A Career in Cardiology

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

Cardiology

Cardiology is a branch of medicine dealing with disorders of the heart as well as parts of the circulatory 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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 Résumé’s (also known as CVs) are great. They sumarize your experiences onto a few pages so your employer can quickly get a sense of who you are before hiring you. However, employers have to go through a lot of résumés in their search for a potential hire, so making a great résumé can result in a good first impression. 

 Traditionally, résumés have been blocky, information-dense pieces of paper that you send out to employers you’re checking out. With the advancements in personal computing, software and printing, people have been more and more creative with how they craft their résumé’s. 

 The more traditional approach can look more professional and neat, but a creative approach can often help you stand out from the crowd. Choose a method that best presents you in a positive light. 

 Before you write your résumé 

 Before you write down your résumé, sit down and take note of what you’ve done. Any interesting projects taken? Achievements? List it down. 

 Also verify the dates of your education background. It can be easy to forget, especially if you’ve left your academic studies for a long time. Also try and find out the full course or programme names of your certificates, degrees, doctorates. 

 Doing great things lead to a great résumé. Take up as many opportunities as possible that can be put on a résumé, like volunteer work, teaching, skills training, etc. 

 The traditional approach 

 Easy way: Use a predefined template from Word, Pages, or Docs. 

  Tools needed: A PC, tablet, or smartphone.  

 This is as simple as it gets: 

 
	 Open the word processor, and select from the list of templates given. 
	 You can add, remove, or move around certain sections which do not pertain to you. 
	 For example, for a fresh graduate, your education background would come above your work experience because the former is more important at that stage of life. Vice versa for those already working. 
	 Want more templates? Check out  https://r  ésumégenius.com/résumé-templates . 
 

 Normal way: Build it from scratch. 

  Tools needed: PC, tablet, smartphone. Word editing software needed.  

 Building your résumé from scratch allows you to customize every single aspect of that you can present to your future employer. 

 Start by writing down your info. Be concise, truthful, and accurate. 

 Then  add your work experience , or educational background. As previously mentioned, this depends on whether you’re still studying or have already worked. Put it in reverse-chonological order; meaning the latest job first, and the first job last. Same with education. 

  Add in your skills.  It helps employers a lot if you could put in the degree of proficiency. To keep it simple, just rate it from 1-5. For example, ANSYS = ⅘ , SolidWorks = ⅗, verbal communication ⅗, and so on. Some skills to add include software (ANSYS, SPSS), or equipment handling (telemetry, ECG, cardiographs). 

  Don’t forget to add in your language ability.  When working in sectors like healthcare, where you deal with a diverse set of people (especially in multi-cultural Malaysia!) it helps to be bi- or trilingual. Employers love that. 

 Now that you’ve added all you have to add, start by styling the text appropriately. A good rule to follow is to enlarge each point by a few titles, then bold it, so the reader can quickly skim through your résumé. 

  Ensure there is enough spacing.  Think of whitespace as breathing room. You want your text to be able to breathe in order to be legible. A cramped document is not fun to read. 

 Add in the headers and footers. A good use of headers would be your  name and contact number , in 9-pt font. Employers often put your résumé in a stack, and putting something to identify you there would help a great deal. You can put a page number on the footer for continuity purposes. 

 View over the entire document. Ensure the margins are properly aligned. Is the font legible? Clear? Then head over to save and print it out. You’re done! 

 The creative approach 

 With easy application processes from job portals like MIMS Career, employers now are as equally likely to read your résumé in a digital format, on a screen. 

 This allows for some creativity, as current screens can now reproduce millions of colors, in different shapes and sizes. 

 Remember not to overdo a creative design; keep it subtle, keep it clean, and keep the information legible. 

 Easy way: Use an online résumé builder. 

  Tools needed: PC, with keyboard and mouse recommended. An internet connection is important.  

 My favorite résumé builder is, by far,  Novorésumé . 

