A Career in Cardiology

Oct 9, 2017

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 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.

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.

Pathway

Cardiology OT

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

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

source

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.

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A few weeks back Malaysians were shocked to hear of a man impersonating a medical officer at a hospital in Alor Setar. What was impressive was that the man kept the act up for about a year before authorities caught him! There have been many cases of people impersonating doctors or surgeons for all kinds of reasons. These are some of the most interesting throughout recent history. 1. Kristina Ross Fake profession : Plastic Surgeon Kristina Ross frequented bars and pubs, claiming to be a plastic surgeon. She’d approach unsuspecting women, sweet-talk them and get them to know about her “private practice.” Under the guise of a plastic surgeon, she would conduct “breast examinations” on these women, and have them contact her number. Her years of fake activities was brought to a halt when two recipients of her “free breast examinations” contacted the number Ross gave. The number belonged to a real plastic surgery clinic, but had no surgeon that went by the name of Kristina Ross. Their suspicions of the phony surgeon grew, so they called the police. The authorities launched an investigated, and arrested Ross sometime later. But that’s not the last part of the story; upon arrest, it was discovered that she was actually a transgender man who changed his sex. Bottomline: don’t subjugate yourselves to medical exams in non-clinical settings. 2. Francisco Rendon Fake profession : Dentist Rendon was able to practice his own twisted brand of dentistry for about 16 months before the police finally caught on. His dental clinic was situated between two automobile workshops. His patients grew wary of his dental credentials as they had to sit in a leather office seat instead of a reclining chair. Hygiene was not maintained well; Rendon made his patients spit into a trash can rather than a proper sink. He used unlicensed tools, including a tool which purpose was to polish cars on his patients. When the authorities came to his “office” to arrest him for practicing without a license, he still had many patients in the waiting room. 3. Keith Allen Barton Fake profession : Doctor This lying physician claimed that he could cure serious diseases like HIV and cancer. He claimed he could “stop the diseases before they spread” and “nip it off from the bud.” He spread lies about the pharmaceutical industry, propagating the myth that corporations were hiding the real cure to those diseases. In reality, what he did was charge his patients exorbitant fees for his homemade cures. Most of his remedies were made of cheap ingredients and did nothing to improve patients’ conditions. Sometimes he even made it worse. He shares the same name as a registered doctor in California, and used this fact to swerve past the authorities. He was finally arrested under charges of identity theft and grand theft. 4. William Hamman Fake profession : Cardiologist and Medical Speaker Everybody liked him; he flew commercial planes for a living, and was also a cardiologist with 15 years of experience at the side. He frequently published papers in academic journals. He went around delivering lectures at universities and Cardiology seminars. One day he submitted an early draft to a university committee that oversaw publication for their medical journal. One staff member spotted a glaring flaw in the otherwise impeccable paper; he had no M.D. (medical doctor) qualification. What makes Hamman so interesting is that his academic achievements as a fake cardiologist were particularly impressive. His focus was on team-based efforts and how to get cardiology teams to work better together to improve outcomes. It had real academic weight to it. 5. William Bailey Fake profession : Doctor Bailey was an eccentric man. Being born in the late 1800s, when radioactivity was still a poorly understood science, he was obsessed in marketing the health benefits of consuming radioactive substances for the masses. In 1918, he released Radithor; a tonic that he claimed could cure diseases and restore health by stimulating the endocrine glands. Of course, there was no scientific basis to this. Radithor was made by adding radium crystals into water. It gave off an emission of 1 microcurie per mole of Ra. Despite not being proven to be effective, the public lapped up Bailey’s bogus claims of the healing properties of Radithor. Eben Byers, a young Pennsylvanian competitive golf player, was urged to take the irradiated substance after a consultation with his doctor. He was suffering from pains in his side; so he bought and drank Radithor on a daily basis. Byers died in 1932. He had holes in his skull due to radiation poisoning; his jaw even fell off as it degenerated. He had to be buried in a lead coffin to contain the radioactivity from his body. Bailey died after the Second World War, after having suffered from multiple cancers and poisoning. Source: http://www.dailymail.co.uk/news/article-1330725/Kristina-Ross-pretended-plastic-surgeon-conduct-bar-room-breast-exams.html http://www.nbcchicago.com/news/local/francisco-rendon-fake-dentistry-charges-91216374.html http://www.nbcsandiego.com/news/local/Phony-Doctor-Keith-Barton-Claimed-He-Could-Cure-HIV-Cancer-DA-186240712.html http://abcnews.go.com/Health/MindMoodNews/fake-cardiologist-william-hamman-duped-real-doctors/story?id=12395288 https://en.wikipedia.org/wiki/Radithor

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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 . 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

