within 36 hours.  

 After unsuccessfully trying to stabilize her blood pressure, she died of heart failure.   The young nurse was devastated. It wasn’t her own mother, but it might as well seemed like it. It was her first patient death while working as a nurse. It affected her so much she found it difficult to work for the next week.   

 This experience is shared by many nurses in the country.   How nurses bond with their patients depends on circumstances and the length of time they provided care to them. A strong bond between patient and nurse is essential to effective nursing, but when death happens, it can deal a very significant blow.   

 The first death of your patient can massively impact you as a nurse. So will subsequent ones.    

 It is extremely important that this doesn’t mentally compromise your ability to do your work. 

 How can you, as a nurse, deal with it? 



 1. It’s okay to feel emotions. Embrace it fully. 

 You are human. You are in a compassionate profession: the very basis of nursing started on the principle to relieve pain, assuage suffering, and provide help to those of ailing health.  

 It is okay to feel overwhelmed at first, especially when you have cared for the patient for so long. 

 Empathy is good for your job, it makes you a better nurse, but it makes loss more painful.  

 Allow yourself some time to feel, and understand your emotions. 

 Your line of work is to care for people, the noblest of all human traits. Your grief on the death of your patient means that you have done your job. 

 2. Try to accept the death happened. 

 Some wards have it harder than others for this. 

 A geriatric ward would have the oldest, most needy patients. Conducting CPR on these patients can be cruel, especially if you or your team are not willing to “let go” of the patient. 

 However, death in these parts of the hospital would be a routine part of the day. It is wise to accept it, so you can continue giving out the best care to the other still-living patients without letting it affect the quality of your work. 

 Accept their deaths, and the fact that you have done all you could to alleviate their suffering. Know that you have done your best to keep them comfortable and retain their dignity. 

 3. Remain in control and neutral if breaking the news to the family. Don’t add to the problem. 

 It is okay to share your emotions with the patient’s loved ones. 

 Respect the family; if they do not wish you to partake in their grief, then kindly leave them alone. They have also gone through much, just like you. 

 Some relatives will blame the doctor/nurse for causing the death. Don’t take this to heart. The Kubler-Ross model of grief lays out five stages, and anger is one of them.  
Find your own ways to vent, either through support groups, family, or colleagues. 

 4.  Talk about it. Don’t bottle it in. 

 One of the best things about being in the nursing workforce is that you’re surrounded by people who have gone through similar experiences too. 

 Death is prevalent amongst healthcare professions, and sometimes just talking to a senior can help a lot. 

 Find someone you’re comfortable with. It can be a senior nurse, a matron, or even your other colleagues in the ward. 

 Ask them how they managed to overcome such periods of distress. Pour out whatever you’re feeling to them; it is very likely that they have felt everything you are feeling right now. 

 Talking about it helps you make sense of what you’re feeling. By articulating it into words, you can pinpoint exactly what’s bothering you, and help you to come to terms. 



 5. Realize that these things happen. 

 Things happen. Death is part and parcel of the life in a hospital. Some areas will be more prone to dealing with death than others, like the ER, surgical ward, the ICU.   
You might find yourself poring over the moments that led up to the death in your mind, going over what you could have done better, what you could have done differently. 

 This leads to a general feeling of guilt. This can be very destructive to your well-being, and can affect the performance of your work to other patient who also need your care. This is not a good coping mechanism if it jeopardizes the health of your other patients. 

 6. Believe that you are making a difference. 

 The death of a patient does not equal to failure. 

 How you deal with the patient’s relatives is an extension of how you treated their late relative. 

 For all the grief that you may be feeling right now, the patient’s family has it harder. 

 Showing that you cared provides a monumental difference, and leads the family to a safer path of acceptance. 



 Conclusion 

 The trait that sets humans apart from other species is our ability to empathize for our fellow brethren. 

 Other fauna have demonstrated this to a certain degree, but only humans have been able to take it to their very core, make it into their reason to live, and deliver it back to their community. 

