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 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.



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  Photo cr: Unsplash  

 Mental Health 

 Mental health is a level of psychological well-being, or an absence of mental illness. It is the “ psychological state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment” . From the perspective of positive psychology or holism, mental health may include an individual’s ability to enjoy life, and create a balance between life activities and efforts to achieve  psychological resilience . 

 According to the World Health Organization (WHO), mental health includes “ subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one’s intellectual and emotional potential, among others.”  Cultural differences, subjective assessments, and competing professional theories all affect how mental health is defined. 

 Mental health nurses play and important part in helping patients lead a positive life. It is not uncommon for physical disorders to arise from mental issues. It is a field that is growing in awareness. It is estimated that  40% of Malaysians will suffer from mental health issues in their lifetime . 

 Specialization tasks 

 Maintaining good mental health is crucial to living a long and healthy life. Mental health nurses are required to show a considerable amount of empathy towards their patients in assisting them to make a full recovery. Research has shown that there is stigma attached to mental illness. Therefore, it is extremely important that mental health nurses develop excellent observational skills in the treatment of the patient. 

 Activity therapies 

 Activity therapies, also called recreation therapy and occupational therapy, promote healing through active engagement. Making crafts can be a part of occupational therapy. It is very common for nurses to take patients on walks as part of this type of therapy. 

 Psychotherapy 

 Psychotherapy is the general term for scientific based treatment of mental health issues based on modern medicine. It includes a number of schools, such as  gestalt therapy ,  psychoanalysis ,  cognitive behavioral therapy  and  dialectical behavior therapy . 

 Legal requirements 

 Mental health nurses assist in the legal requirements for the patient. Requirements encompass the setting of the patient or a group of patients. 

 Progress monitoring 

 Mental health nurses may have roles that include visiting patients in their home to monitor their progress and carry out risk assessments. While carrying out this task, nurses assess the risks involved to the patients’ safety, health, and welfare. 

 Pathway 

 In order to specialize as a mental health nurse, you must be a registered nurse, practicing for a minimum of three years. A Bachelor’s of Science in Nursing is an advantage. You must take up a psychiatry-based training course with practical hands-on experience. For those courses, you may be able to get accreditation if you have a degree in psychology, or social work. 

 Required skills 

 You will need to display: 

 
	 
	 Exceptional observational skills. You will be required to assess patients and look out for signs of tension or anxiety, which sometimes are not that obvious. 
	 
	 
	 Physical fitness, especially when working in a hospital. Increased stamina and strength is an added bonus. 
	 
	 
	 Emotionally and spiritually resilient to work in a challenging environment. 
	 
 

 Job prospects 

 While a lot of work for mental health nurses is done in the hospital, the majority is community-based in a wide variety of settings. Some of them include community mental health centers, nursing homes for the elderly, rehab units, and private clinics. 

 Working conditions 

 Salaries for mental health nurses will depend on the level of education that they possess. Those with a BSN or MSN will earn more. The type of institution and experience that you have will also factor in your earnings. 

 It is important to have a calm demeanor and able to handle stress well as you will be working with many difficult patients with psychotic episodes. It can be rather jarring to those who are not used to it. However, when approaching these situations without judgement, many mental health nurses manage to overcome these issues and help the patients with their treatment. 

 Career opportunities 

 Search for high-paying mental health 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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Photo cr: Unsplash Mental Health Mental health is a level of psychological well-being, or an absence of mental illness. It is the “ psychological state of someone who is functioning at a satisfactory level of emotional and...

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 A few weeks back Malaysians were shocked to hear of a man  impersonating a medical officer at a hospital  in Alor Setar. What was impressive was that the man kept the act up for about a year before authorities caught him! 

 There have been many cases of people impersonating doctors or surgeons for all kinds of reasons. These are some of the most interesting throughout recent history. 

 1. Kristina Ross 

   

  Fake profession : Plastic Surgeon 

 Kristina Ross frequented bars and pubs, claiming to be a plastic surgeon. She’d approach unsuspecting women, sweet-talk them and get them to know about her “private practice.” Under the guise of a plastic surgeon, she would conduct “breast examinations” on these women, and have them contact her number. 

