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 As nurses, we are at risk of endangering our patients as our skills are steadily becoming more outdated.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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  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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 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.

How to Work as A Nurse in the USA

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...

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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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Career Highlight: Intensive/Critical Care Nursing

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....

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 Recently there’s been talk about the Malaysian Nursing Board phasing out the Diploma in Nursing programme. As a result, soon all future nursing students that want to practice the profession in the country has to complete a four-year degree (Bachelor of Science in Nursing). 

 Many parties have been very vocal about this, citing that many nurses cannot afford the extra costs it takes to study for four years instead of the usual two for a diploma. Some students get into nursing for that reason; it offers a quick pathway to work in a respectable profession, without the added burden of a pre-university programme after completion of secondary school. 

 While I understand that some nurses have to support their families ASAP, I’m here to argue that there is a hidden benefit to all nurses being required to do their degree in order to be registered practitioners. 

 That benefit is the extra 2-4 years of age that nurses have upon graduation. 

 Older… Wiser? 

 A few days ago there was news of a 19-year old girl who will become the  youngest medical doctor in Malaysia  this year. The prodigy completed her secondary education at the age of 14, enrolling straight into an Australian pre-U programme, followed by medical school. 

 While I applaud her achievements (it is nothing to make light of), for the rest of us entering the healthcare workforce at 19 is not the best of ideas. 

 A doctor fresh out of medical school at the age of 25 is six years older than 19, and will have six years of extra life experiences that will make him or her relate better to patients. 

 The healthcare line, as we all know, is riddled with a lot of challenges and difficulties that are difficult to teach in training colleges. There are unexpected obstacles from patients, their relatives, and colleagues that are difficult to circumnavigate without emotional maturity. When these are not handled well they lead to burnouts and depression. 

 Forcing the degree programme for nurses rather than diploma grants student nurses extra time to prepare themselves. Most of the time, maturity comes with age. Being a nurse (or a doctor for that matter) is an arduous endeavor in itself. There will be times when you have to react to difficult situations requiring you to make a choice. Maturity grants the wisdom to make the right ones. 

 
 The healthcare line, as we all know, is riddled with a lot of challenges and difficulties that are difficult to teach in training colleges. 
 

 Being sure about oneself 

 As a patient, you would want nurses or doctors who are sure of themselves for your treatment. You want those who believe in what they do and believe in the importance of their work. Not the reluctant ones. 

 It is common for healthcare practitioners to leave the profession within the first 5 years of working. An extra few years of study provides the extra time to contemplate on whether this career path is really for them or not. This creates better rounded nurses and doctors. 

 Better clinicians 

 Better rounded nurses and doctors, who can find the balance between their personal growth and career, make for better clinicians. They are more likely to innovate and push medicine forward. This is why countries like the US and Sweden require prospective medical school students to have a Bachelor’s degree beforehand. These countries have the most number of medical innovations in history. 

 Removal of bad habits 

 
 Better rounded nurses and doctors make for better clinicians. 
 

 For nurses, making BSN degrees mandatory in order to be registered means an addition 4-5 years of study; 1-2 years for a pre-university course (like STPM) and another 4 years for the degree. Contrast this with immediately hopping on the diploma programme for two years after school. 

 The work involved to obtain a degree is very hard. It can only be done by being mentally sound, organized, and effective. These habits are not necessarily attained in school. 

 An older nursing graduate has more time to become a better, organized person; to know her strong points, faults, breaking points, things she cannot do, and learn how to deal with them knowing that a harder road lies ahead.

Making The Case For Longer Studies

Recently there’s been talk about the Malaysian Nursing Board phasing out the Diploma in Nursing programme. As a result, soon all future nursing students that want to practice the profession in the country has to complete a four-year...

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