 Very intuitive controls. A good degree of customization available. 

 Their presets are killer design. They’ve matched out complementary colors in each of their templates so you don’t have to. They’re all subtle, yet sophisticated. Clean, yet intricate. 

 It’s also multi-lingual, so you can craft your Bahasa Malaysia résumé in it as well. 

 Have a look at Elon Musk’s résumé, generated by Novorésumé. It’s simple, packed, and most importantly, eye-catching. It already looks superior compared to a lot of the résumés we have seen. It also proves that you don’t need many pages to list down your info, despite being one of the world’s most successful visionaries. 

   

 There are also other résumé builders online:  Reed  is one of them. Just do a Google search, you’ll eventually find out with layouts or usability that you really like. 

 The Normal way: Design it yourself! 

  Tools: PC, Keyboard + Mouse, Drawing tablets optional, PhotoShop/Illustrator/Any online sketching tool.  

 To do this, you might need some additional skills with illustration software. 

 The idea is to create a layout that draws attention but doesn’t compromise on information legibility. 

 You can have a look at great designs from dribbble.com, a site where great designers like to post their work. Have a look at the ones you like, and determine what you like about them and incorporate them into your design. It’s good inspiration. 

  You need to keep in mind 4 things:  

  Typography  

 
	 Use 15-25px only. A too large text-size can look goofy and awkward. 
	 Like a kids book. Use a big font for headlines, and employ a low font weight. Like Helvetica or Lato. 
	 Since you’re sending this over the web, and it will be read on screen, go for a sans-serif font for easier legibility. 
 

  Colors  

 
	 Use only one base color. A résumé with too many colors will make it look amateur and is a pain to see. In the end, your résumé is an official document used to represent you in a good light. 
	 Never choose black for your base color. Black never appears in the real world. It is sombre, demure, and lacks energy. 
	 It is always a bad idea to use black for anything that is to be displayed on-screen, other than text. 
 

  Icons  

 
	 Icons can help increase aesthetic features and help you stand out. 
	 Use icons that are recognizable, like a suitcase for work experience, a graduation hat for education, etc. 
	 I recommend the use of icon fonts. They are scalable at various dpi on-screen. 
 

  Whitespace layout  

 
	 Whitespace is space where there’s no stuff. 
	 Use it to define hierarchy by putting some space between your education, work, skills, and information sections. 
	 Use that whitespace to build flow for the résumé reader. 
 

 Conclusion 

 That’s it! It all depends on how much time and effort you can put in to your résumé. Remember to keep it simple, accurate info, and not too long; 2 pages should be the absolute maximum. 

 You what would be a great use of that résumé? Use it when applying for jobs in Malaysia, Singapore, Philippines, and Indonesia with our job portal,  MIMS Career .. A lot of nurses, doctors, and other healthcare practitioners have been using the service, and many of them have landed the jobs at the location they’ve always wanted. Signup and apply now using our 1-click application feature. It’s fast, safe, and free. Any problems? Email us at mycareer@mims.com for more inquiries.

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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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 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.

The Importance of Lifelong Learning for Nurses

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  source: Larm Rmah  

  1. Paediatrics  
 2. History  
 3. Key differences  
 4. Ethics  
 5. Training  
 6. Job scope  
 7. Required skills  
 8. Common Cases  
 9. Career Opportunities  

 Paediatrics 

 Paediatrics is the branch of medicine that deals with the medical of infants, children, and adolescents. The American Academy of Paediatrics recommends people be under paediatric care up to the age of 21. A medical practitioner who specializes in this area is known as a paediatrician. 

 The word paediatrics can be spelled as either  paediatrics , as per British English, or  pediatrics , as per the American counterpart. Both spellings are acceptable. 

 The word paediatrics comes from two Greek words: “ pais “, meaning children, and “ iaitros “, meaning “doctor” or “healer”. Paediatric nurses usually work in hospitals, assisting physicians in specialized subfields like  neonatology . 