 Her years of fake activities was brought to a halt when two recipients of her “free breast examinations” contacted the number Ross gave. The number belonged to a real plastic surgery clinic, but had no surgeon that went by the name of Kristina Ross. Their suspicions of the phony surgeon grew, so they called the police. 

 The authorities launched an investigated, and arrested Ross sometime later. But that’s not the last part of the story; upon arrest, it was discovered that she was actually a transgender man who changed his sex. 

 Bottomline: don’t subjugate yourselves to medical exams in non-clinical settings. 

 2. Francisco Rendon 

   

  Fake profession : Dentist 

 Rendon was able to practice his own twisted brand of dentistry for about 16 months before the police finally caught on. 

 His dental clinic was situated between two automobile workshops. His patients grew wary of his dental credentials as they had to sit in a leather office seat instead of a reclining chair. 

 Hygiene was not maintained well; Rendon made his patients spit into a trash can rather than a proper sink. He used unlicensed tools, including a tool which purpose was to polish cars on his patients. 

 When the authorities came to his “office” to arrest him for practicing without a license, he still had many patients in the waiting room. 

 3. Keith Allen Barton 

   

  Fake profession : Doctor 

 This lying physician claimed that he could cure serious diseases like HIV and cancer. He claimed he could “stop the diseases before they spread” and “nip it off from the bud.” He spread lies about the pharmaceutical industry, propagating the myth that corporations were hiding the real cure to those diseases. 

 In reality, what he did was charge his patients exorbitant fees for his homemade cures. Most of his remedies were made of cheap ingredients and did nothing to improve patients’ conditions. Sometimes he even made it worse. 

 He shares the same name as a registered doctor in California, and used this fact to swerve past the authorities. He was finally arrested under charges of identity theft and grand theft. 

 4. William Hamman 

   

  Fake profession : Cardiologist and Medical Speaker 

 Everybody liked him; he flew commercial planes for a living, and was also a cardiologist with 15 years of experience at the side. He frequently published papers in academic journals. He went around delivering lectures at universities and Cardiology seminars. 

 One day he submitted an early draft to a university committee that oversaw publication for their medical journal. One staff member spotted a glaring flaw in the otherwise impeccable paper; he had no M.D. (medical doctor) qualification. 

 What makes Hamman so interesting is that his academic achievements as a fake cardiologist were particularly impressive. His focus was on team-based efforts and how to get cardiology teams to work better together to improve outcomes. It had real academic weight to it. 

 5. William Bailey 

   

  Fake profession : Doctor 

 Bailey was an eccentric man. Being born in the late 1800s, when radioactivity was still a poorly understood science, he was obsessed in marketing the health benefits of consuming radioactive substances for the masses. 

 In 1918, he released Radithor; a tonic that he claimed could cure diseases and restore health by stimulating the endocrine glands. Of course, there was no scientific basis to this. Radithor was made by adding radium crystals into water. It gave off an emission of 1 microcurie per mole of Ra. 

 Despite not being proven to be effective, the public lapped up Bailey’s bogus claims of the healing properties of Radithor. Eben Byers, a young Pennsylvanian competitive golf player, was urged to take the irradiated substance after a consultation with his doctor. He was suffering from pains in his side; so he bought and drank Radithor on a daily basis. 

 Byers died in 1932. He had holes in his skull due to radiation poisoning; his jaw even fell off as it degenerated. He had to be buried in a lead coffin to contain the radioactivity from his body. 

 Bailey died after the Second World War, after having suffered from multiple cancers and poisoning. 

 
 Source: 

 
	  http://www.dailymail.co.uk/news/article-1330725/Kristina-Ross-pretended-plastic-surgeon-conduct-bar-room-breast-exams.html  
	  http://www.nbcchicago.com/news/local/francisco-rendon-fake-dentistry-charges-91216374.html  
	  http://www.nbcsandiego.com/news/local/Phony-Doctor-Keith-Barton-Claimed-He-Could-Cure-HIV-Cancer-DA-186240712.html  
	  http://abcnews.go.com/Health/MindMoodNews/fake-cardiologist-william-hamman-duped-real-doctors/story?id=12395288  
	  https://en.wikipedia.org/wiki/Radithor

Top 5 Fake Medical Practitioners

A few weeks back Malaysians were shocked to hear of a man impersonating a medical officer at a hospital in Alor Setar. What was impressive was that the man kept the act up for about a year before authorities caught him! There have been...

