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!

Other Articles

  This week we managed to get in touch with Nejlika (pronounced neh-lika) Confinement Care Centre. They provide confinement services for mothers with newborn babies. Established in 2014, Nejlika is committed to providing the best and safest form of care for the newborns’ first 28 days, and for the mothers’ recoveries.  

  What really got us interested with Nejlika was their practice in bringing confinement, which is a traditional concept in post-natal care, into modern times by using scientific methods of observation and critical analysis.  

  Nejlika is currently hiring for post-natal care nurses.  See the job posting page here for more details .  

  Can you describe what your institution provides?  

 Nejlika Confinement Centre provides confinement care for post-natal mothers and newborn babies. 

 We assess the health conditions of the mother and baby, monitoring them daily. We provide professional and scientific feeding, nursing care, and early intellectual development for the baby. For the mother we have uniquely customized meals that are both healthy and delicious. These efforts do a lot to promote healing. 

  How did this place come about?  

 We first saw that there was a market demand for confinement centers in the Klang Valley. We saw that in places like Penang or Johor there are already a substantial amount. But a lot of them are sort of like household business. They hire non-medical professionals for treatment. So we set up this place in 2014. 

 The founders of this centre are all from the healthcare industry. The first 28 days of a newborn will be the most critical stage of a baby’s life. Although confinement is a traditional concept of post-natal care, we bring in present, scientific methods to bring this practice to modern times. 

 New parents or non-professionals are not able to take care of the newborn baby and mother as well as trained nurses and physicians. We aim to provide the best quality service, comfortable living environment, nutritious meals and warm family surroundings to help both the mother and newborn navigate this crucial period of their lives. 

  I saw on your Facebook you have many customers; even non-malaysians. What do you do to attract people to come here?  

 To be honest we don’t really go out to promote the centre. So far it’s all been through word of mouth, maybe a bit of Facebook postings. 

  How do you convince someone who is pregnant to use your services, rather than carry out traditional confinement at home?  

 Usually after the customer knows about us, they will call to inquire. This is before they give birth. So we arrange a 1-to-1 appointment with them. So during this appointment period we explain to them what is the service that we provide, and the philosophy behind our service. 

 Over here, our center advocates breast-feeding, and we have a certified infant massage instructor. We promote early brain development for the baby through the infant massages. 

  What makes you different from the other confinement centres?  

 First of all we are one of the pioneers here, so we are very experienced in specialized confinement care. Also, one of our founders is the only person in Malaysia with twin certificates specialized in confinement care from Taiwan. She purposely went to Taiwan to obtain this certification, not just once but twice. 

 At the same time we engage the service of chinese traditional medicine practitioners. Although we advocate scientific and modern confinement care, we also incorporate the traditional care to bring a well-rounded care to the mother and baby. 

 In Traditional Chinese Medicine, we believe the body constitution of humans can be divided into nine types. Different type of body constitution will require different forms of nutrition or medication. Our chef will prepare the personalized herbal tonic soup for each post-natal mother upon advice by our chinese medicine practitioner for greater rejuvenation.  

 Not many other confinement care provide this service. 

  Can we talk about the food you serve here? They look great! Do you have an in-house cook?  

 We have a special cook. We put out an ad in the newspaper, and managed to get one with training for confinement cooking. We advocate healthy and nourishing foods that aids the mothers’ recovery. 

 Everything that comes into contact with the mothers and babies have to be clean, healthy, and promote recovery. This includes the furniture, beds, food, even the air in the centre as well. 

  How many staff members do you now have?  

 We have 10 nurses, 2 maids, 2 chefs and 1 assistant to help us run the operation. 

 As for now, there are not many customers. It is a bit of a low season. Usually there are more births from late July-early August til the end of the year. 

  To staff: What do you do to make your staff happy and enjoy working here?  

 We feel happy because we enjoy what we do. It’s a slower pace than hospitals, and we love to look after babies. 

  What’s the hiring process like? Who decides on the hire?  

 Advertising on newspaper, platforms online, recommendations of current nurses. More so on the EQ. 

 We advertise in the newspapers, online platforms such as MIMS Career, and word of mouth. Very often we get new hires based on the recommendations of nurses currently working here. 

  What kind of people do you look for when you hire staff?  

 We need staff who are passionate about care for post-natal mothers and infant babies. Post-partum depression is very real, so nurses here have to be very aware of the telltale signs of it. They need to have high EQ to be able to console and advise mothers suffering through post-partum depression and help guide them out of it. 

 We also look out for staff who have high patience levels. Dealing with babies can sometimes prove to be a frustrating task. 

  What cool pieces of technology do you have in this centre?  

 We have a  bilirubinometer ; it is a device that measures the level of bilirubin in the babies to detect jaundice. If jaundice is determined to be present in the baby, we bring in a “jaundice phototherapy” machine and treat the infant until bilirubin levels drop to normal levels. We are the first confinement centre to provide this service. It avoids the hassle of going to the hospital, which can be very strenuous on both mother and newborn. 

 Also, to really avoid cross-contaminations we sterilize the rooms with a  UV light emitter . UV light destroys germs and bacteria. 

 On the other side of the  light spectrum , we use Infrared light emitters to promote healing of mothers’ wounds, especially ones after C-sections. 

 Finally, we have a baby swimming pool! Therapy done in the pool promotes brain development. 