 History 

 Paediatrics is considered to be a new subset of medicine today. Ancient Greek physicians like Hippocrates, Aristotle, Celsus, Soranus, and Galen understood the differences in growing organisms like children; as compared to fully-mature adults. Soranus, a Greek physician and gynaecologist from Ephesus (located in modern-day Turkey) has published  records dealing with neonatal paediatrics . 

   

  source: EIT Mental Health  

 Paediatrics as a specialized field of medicine continued to develop in the mid-19th century. The first generally accepted paediatric hospital is the L’Hopital des Enfants Malades, which literally translates from French as “The Hospital for Ill Children.” It opened in Paris in the month of June, 1802. It accepted patients up to the age of 15 years, and still continues to operate today. 

 Key Differences Between Adult and Paediatric Medicine 

 Maturation of the human body is paralleled by differences in body size. In other words, the smaller the infant, the more different the physiology of the said patient. The smaller body of an infant or a neonate (a baby) provides a greater concern to physicians or nurses in the paediatric ward. Congenital defects, genetic variance, and developmental issues adversely affect children more than adults. 

 Children, therefore, must not be treated as “a smaller version of adults.” 

 Nurses and physicians in the paediatric specialty must take into account the immature physiology of the infant or child when considering symptoms, prescribing medications, and diagnosing illnesses. 

 Ethics 

 Another major difference between adult and paediatric medicine, is that  children cannot make decisions for themselves . This is important enough to warrant its own subsection in this article. 

 The issues of guardianship, privacy, legal responsibility and informed consent must  always  be considered in every procedure. 

 
 … children cannot make decisions for themselves. 
 

 Rather than just treating the child, those working in paediatrics often have to treat the parents and the family. Adolescents are in their own legal class, depending on the country, and they have rights to their own health care decisions in certain circumstances. 

 Not only will a paediatric nurse or doctor take into account the desires of a child when considering treatment options, he or she will conform to the wishes of many people. This becomes especially  important when dealing with conditions of poor prognosis, and complicated or painful procedures.  

 Training 

 Courses are available to registered nurses who have completed a minimum number of service years. The number of years differ according to country. The qualifications range from advanced diplomas, to PhD research focusing on paediatric care. Many academicians forgo clinical practice in order to pursue research that will improve the quality of healthcare or bring about favourable policies to the care of children and adolescents. 

   

  source: paediatricemergencies.podbean.com  

 It is very common for paediatric nursing training to be comprised of  didactic  and clinical components covering the management and treatment of acute and complex child patients. 

 In Malaysia, paediatric training also comprises of management of sophisticated technology, providing nurses with the capability to offer quality care in a variety of situations. Training for disease prevention and recuperative treatment are also common modules in a paediatric nursing course. 

 Core modules of training would include  interpersonal skills and counselling ,  values and ethics ,  paediatric principles and practice ,  nursing of children with special needs ,  paediatric oncology , and some clinical practice. 

 Job scope and responsibilities 

 Typical activites may vary according to the role and work setting of the paediatric nurse. Children with special needs often require a different level of care compared to others. With that said, responsibilities include: 

 
	 assessment and critical reporting of patients 
	 preparing patients for pre- or post-op 
	 setting up drips, transfusions 
	 administering drugs and injections 
	 explaining procedures, treatments, to patients or guardians to acquire their consent to treatment 
	 support, comfort, and advise the child and family 
 

 Required skills 

 Children are sensitive, therefore tread lightly when giving care. Paediatric nurses need to display: 

 
	 respect towards the patients and their family’s decisions 
	 excellent communication skills 
	 be able to communicate on a level that the child would understand (if required) 
	 ability to deal with a range of patients at one time 
	 emotional resilience, and mentally strong to handle patients under difficult conditions 
	 compassion to others’ suffering 
 

 Common cases 

 Flat feet 

   

  source: smartlivingnetwork.com  

 Usually happens when the bar ossifies, about 8-12 years old. The tarsal area coalesces and causes rigid and painful flat feet. Operative treatment is not usually needed, unless severe. Usually managed non-operatively. 