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  1. Specialization tasks  
 2. Pathway  
 3. Common job scopes  
 4. Common terms  
 5. Career opportunities  

 Cardiology 

 Cardiology is a branch of medicine dealing with disorders of the heart as well as parts of the circulatory system the field includes medical diagnosis and treatment of  congenital heart defects ,  coronary artery disease ,  heart failure ,  valvular heart disease  and  electrophysiology . Physicians who specialize in cardiac surgery are called cardiothoracic surgeons or cardiac surgeons. The supporting role of the surgeons and physicians are  cardiology nurses . 

 Although the cardiovascular system is inextricably linked to blood, cardiology is relatively unconcerned with hematology and its diseases. Some obvious exceptions that affect the function of the heart would be blood tests, decreased oxygen carrying capacity, and  coagulopathies . 

   

  source: Resus.me  

 Specialization Tasks 

 All cardiologists study the disorders of the heart and all cardiology nurses are trained to take care of either adult or children conditions. This is due to differing aspects of training for adult and paediatric physiology. Surgical aspects are not included in cardiology and are in the domain of cardiothoracic surgery. 

 For example, coronary artery bypass surgery and cardiopulmonary bypass are both surgical procedures performed by surgeons, and not cardiologists. As a nurse, your task will be that of assisting the cardiologists in this matter. A properly-trained cardiology nurse would have the necessary critical thinking in order to draw conclusions to make meaningful impact of treatment. 

 Common tasks in the wards that you might have to do include the insertion of stents, pacemakers, and valves. 

 Pathway 

   

  source: verywell  

 Cardiology is a specialty of internal medicine. To be a cardiology nurse, a three-year work experience followed by a post-basic or relevant course is required. It is possible to sub-specialize in Malaysia. Recognized sub-specialties in cardiology for Malaysia are cardiac  electrophysiology ,  echocardiography,  interventional cardiology, and  nuclear cardiology . 

 Currently there is insufficient data for Malaysia, for salary, but it is guaranteed to be higher or on par with other similar nursing specialists. 

 Common job scopes 

 Cardiology is a vast field. Not only does it involve the heart and its systems, it also involves supporting systems such as haematology and its diseases. It is important to know and train for this when pursuing this specialization. 

 Cardiac electrophysiology 

   

  An example of echocardiography  

 This is the science of elucidating, diagnosing, and treating the electrical activities of the heart. The term is usually used to desccribe studies of such phenomena by  invasive catheter recording  of spontaneous activity as well as of cardiac responses to programmed electrical stimulations. These studies are performed to assess complex arrythmias, relieve symptoms, evauate abnormal ECGs, assess risk of developing arrhythmias in the future, and to design treatment. 

 Cardiac examination 

 The cardiology nurse is able to carry out cardiac examinations of patients. It is performed as part of a physical examination, or when a patient presents with chest pain suggestive of a cardiovascular pathology. It would typically be modified depending on the indication and integrated with other examinations especially the respiratory examination. Like all medical examinations, the cardiac examination follows the standard structure of inspection, palpation, and auscultation. 

 Paediatric cardiology 

   

  source  

 Paediatric cardiology is a specialty of paediatrics. To be a paediatric cardiology nurse, one must complete at least three years of registered working experience and pass all the required courses. Adult cardiology certifications are not valid due to differences in physiology in children. 

 Common complications that you will see as a nurse practicing paediatric cardiology are  paediatric hypertension ,  paediatric hyperlipidemia , heart palpitations and arryhthmias. 

 Diagnostic tests 

 Diagnostic tests in cardiology are the methods of identifying heart conditions associated with healthy vs. unhealthy pathology heart function. It is commonly started by obtaining a medical history, followed by auscultation. Blood tests soon precede after, and imaging can be done on a need-to-do basis. 