 Nursing is more than just facts or skills or the amount of certifications that you can obtain to move your career. It is founded on empathy; the ability to understand others’ suffering and pain. 

 During times when you feel overwhelmed or devastated by the loss of your patient, stand firm and be proud of who you are, because nurses do things that not many will have the capacity to accomplish. 

 You will find your way to deal with it as you become more experienced, and become better at learning what is the best way to help families cope with grief over time. 

 Steel your heart, adjust that uniform, and carry on providing the best that you can give to your other patients.

How to Cope with Death and Loss, as A Nurse

A close relative of mine is a young nurse. Two years ago she started taking care of this nice lady who was partially paralysed; her breathing muscles would no longer function autonomously, hence a tracheostomy was done so she could breathe....

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  source: Larm Rmah  

  1. Paediatrics  
 2. History  
 3. Key differences  
 4. Ethics  
 5. Training  
 6. Job scope  
 7. Required skills  
 8. Common Cases  
 9. Career Opportunities  

 Paediatrics 

 Paediatrics is the branch of medicine that deals with the medical of infants, children, and adolescents. The American Academy of Paediatrics recommends people be under paediatric care up to the age of 21. A medical practitioner who specializes in this area is known as a paediatrician. 

 The word paediatrics can be spelled as either  paediatrics , as per British English, or  pediatrics , as per the American counterpart. Both spellings are acceptable. 

 The word paediatrics comes from two Greek words: “ pais “, meaning children, and “ iaitros “, meaning “doctor” or “healer”. Paediatric nurses usually work in hospitals, assisting physicians in specialized subfields like  neonatology . 

 History 

 Paediatrics is considered to be a new subset of medicine today. Ancient Greek physicians like Hippocrates, Aristotle, Celsus, Soranus, and Galen understood the differences in growing organisms like children; as compared to fully-mature adults. Soranus, a Greek physician and gynaecologist from Ephesus (located in modern-day Turkey) has published  records dealing with neonatal paediatrics . 

   

  source: EIT Mental Health  

 Paediatrics as a specialized field of medicine continued to develop in the mid-19th century. The first generally accepted paediatric hospital is the L’Hopital des Enfants Malades, which literally translates from French as “The Hospital for Ill Children.” It opened in Paris in the month of June, 1802. It accepted patients up to the age of 15 years, and still continues to operate today. 

 Key Differences Between Adult and Paediatric Medicine 

 Maturation of the human body is paralleled by differences in body size. In other words, the smaller the infant, the more different the physiology of the said patient. The smaller body of an infant or a neonate (a baby) provides a greater concern to physicians or nurses in the paediatric ward. Congenital defects, genetic variance, and developmental issues adversely affect children more than adults. 

 Children, therefore, must not be treated as “a smaller version of adults.” 

 Nurses and physicians in the paediatric specialty must take into account the immature physiology of the infant or child when considering symptoms, prescribing medications, and diagnosing illnesses. 

 Ethics 

 Another major difference between adult and paediatric medicine, is that  children cannot make decisions for themselves . This is important enough to warrant its own subsection in this article. 

 The issues of guardianship, privacy, legal responsibility and informed consent must  always  be considered in every procedure. 

 
 … children cannot make decisions for themselves. 
 

 Rather than just treating the child, those working in paediatrics often have to treat the parents and the family. Adolescents are in their own legal class, depending on the country, and they have rights to their own health care decisions in certain circumstances. 

 Not only will a paediatric nurse or doctor take into account the desires of a child when considering treatment options, he or she will conform to the wishes of many people. This becomes especially  important when dealing with conditions of poor prognosis, and complicated or painful procedures.  

 Training 

 Courses are available to registered nurses who have completed a minimum number of service years. The number of years differ according to country. The qualifications range from advanced diplomas, to PhD research focusing on paediatric care. Many academicians forgo clinical practice in order to pursue research that will improve the quality of healthcare or bring about favourable policies to the care of children and adolescents. 