 SUFE (Slipped Upper Femoral Epiphysis - also known as SCFE) 

   

  source: Raymond Liu, MD  

 This is a disease that afflicts adolescents (13-18 years old). The growth plate widens during growth spurt and some factors then predispose to slip. Adolescents who suffer from obesity, femoral neck retroversion, endocrinopathies, and trauma are particularly likely to be diagnosed with this. 

 Bradycardia 

   

  source: cardiachealth.org  

 Bradycardia is defined by a heart rate less than the lower limit of normal for age. For infants below 3 years, it is 100 bpm. For children 3-9 years, it is 60 bpm. For 9-16 years, it is 50 bpm. Bradycardial abnormalities can be diagnosed using the 12-lead ECG or the 24-hour holter monitor. 

 Exercise stress testing is not needed in the diagnosis, but may be helpful to determine chronotropic competence. 

 Non-neonatal jaundice 

   

  source: patient.info  

 Jaundice is a yellowish discolouration of the skin, sclera, and mucous membranes due to high counts of bilirubin. It occurs as a result of abnormal bilirubin metabolism and/or secretion. Typically occuring in neonates, jaundice can occur in all age groups. 

 Treatment is done after classifying the jaundice as conjugated or unconjugated hyperbilirubinemia in the older child. Jaundice in older children may be the first clinical manifestation of unrecognized chronic liver disease. 

 Career opportunities 

 Paediatrics is one of those specialties that becomes deeper with more things to explore the more experience you have. Subspecialties in hospitals and community areas include: 

 
	  neonatal intensive care  
	 paediatric oncology 
	 child protection 
	 ambulatory care 
	 asthma 
	 diabetes 
	 counselling 
	 special needs 
 

 A more senior paediatric nurse is likely to have less and less clinical duties as a ward manager or ward sister. A future as a clinical unit manager is entirely within reach. 

 Outside clinical settings, opportunities to work in private healthcare, social services, NGOs, charities, or volunteer organizations are aplenty. 

 Search for high-paying nursing jobs on  MIMS Career . Browse, save, and apply for nursing jobs, all in one-click. Take the opportunity for higher pay and better work locations. Our pages are all mobile-responsive, allowing you to take that leap for a better job whenever, wherever you are. All our job postings are heavily screened to  prevent scams and mistrustful behavior.  
   

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Career Highlight: Paediatric Nursing

source: Larm Rmah 1. Paediatrics 2. History 3. Key differences 4. Ethics 5. Training 6. Job scope 7. Required skills 8. Common Cases 9. Career Opportunities Paediatrics Paediatrics is the...

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 As productivity writer  Benjamin Hardy  puts it, survival mode is: “ your life being filled to the brim with nonessential and trivial things. You don’t have time to make anything meaningful. ” 

 Do you often feel like this? Crazy shift hours, demanding patients, children to take care and worry about at home… It’s no wonder that  nurses are falling sick because of their stress levels . Your busy life just gnaws at the corners of your mind. It’s difficult to sleep, hard to find time to eat, and care about yourself. As you fend off your exhaustion, you realize at the end of your day the worst thing about your predicament is that you have to face the same thing tomorrow. 

 And the next day. 

 And the next one. 

  So you go through life on autopilot.  

 There is a way to break this cycle, and return your sense of self. You will feel happier, healthier, and achieve your personal and professional goals with these simple daily practices. 

 Re-orient your life 

   

  Take charge of your life . Most importantly, be conscious of your decision to take charge of your life. Decide on a better way of looking at how you live, and decide to act on it. Intention is very important; actions only come after that. 

  A good plan today is better than a perfect plan tomorrow.  

 You have only one life; it would be a shame to live it miserably, because you won’t be getting any of your youth back. 

