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 As nurses, we are at risk of endangering our patients as our skills are steadily becoming more outdated.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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 Technological developments continue to improve well into the 21st century, bringing in advancements in surgical care. By extension, the responsibilities of the registered nurse that assists in patient care in the operating room/theater need to keep up with the times. 



 Definition: 

 These nurses who have more specialized duties in the OT/OR are called perioperative nurses. The word “peri-” is Greek for “about”, or “around”, “enclosing.” Just think of the word “perimeter. Hence, “perioperative nursing” means the care of a patient before, during, and after a surgical procedure. 



 Duties: 

 Typically, perioperative nurses fall into two categories: 

  Scrub nurse  - These nurses select and pass surgical instruments to the surgeon during the operation. He/she might also assist in the procedure. 

  Circulating nurse  - This kind of nurse manages the operating room. She ensures the place is safe for the patient and operating staff. 

  Anaesthetic nurse  - Provides support to the anaesthetist during or before the procedure. Duties include preparing the equipment, and administering anaesthesia to the patient in a safe manner. 

  Holding bay nurse  - this term might be called differently in other countries. The holding bay nurse is responsible to bring the patient up to speed in the pre-perioperative environment. She is also responsible for all the information to be correct prior to procedure, such as fasting status, reports, and medication. 

  Post-surgery Recovery Nurse  - As the name indicates, this nurse cares for the patient immediately after surgery. Tasks such as ensuring patient’s airways are open, recording results, are the norm. 

  It is common for a single perioperative nurse to carry two or three of the aforementioned duties during a patient’s course of the surgery.  



 Education: 

 A post-basic certification is needed in order to qualify one to take up perioperative duties. The duration of the post-basic training might be within 1-2 years. Nurses undergoing training are exposed to surgical care, intensive care, and treatment of critically ill patients.  

 Most post-basic programs require 3-4 years of work experience as a registered nurse beforehand.  



 Workload and Working Conditions: 

 Surgical procedures can be very long. Moreover, complications can sometimes occur, further delaying the endpoint of the surgery. 

 Perioperative nurses are expected to be alert of the patients’ vitals during the post-surgical state to monitor any signs of abnormalities. 

 Working hours may differ across institutions. A small clinic specializing in aesthetic surgery might have more regular hours, compared to a teaching hospital that has multiple wards. 

 Work conditions and intensity also depend on the severity and complexity of the patient’s surgery. 



 Opportunities in Perioperative Nursing 

 Like most areas of nursing, job opportunities continue to grow. This specialization is expected to grow at a high rate as more institutions begin to provide surgical procedures. 

 The additional training provided to nurses with perioperative backgrounds can open many career doors. In the future, they will be able to function as OT directors, handle fiscal matters, and other managerial aspects of the operating theater. 

 With some more experience, nurses can proceed to becoming academicians or educators, as well as go into research. 

  Read more on advancing your nursing career into nursing education HERE.  

 Salary and income  
Nurses with specialization (such as perioperative nursing) stand to earn higher than the national average of nurses’ income. However, it is subject to location and healthcare institution facilities. 

 For those in the public sector, you have a high chance of being put in a higher grade. 

  Read more on how nurses can increase their income HERE.  



 Source: 

  https://healthtimes.com.au/hub/perioperative/46/guidance/nc1/perioperative-nursing/563/  

  http://www.mayo.edu/mayo-clinic-school-of-health-sciences/careers/perioperative-nursing  

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Career Highlight: Perioperative Nursing

Technological developments continue to improve well into the 21st century, bringing in advancements in surgical care. By extension, the responsibilities of the registered nurse that assists in patient care in the operating room/theater need...

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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. 
   

 Scope 

 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. 

 Training 

 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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 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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