The Importance of Lifelong Learning for Nurses

Why do we, as nursing professionals, have to put in effort to continuously learn?

The rate of progress in technology is growing at an exponential rate. The more things we discover, the faster we do it. What we learnt in nursing school 10 years ago might already be obsolete next year. As nurses, we are at risk of endangering our patients as our skills are steadily becoming more outdated.

Lifelong learning is a term that is freely being thrown around these past two decades. Lifelong learning means that education does not end at the academic level upon graduation; it means new skills, knowledge, and practices are always there to be learnt to improve oneself.

New Methods of Nursing

Take CPR, for example.

A vital procedure, many lives are saved with it. You would think that for something used so much in hospitals, it would be a science that’s very well established.

Unfortunately, no. Researchers and new observations change the way CPR is done. A decade ago, CPR was considered futile after a certain amount of time. Now, you are encouraged to not give up those chest compressions until medical help arrives.

Even the steps for CPR ten years ago are in different order. It used to be A-B-C; clear Airway, apply rescue breaths, then begin compressions. Now compressions come first and foremost. The reason is because rescue breaths lower chest cavity air pressure, slowing circulation (which is exactly what we do not want in cardiac arrest).

The new methods are more effective than the older ones. And it took only ten years for the old methods to become obsolete.

Not knowing the newer, more effective method could cost someone his/her life.

Renewing Your Nursing License

In Malaysia, you have to renew your license every year.

When you renew your license, they will check your CPD points: Continuous Professional Development points. These are points that you gain when you go for any nursing related courses.

For example, attend a Midwifery course and gain 5 CPD points. Attend a Wound Management course and get 3.

These points accumulate throughout the year, and when you want to renew your license, you need about 20-30 points. Otherwise, you will not be able to renew, thus leaving you without any form of registration. Meaning you can’t practice nursing!

Improving care towards patients

Nurses with a higher level of education are able to think more critically of their patients. They are able to aid in diagnosis, notice patterns in communication, and other physical cues that would help in determining the best course of treatment.

A nurse with a post-basic in cardiology is much more useful to a cardiologist compared to a general staff nurse. They can work together, exchange information, and execute procedures that the latter would not normally have the ability to do.

21st Century patients

Nowadays, patients are have more access to information than ever before. They are more learned, and have different set of expectations. They query a lot; so nurses have to be armed with the right set of information to cater to these patients. It goes a long way in establishing their trust towards you.

A good nurse-patient relationship is very important to achieve successful recovery.

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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 Intensive care nursing 

 Intensive care nursing or critical care nursing is a branch of medicine concerned with the diagnosis and management of life-threatening conditions requiring sophisticated organ support and invasive monitoring. 

 Overview 

 Patients requiring intensive care may require support for instability, airway or respiratory compromise, acute renal failure, potentially lethal cardiac arrhythmias, or the cumulative effects of multiple organ failure. It is also commonly known now as multiple organ dysfunction syndrome. They may also be admitted for intensive or invasive monitoring, such as the crucial hours after major surgery when deemed too unstable to transfer to a less intenseively monitored unit. 

 Intensive care is usually only offered to those whose condition is potentially reversible and who have a good chance of surviving with intensive care support. A prime requisite for admission to an intensive care unit is that the underlying condition can be overcome. Patients with a non-overcomeable condition are not admitted into intensive care units (ICU). 

 ICUs are the most expensive area of nursing or medical care. It is also the most technologically advanced, requiring nurses with a higher level of qualifications and education than most. Telemetry, data-analysis, and surgical procedures are all part and parcel of the ICU nurse’s daily responsibilities. 

 Work Location 

   
ICU or Critical Care nurses are provisioned in a specialized unit of a hospital called the intensive care unit (ICU) or critical care unit (CCU). Many hospitals have also designated intensive care areas for certain specialties of medicine, such as: 

 
	 the coronary intensive unit for heart disease 
	 medical intensive care unit 
	 surgical intensive care unit 
	 pediatric intensive care unit 
	 neuroscience critical care unit 
	 overnight intensive recovery unit 
	 shock/trauma intensive care unit 
	 Neonatal 
	 and more 
 

 The terminologies and nomenclature of these units may vary from hospital to hospital. They are also subject to funding, research capability, and availability of trained medical staff. 

 Equipment and systems in unit 

 In the ICU/CCU nurses are required to fundamentally understand and able to operate certain equipment and systems that are critical to the survival of the patient admitted. Common equipment in the unit includes mechanical ventilation to assist breathing through an endotracheal tube or a tracheotomy; hemofiltration equipment for acute renal failure; monitoring equipment; intravenous lines for drug insusions or total parenteral nutrition. 