   

  source: paediatricemergencies.podbean.com  

 It is very common for paediatric nursing training to be comprised of  didactic  and clinical components covering the management and treatment of acute and complex child patients. 

 In Malaysia, paediatric training also comprises of management of sophisticated technology, providing nurses with the capability to offer quality care in a variety of situations. Training for disease prevention and recuperative treatment are also common modules in a paediatric nursing course. 

 Core modules of training would include  interpersonal skills and counselling ,  values and ethics ,  paediatric principles and practice ,  nursing of children with special needs ,  paediatric oncology , and some clinical practice. 

 Job scope and responsibilities 

 Typical activites may vary according to the role and work setting of the paediatric nurse. Children with special needs often require a different level of care compared to others. With that said, responsibilities include: 

 
	 assessment and critical reporting of patients 
	 preparing patients for pre- or post-op 
	 setting up drips, transfusions 
	 administering drugs and injections 
	 explaining procedures, treatments, to patients or guardians to acquire their consent to treatment 
	 support, comfort, and advise the child and family 
 

 Required skills 

 Children are sensitive, therefore tread lightly when giving care. Paediatric nurses need to display: 

 
	 respect towards the patients and their family’s decisions 
	 excellent communication skills 
	 be able to communicate on a level that the child would understand (if required) 
	 ability to deal with a range of patients at one time 
	 emotional resilience, and mentally strong to handle patients under difficult conditions 
	 compassion to others’ suffering 
 

 Common cases 

 Flat feet 

   

  source: smartlivingnetwork.com  

 Usually happens when the bar ossifies, about 8-12 years old. The tarsal area coalesces and causes rigid and painful flat feet. Operative treatment is not usually needed, unless severe. Usually managed non-operatively. 

 SUFE (Slipped Upper Femoral Epiphysis - also known as SCFE) 

   

  source: Raymond Liu, MD  

 This is a disease that afflicts adolescents (13-18 years old). The growth plate widens during growth spurt and some factors then predispose to slip. Adolescents who suffer from obesity, femoral neck retroversion, endocrinopathies, and trauma are particularly likely to be diagnosed with this. 

 Bradycardia 

   

  source: cardiachealth.org  

 Bradycardia is defined by a heart rate less than the lower limit of normal for age. For infants below 3 years, it is 100 bpm. For children 3-9 years, it is 60 bpm. For 9-16 years, it is 50 bpm. Bradycardial abnormalities can be diagnosed using the 12-lead ECG or the 24-hour holter monitor. 

 Exercise stress testing is not needed in the diagnosis, but may be helpful to determine chronotropic competence. 

 Non-neonatal jaundice 

   

  source: patient.info  

 Jaundice is a yellowish discolouration of the skin, sclera, and mucous membranes due to high counts of bilirubin. It occurs as a result of abnormal bilirubin metabolism and/or secretion. Typically occuring in neonates, jaundice can occur in all age groups. 

 Treatment is done after classifying the jaundice as conjugated or unconjugated hyperbilirubinemia in the older child. Jaundice in older children may be the first clinical manifestation of unrecognized chronic liver disease. 

 Career opportunities 

 Paediatrics is one of those specialties that becomes deeper with more things to explore the more experience you have. Subspecialties in hospitals and community areas include: 

 
	  neonatal intensive care  
	 paediatric oncology 
	 child protection 
	 ambulatory care 
	 asthma 
	 diabetes 
	 counselling 
	 special needs 
 

 A more senior paediatric nurse is likely to have less and less clinical duties as a ward manager or ward sister. A future as a clinical unit manager is entirely within reach. 

 Outside clinical settings, opportunities to work in private healthcare, social services, NGOs, charities, or volunteer organizations are aplenty. 

 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.  
   

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Career Highlight: Paediatric Nursing

source: Larm Rmah 1. Paediatrics 2. History 3. Key differences 4. Ethics 5. Training 6. Job scope 7. Required skills 8. Common Cases 9. Career Opportunities Paediatrics Paediatrics is the...

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