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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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How do we define a great nurse? Is it one that fully accomplishes his/her tasks? Completes her shifts well without any issues? Great nurses are those who alleviate suffering and heal the body, mind, and soul. Compassion Compassion is the feeling of concern and sympathy for others. The word compassion literally means to “suffer together.” It arises when a person sees another suffering, and feels a deep desire to relieve the said suffering. It is a central tenet of nursing; the very mature of the work originates from the compassion of individuals to relieve suffering and pain. A compassionate nurse will always do what is right for her patients. In times of fatigue, tiredness, or exhaustion, compassion for that patient will drive this nurse to trudge onwards and do her job. On developing compassion: Make it a daily practice: Think about it in the morning during rounds. At night during late shifts. When you talk to patients. It is a simple philosophy of kindness. If you’re finding it hard to develop compassion in your nursing life, remind yourself that everyone you meet is seeking happiness, avoiding suffering, has lost something, and is learning about what it means to be human. Think about a person you know who’s recently suffering. Imagine if the suffering happened to you. Now imagine if there is another person who realizes your situation and is trying her very best to make you feel better. You would appreciate that a lot. This helps you develop the feeling of wanting to relieve others’ suffering, which is the definition of compassion. Compassion has many benefits: it has been proven that compassionate people produce 23% less cortisol, the “stress” hormone. Empathy: The ability to understand and share the feelings of another. Understanding the feelings of patients is crucial to their recovery. It does not mean you completely understand what they are going through. It also does not mean you agree with everything they are feeling. It means that you are willing to make a voluntary effort to listen to them and understand their challenges. It is shown that patients are more receptive to treatments when they feel that their caregivers understand their situation. On developing empathy: It needs to be done without judgement. Everyone has a different set of values. Two similar patients can have completely different challenges. Understand what they are fighting against, and what they are fearful of. Use it to better develop a relationship with your patient, so he/she may continue to recover holistically. Selflessness The ability to think less about ourselves, and more about other people. Nurses need this trait, mostly for their own benefit over the patient’s. Being selfless means to give to others at the expense of their own selves. By being selfless, it makes working the stressful nursing life a lot better. Some nurses miss their lunches just to hold their patient’s hand. Some stay up the night to make sure their patient manages to live through it. The reason why these kind of nurses are great is that they would do it all over again. For many more years to come. They also have to. Selflessness prevents these nurses from burning out on their work by caring for others more. On developing selflessness: Take pleasure in the happiness of your patients. Don’t hurt another person for the sake of hurting them. Watch your selfish thoughts; like when a patient irritates you, threatens you, you get the idea. That kind of thinking gets in the way of compassion as well. Good communicator Not only will you be needing to administer IVs, triage patients in the ER, or carry out CPR, you will also need to be dealing with your patients as humans. There are instances where you will have to help patients and their relatives to understand their medical situation, in a comprehensible way. Moreover, you will need to deal with your superiors, and sometimes you might not agree with what they would have you do. Being a solid communicator allows you to express those feelings of disagreement, and come to a favorable conclusion. If deciding to go into teaching, being a great communicator is essential that you can impart your knowledge onto junior nurses effectively. On developing communication skills: Practice practice practice. Try to be as understandable as possible. It helps to realize what kind of patient or relative you’re talking to, their proficiency in the language you speak and their terminologies. Some states of malaysia have a different colloquial grammar compared to the standard Bahasa. It helps to understand these nuances in language. Mirror their way of speaking and you’ll come off as more approachable. Never EVER condescend someone else for not understanding what you were trying to tell them. More often than not it is the inability of the speaker to explain, not the inability of the listener to understand. Possess mental fortitude Some days are pleasant. Some are rewarding. But some are difficult. Some are downright devastating, like when you lose a patient you cared for. It is important not to let these things mentally incapacitate you, and compromise your ability to care for your patients. It is okay to feel sad, angry, frustrated, or even shattered. We are all human. Great nurses have the mental fortitude to weather these types of events. It might not be easy, but they still return to practise their art of healing. On developing mental fortitude: Identify the obstacle in your path. Is it a difficult patient? An angry relative? Death? Understand how your emotions are making you react. Are you upset? Why? Know that the obstacle can sometimes be the way. A difficult patient can teach you patience. An angry relative can teach you to deal with irrational people with stride. Death can teach you to be compassionate of other people’s loss. Focus on making the obstacle that’s disturbing you. Ask yourself, “If I can’t solve this for myself, how can I make this better for othe people?” Calm under pressure Great nurses remain calm and composed under great duress. Diamonds are forged under high pressure. Great nurses too, are like that; the do not cave under the load, they emerge stronger and better. Being calm under pressure-filled situations allows you to perceive problems with better accuracy. It leads to better decision making, which can mean life or death for your patients. Remain calm, and you will make better sense of things around you. On developing mental calm: The events that we see as negative all have a positive benefit that we can act on. A computer glitch that destroys your work in the hospital is now an opportunity to become two times better at your job because you’re going to do it twice. Having a terrible supervisor in the wards is now an opportunity to learn from his/her faults while you fill up your resume and look for better opportunities elsewhere. Being mentally calm is seeing through the negative, past its underside and through to the positive. Lifelong learner A carpenter is only as good as the tools he is given. Same thing applies to a nurse. However, in this case, the tools to a nurse are her knowledge and skillset. A diverse skillset will make you valuable at a lot of situations. A deep understanding of a certain skillset will make you highly valued at that field. Whatever it is, learning new things and constantly studying to make yourself better is always a good idea. On developing lifelong learning skills: Develop a passion for the latest advancements in nursing policy, technology, and laws. The changes in those areas will ultimately affect the future of your work. Have a career plan, and work towards getting the skills, certifications, or knowledge that you need to move on to the next stage of your career. Follow great medical podcasts to listen to on your commute. Subscribe to nursing-related journals and publications, and make it a point to read in your spare time. Conclusion It is said that in times that require greatness, we do not rise to the occasion but we fall back on our training. These habits may not be in you, but with deliberate and constant practice, you can cultivate these, and continue on your path of becoming not only a good nurse, but a great one. Great nurses are always on the lookout for new, exciting, and better opportunities to grow their career. Find out your next employment with MIMS Career, a fast, secure, and convenient portal to connect you to top-class healthcare employers in MY, SG, ID, and PH.

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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...

Read More