 A wide array of drugs are also kept in the ICU/CCU, such as inotropes, sedatives, broad spectrum antibiotics and analgesics. 

 Work staff 

 Intensive care/critical care medicine is a relatively new but increasingly important medical specialty. The ICU/CCU is staffed by multidisciplinary and multiprofessional teams including nurses, respiratory therapists, physicians and critical care pharmacists. Doctors with training in intensive care are called intensivists; ICU/CCU nurses are a major form of support for this group. 

 Training 

 ICU nurses will have completed a minimum of three years as a registered nurse following their nursing diploma or degree. Depending on the hospital, ICU nurses may have opted to do a BSN or MSN in order to develop the critical thinking skills required of medical staff in a such a high dependency ward. 

 A post-basic certification in ICU care is commonly around the duration of 12-24 months, where nurses in training will cover internal medicine, pediatrics, anesthesiology, surgery, and emergency medicine. 

 Nurses may also pursue additional education and training in critical care medicine leading to certification by bodies such as the American Association of Critical Care Nurses. This certification carries a lot of weight in terms of qualification for those seeking career advancement. 

 ICU/CCU nurses choose to specialize in one or more of the nine key systems, which are: 

 
	 Cardiovascular system 
	 Central nervous system 
	 endocrine system 
	 gastro-intestinal 
	 haematology 
	 microbiology 
	 peripheries 
	 renal 
	 respiratory system 
 

 Work Conditions 

 Common tasks and responsibilities 

  Hypoxemic Respiratory Failure 
   
The primary aim in treatment of this kind of failure is maintenance of adequate oxygenation, while limiting ventilator-induced lung injury and oxygen toxicity. 

  Assist Patients to Wean Off Mechanical Ventilation 
   
Weaning is the process of gradual withdrawal of mechanical ventilation. The process is uneventful in most patients, but may take up half the time on a ventilator in problematic patients. Nurses are to assess the readiness of patient to wean using clinical and objective measures, and moderate weaning failure on difficult-to-wean patients. 

  Inotropic and Vasopressor Support for Hypotensive Patients 
   
This treatment aims to maintain a perfusion pressure necessary for tissue oxygenation in patients with hypotension and inadequate tissue perfusion. Tasks are to correct hypovolemia, titrate doses of inotropes and vasopressors to targeted levels, monitoring of blood pressure via the arterial line, and prevent septic shock. 

  Feeding via Enteral or Parenteral Methods 
   
In ICU care, nutritional therapy is plays an important part. The goal is to provide adequate calories and protein to keep up with ongoing losses, prevent or correct nutrient deficiencies and promote wound healing and immune function. 

 Work Opportunities 

  Search for high-paying ICU/CCU 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 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 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. The...

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 Finding a new job can be very tiring, and time-consuming. It can be difficult to schedule some time to your job-seeking activities. However, the end of the year is a period of time you don’t want to miss if you want to maximize your chances of landing that precious new job. Here are four reasons why: 

  1. Employers are getting ready for the New Year  

   

 Traditionally people wouldn’t advise you to hunt for a job at the end of the year, when employers have maxed their yearly budgets and are just closing the financial year with some wrap-up activities. 

 But growing evidence seems to suggest otherwise: as employers return from the holidays with a renewed vigor, new goals, and new KPIs, they are more inclined to act upon your application immediately. 

  2. Employers have plans for 2018  

   

 Whether its a big hospital, a small clinic, or a humble retirement home, everybody uses the last few weeks of the year to reflect back on their performance in order to stay afloat. It is normally during these periods of time that they make the decision to allocate budgets to hire new staff… 

 So get to applying! 

  3. You’re ready to apply for one  

   

 The best time to apply for a job is also whenever you feel you’re ready. 

 When you want new experiences, new training, different exposure, or an increase in salary… you know it’s time to go. 

 So update your resume, acquire new skills, and hunt for that job. 

  4. You’re starting to feel miserable at your job  
 
  
Find yourself feeling unnaturally tired? Even if you’ve been getting enough sleep? 

 If you’ve been exhibiting signs of stress due to your current job like fatigue, headaches, migraines and depression, it’s probably a sign that you should cut your losses and look for opportunities elsewhere. 

 Don’t think it’s your fault for not being able to fit in… sometimes the shoe just doesn’t fit.

4 Reasons You Should Apply For A New Job NOW

Finding a new job can be very tiring, and time-consuming. It can be difficult to schedule some time to your job-seeking activities. However, the end of the year is a period of time you don’t want to miss if you want to maximize your...

Read More