 Get Good Sleep 

   

 So many things can be attributed to the irregularity of sleep or the lack of it. Your concentration slips out frequently. Your memory is fuzzled. Your body feels tired, and has no energy. These are all detrimental to the patients under your care. Most importantly, it poses a real danger to your health. 

 Those who sleep 7-9 hours a day are proven to be healthier, fitter, and less likely to be obese or suffer from any other health issues. 

  “But wait…” you say. “I can’t do that! I work shifts.”  

 Don’t worry. Remember that you can space out your sleeps into naps if a long period of rest is not available to you. 

 There are so many benefits to getting enough sleep. Some of them are: 

 
	 Increased concentration 
	 Better cognitive abilities 
	 Less risk of cardiovascular diseases 
	 Reduced chances of depression 
 

 And so on. 

 Prayer, or meditation 

   

 Gratitude upon waking up, or when facing a difficult time, is one of the  best  habits you can form. This mindset of abundance primes you to cope better with challenging situations or periods of your life. Because you are always grateful for the things that you currently have, it negates the negative impact of focusing on the things you don’t have, or would like to be better. 

 Prayer and meditation helps you re-orient yourself to set your most important priorities. It also serves as a good “brain detox”. 

 Your life might be busy and hectic. By devoting some time to honing your spiritual center, you will learn to make sense and derive meaning in a chaotic world. 

 If you don’t know how to meditate, here’s the  5-minute meditation trick every nurse needs to know . 

 Exercise in moderation 

   

 At MIMS Career we all know most of you nurses are very tired. However, exercise is something that still should not be neglected. 

 Take walks. Walking can also be a form of meditation. Just walk a few minutes, being mindful of your surroundings and focusing on your surroundings. Try and get into the habit of exercising, too. It has many benefits which I’m sure you’re aware of. If you want a healthy mind, it has to start with care of the body. 

 No gym membership? Try some no-equipment home exercises. 

 Eat Healthy 

   

 Eat small, frequent meals as opposed to large meals in one sitting. 

 Those working shifts have a tendency to grab whatever food is available, and that is unhealthy. Try to prepare healthy snacks that you can bring to workplace, like cut fruits. 

 Pack food to work. Cooking packed lunches are a lot healthier because you are aware of what you put into your body. Experiment with simple 1-dish meals. They are light enough to bring in one container, and can simply be reheated in a microwave. 

 If going home to eat, experiment with freezing your prepared meals, or slow-marinading meat that you can throw in the oven right when you get back home. YouTube channels like Tasty can give you many ideas. 

 Consume Great Content 

   

 Read, even if you can only do it for ten minutes a day. If done every day, you’ll eventually finish many books in a year. 

 Podcasts and audiobooks are good to listen to on your commute.  Here’s a helpful article also written by me about getting started with podcasts.  

 The world’s most successful people all read at least one book a week. You don’t have to do that, but that goes to show how important the value of reading good content is. 

 By “good”, I don’t mean Facebook posts or tweets. I mean real, thought-provoking forms of prose that teach you something new. 

 Over time, just by doing 10 minutes a day, you’ll have more knowledge on different topics. It will make you a better writer, speaker, and you’ll develop a personality that future employers would absolutely love whenever you go for interviews. You will view the world in a different lens. 

  Here’s a great reading list for you to get started if you like.  

 Write down and review your goals every day 

   

 What are your goals? Write them down. Both short and long term. 

 Then do something that gets you closer to your long term goals every day. 

 Getting out of the rut that is your daily grind can be difficult, but very rewarding when done right. The location and working environment you’re in can make or break your learning curve towards attaining your career goals. 

 Which is why you should give MIMS Career a shot. Browse through our extensive directory of nursing jobs across Malaysia, Singapore, Indonesia, Philippines, and more countries coming soon. Upload your resume and be notified of jobs you might be interested in. 

 Sign up for free, and discover the change of pace in life that you need to get out of autopilot today.

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