  What does the future look like for Nejlika Confinement Care Centre?  

 Obviously we want to expand. That is the only way a business can grow. 

 We have moved from single storey to double storey within three years. We’re looking to set up branches in other places, in order to provide service to customers not within reach of us right now.

Institution Highlight: Nejlika Confinement Centre

This week we managed to get in touch with Nejlika (pronounced neh-lika) Confinement Care Centre. They provide confinement services for mothers with newborn babies. Established in 2014, Nejlika is committed to providing the best and safest form...

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 Nephrology/Renal Nursing 

 Nephrology is a specialty of medicine and pediatrics that concerns itself with the kidneys:  the study of normal kidney function, kidney problems, kidney health, and the treatment of kidney problems.  It encompasses dietary and medication to replacement forms of treatments. Systemic conditions that affect the kidneys and systemic problems that occur as a result of kidney problems are also studied in nephrology. A physician who has undertaken additional training to become an expert in nephrology may call themselves a nephrologist or a renal physician. 

 A nephrology nurse (or renal nurse - those two terms are used interchangeably) is a nursing practitioner that focuses on kidney health. They treat and care for patients that are suffering from those suffering from kidney problems as well as those that are at risk of developing them. 

 As a renal nurse, one must be prepared to stay on top of current developments, as treatments in this field are accelerating their development at a very rapid pace. This is possible to be done by regular consumption of renal-related literary content such as medical journals. Attending seminars and conference is also a possible method. 


 Renal nursing concerns the  diagnosis and treatment of kidney diseases , including electrolyte disturbances and hypertension, and the care of those needing replacement therapy, including dialysis and transplant patients. 

 Many diseases affecting the kidney are systemic disorders not limited to the organ itself. Examples include acquired conditions such as systemic vasculitides and autoimmune diseases, as well as congenital or generic conditions such as polycystic kidney disease. 

 Methodology of nursing 

  History and physical examinations are central to the diagnostic workup in nephrology or renal nursing.   

 This may include inquires regarding family history, general medical history, diet, medication use, drug use and occupation. Examination typically includes an assessment of volume state, blood pressure, skin, joints, abdomen, and flank. 

 Urinary analysis (urinalysis) is an instrumental method in assessing possible kidney problems. Nurses in this specialization are trained to notice the appearance of blood in the urine, protein, pus cells or cancer cells in the urine, often with the help of a urologist or nephrology physician. 

 Basic blood tests can be used to check the concentration of hemoglobin, platelets, sodium, potassium, chloride, or phosphate in the blood. All of these may be affected by kidney problems, and renal nurses are supposed to be well-versed in this area. 

 Under certain circumstances, an invasive test is required for diagnosis. A biopsy of the kidney may be performed. This typically involves the insertion, under local anesthetic and ultrasound or CT guidance, of a core biopsy needle into the kidney to obtain a small sample of kidney tissue. Kidney biopsy is also used to monitor response to treatment and identify early relapse. 


 The process differs across countries, but the outcome is indefinitely similar. Nephrology is a subspecialty of general medicine. A nephrology/renal nurse will have to complete nursing school, a minimum of three years of practice as a general nurse, and a BSN (Bachelor’s of Science in Nursing) or post-basic course in renal subjects. Typically this training lasts 1-2 years. 

 Nurses in training for renal nursing often continue in the world of academia to obtain research degrees, putting a temporary halt to their clinical practice. Some also sub-specialize in dialysis, kidney transplantation, CKD, cancer-related kidney diseases, procedural nephrology or other non-nephrology areas. 

 However, only pediatric-trained nurses are allowed to train in pediatric nephrology, due to differences in physiology. 

 Work environment 

 A major task and responsibility for renal nurses are  administering treatments to patients.  Treatments can include medications, blood products, surgical interventions, renal replacement therapy and plasma exchange. Kidney problems can have a significant impact on quality and length of life, and so psychological support, health education and advanced care planning play key roles in nephrology. 

 Renal nurses often find themselves having a better work setting compared to their non-specialized counterparts. Schedules are less erratic, especially for nurses working in dialysis support roles. 

 On average, renal nurses with post basic certification get  about 10% more pay.  

 Career opportunities 

	 Dialysis centers (out- and in-patient) 
	 Nephrology wards 
	 Transplant units 
	 Home care 
	 Medical device industry 
	 Pharmaceutical industry 
	 Government and nonprofit healthcare settings (eg:  NKF ) 
	 Community clinics 

 There is a severe shortage of nephrology nurses in Malaysia. 

 Search for high-paying job in renal nursing at  MIMS Career . 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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Nephrology/Renal Nursing Nephrology is a specialty of medicine and pediatrics that concerns itself with the kidneys: the study of normal kidney function, kidney problems, kidney health, and the treatment of kidney problems. It...

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


 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. 



  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 



 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 . 

 Our Most Popular Articles 

  Think About These 5 Things Before You Decide On A Specialization  

  5 Things Nurses Need To Know To Be Paid More  

  10 Ways Malaysian Nurses Can Increase Their Income

A Career in Cardiology

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...

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 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. 


 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. 


 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 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. 


 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 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: 

	 Biostatistics programs 
	 Environmental health and science programs 
	 Social behavioral programs 
	 Epidemiology programs 
	 health services and administration programs 

 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.

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...

Read More