 Common terms 

 1. Tetralogy of Fallot 

 It is the most common congenital ehart disease arising in 1-3 cases per 1000 births. The cause of this defect is a ventricular septal defect and an overriding aorta. These two defects combined causes deoxygenated blood to bypass the lungs and going right back into the circulatory system. The modified  Blalock-Taussig  is used as a treatment for this condition. 

 2. Pulmonary atresia 

 This happens in 7-8 births per 100,000 and is characterized by the aorta brancing out of the right ventricle. It causes deoxygenated blood to bypass the lungs and enter the circulatory system. Fixing it can by done by a team of cardiologists and nurses by redirecting the aorta and fixing the right ventricle-pulmonary artery connection in surgeries. 

 3. Double Outlet Right Ventricle 

 Double outlet right ventricle is when both great arteries, the pulmonary artery and the aorta, are connected to the right ventricle. There is usually a ventricle in different particular places depending on the variations of DORV, typically 50% are subaortic. A VSD closure is the most common form of treatment for this condition. 

 Career opportunities 

 Search for  high-paying cardiology 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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 How do we define a great nurse? Is it one that fully accomplishes his/her tasks? Completes her shifts well without any issues? 

 Great nurses are those who alleviate suffering and heal the body, mind, and soul. 



 Compassion 

 Compassion is the feeling of concern and sympathy for others. 

 The word compassion literally means to “suffer together.” It arises when a person sees another suffering, and feels a deep desire to relieve the said suffering. It is a central tenet of nursing; the very mature of the work originates from the compassion of individuals to relieve suffering and pain. 

 A compassionate nurse will always do what is right for her patients. In times of fatigue, tiredness, or exhaustion, compassion for that patient will drive this nurse to trudge onwards and do her job. 

  On developing compassion:  

 
 Make it a daily practice: Think about it in the morning during rounds. At night during late shifts. When you talk to patients. It is a simple philosophy of kindness. 
 If you’re finding it hard to develop compassion in your nursing life, remind yourself that everyone you meet is seeking happiness, avoiding suffering, has lost something, and is learning about what it means to be human. 
 Think about a person you know who’s recently suffering. Imagine if the suffering happened to you. Now imagine if there is another person who realizes your situation and is trying her very best to make you feel better. You would appreciate that a lot. 
 This helps you develop the feeling of wanting to relieve others’ suffering, which is the definition of compassion. 
 

 Compassion has many benefits: it has been proven that compassionate people produce 23% less cortisol, the “stress” hormone. 

 Empathy: 

 The ability to understand and share the feelings of another. 

 Understanding the feelings of patients is crucial to their recovery. 

 It does not mean you completely understand what they are going through. It also does not mean you agree with everything they are feeling. 

 It means that you are willing to make a voluntary effort to listen to them and understand their challenges. 

 It is shown that patients are more receptive to treatments when they feel that their caregivers understand their situation. 

  On developing empathy:  

 
 It needs to be done without judgement. 
 Everyone has a different set of values. Two similar patients can have completely different challenges. 
 Understand what they are fighting against, and what they are fearful of. Use it to better develop a relationship with your patient, so he/she may continue to recover holistically. 
 



 Selflessness 

 The ability to think less about ourselves, and more about other people. Nurses need this trait, mostly for their own benefit over the patient’s. 

 Being selfless means to give to others at the expense of their own selves. By being selfless, it makes working the stressful nursing life a lot better. 

 Some nurses miss their lunches just to hold their patient’s hand. Some stay up the night to make sure their patient manages to live through it. 

 The reason why these kind of nurses are great is that they would do it all over again. For many more years to come. They also have to. Selflessness prevents these nurses from burning out on their work by caring for others more. 

  On developing selflessness:  

 
 Take pleasure in the happiness of your patients. 
 Don’t hurt another person for the sake of hurting them. 
 Watch your selfish thoughts; like when a patient irritates you, threatens you, you get the idea. That kind of thinking gets in the way of compassion as well. 
 

