Why You Feel Like You Suck Even Though You're Doing A Great Job

Aisyah (not her real name) was frustrated.

Last night’s shift made her feel like she never even went to nursing school.

She had a patient with ESRD who was about to go for dialysis at 0800. She was monitoring his blood pressure, and at 0445 it was at 166/89. When she came back at 0545, it was 168/98.

She started to get nervous. She wanted to call the M.O., but a note left by the nephrologist stated to only notify is systolic is over 200 and diastolic 100. 98 was pretty close to 100, so Aisyah started to panic.

It was then that Aisyah realized that the note actually said to call at diastolic > 115.

At 0725, the M.O. came over. Although he was nice about it, he told Aisyah that she should’ve called when diastolic was above 90.

If Aisyah could kick herself, she would. Even though that happened last night, she is still thinking about the mistake feels bad about it. She feels that she should’ve known better, should’ve talked to her coworkers about it, should’ve made a better decision about the note…


Does this sound familiar to you? Do you seem to finally be doing well at work, only to make a mistake that bogs you down and makes you miserable, long after it’s happened? Do you feel like you’re a bad doctor/nurse/pharmacist?

You have impostor syndrome.

Impostor Syndrome

It is the feeling of being a fraud, a fake, and people are going to find out. It’s fine for people who are undercover secret agents or quacks, but it’s a terrible feeling for people who are trying to make the world a little better.

“There are an awful lot of people out there who think I’m an expert. How do these people believe all this about me? I’m so much aware of all the things I don’t know.” - Dr. Chan, Chief of the World Health Organization

You’re actually doing a good job, but you don’t feel that way. Left unchecked, this will harm your mental health and affect your career.

Focus on providing value

What do people/the ward sister/the HOD think of me? They must think I’m an idiot!

We say this to ourselves time and time again.

The rule of thumb is that if you’re so concerned about what other people think, you’re not focusing on your work enough.

Focus on providing value. Show up, do your best work. Provide value to your patients, colleagues, departments.

Stop comparing yourself to others

Respect your own experiences. You went to nursing/med/grad school. You studied extremely hard for this. You sacrificed a ton of your time and energy. You suffered through grueling on-calls and surgeries.

You are the sum of your experiences. Please respect all the things you went through to make you who you are.

Don’t just be aware of other’s successes. They have their own shortcomings too, just like you. It’s just that you don’t see them.

Being wrong doesn’t mean you’re bad.

Being wrong does not mean you’re a bad nurse, bad doctor, bad pharmacist, physician; bad anything.

Everybody makes mistakes. The designers of the Titanic, supposedly the smartest engineers of their time, designed a now-obvious flaw into the doomed ship. The Terengganu stadium collapse in 2013 was also a mistake done by contractors, the state government, and inspectors. Thousands of mistakes are made in surgery every year.

It’s just how the world works. Don’t let your mistakes and failures define you, and carry on.

Nobody really knows what they’re doing

Really, no one does.

Even multi-million dollar companies run by the smartest people fail a lot.

You only feel like you know nothing because you’re more aware of the things you don’t know.

Final words

If you already feel like a failure right now, it probably means you’re doing a good job because of the Dunning-Kruger effect. It’s a psychological phenomenon that describes low-ability people’s incompetence to realize their incompetence.

In other words, people who are bad at something don’t know they’re bad at it.

The fact that you’ve come to a self-actualization level sufficient to see your own shortcomings means that you’re learning and growing as a healthcare professional, and as a person.

Comfort zone is very nice, but nothing ever grows there.

Carry on!



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  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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 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.

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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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  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.  
   

 Our Most Popular Articles 

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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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