  Good communicator  

 Not only will you be needing to administer IVs, triage patients in the ER, or carry out CPR, you will also need to be dealing with your patients as humans. 

 There are instances where you will have to help patients and their relatives to understand their medical situation, in a comprehensible way. 

 Moreover, you will need to deal with your superiors, and sometimes you might not agree with what they would have you do. Being a solid communicator allows you to express those feelings of disagreement, and come to a favorable conclusion. 

 If deciding to go into teaching, being a great communicator is essential that you can impart your knowledge onto junior nurses effectively. 

  On developing communication skills:  

 
 Practice practice practice. Try to be as understandable as possible. It helps to realize what kind of patient or relative you’re talking to, their proficiency in the language you speak and their terminologies. 
 Some states of malaysia have a different colloquial grammar compared to the standard Bahasa. It helps to understand these nuances in language. Mirror their way of speaking and you’ll come off as more approachable. 
 Never EVER condescend someone else for not understanding what you were trying to tell them. More often than not it is the inability of the speaker to explain, not the inability of the listener to understand. 
 

  Possess mental fortitude  

 Some days are pleasant. Some are rewarding. 

 But some are difficult. Some are downright devastating, like when you lose a patient you cared for. 

 It is important not to let these things mentally incapacitate you, and compromise your ability to care for your patients. 

 It is okay to feel sad, angry, frustrated, or even shattered. We are all human. 

 Great nurses have the mental fortitude to weather these types of events. It might not be easy, but they still return to practise their art of healing. 

  On developing mental fortitude:  

 
 Identify the obstacle in your path. Is it a difficult patient? An angry relative? Death? 
 Understand how your emotions are making you react. Are you upset? Why? 
 Know that the obstacle can sometimes be the way. A difficult patient can teach you patience. An angry relative can teach you to deal with irrational people with stride. Death can teach you to be compassionate of other people’s loss. 
 

 Focus on making the obstacle that’s disturbing you. Ask yourself, “If I can’t solve this for myself, how can I make this better for othe people?” 



 Calm under pressure 

 Great nurses remain calm and composed under great duress. 

 Diamonds are forged under high pressure. Great nurses too, are like that; the do not cave under the load, they emerge stronger and better. 

 Being calm under pressure-filled situations allows you to perceive problems with better accuracy. It leads to better decision making, which can mean life or death for your patients. 

 Remain calm, and you will make better sense of things around you. 

  On developing mental calm:  

 
 The events that we see as negative all have a positive benefit that we can act on. A computer glitch that destroys your work in the hospital is now an opportunity to become two times better at your job because you’re going to do it twice. 
 Having a terrible supervisor in the wards is now an opportunity to learn from his/her faults while you fill up your resume and look for better opportunities elsewhere.  
Being mentally calm is seeing through the negative, past its underside and through to the positive. 
 



 Lifelong learner 

 A carpenter is only as good as the tools he is given. 

 Same thing applies to a nurse. However, in this case, the tools to a nurse are her knowledge and skillset. 

 A diverse skillset will make you valuable at a lot of situations. 

 A deep understanding of a certain skillset will make you highly valued at that field. 

 Whatever it is, learning new things and constantly studying to make yourself better is always a good idea. 

  On developing lifelong learning skills:  

 
 Develop a passion for the latest advancements in nursing policy, technology, and laws. The changes in those areas will ultimately affect the future of your work. 
 Have a career plan, and work towards getting the skills, certifications, or knowledge that you need to move on to the next stage of your career. 
 Follow great medical podcasts to listen to on your commute. 
 Subscribe to nursing-related journals and publications, and make it a point to read in your spare time. 
 



 Conclusion 

 It is said that in times that require greatness,  we do not rise to the occasion but we fall back on our training.  These habits may not be in you, but with deliberate and constant practice, you can cultivate these, and continue on your path of becoming not only a good nurse, but a great one. 

 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.

Develop These 7 Habits To Become A Great Nurse

How do we define a great nurse? Is it one that fully accomplishes his/her tasks? Completes her shifts well without any issues? Great nurses are those who alleviate suffering and heal the body, mind, and soul. Compassion...

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