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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For those nurses serving with Kementrian Kesihatan Malaysia (KKM), the start of your work life will present you with one of the toughest choices you’ll make: EPF (Employees’ Provident Fund, also known as KWSP), or choose the pension fund? Both are viable options in securing your financial health after you retire. Although retirement might seem like ages away, a good amount of planning and successful investments can mean the difference between being able to live comfortably in your golden years, or struggle with daily or medical expenses. So which to choose? We’ll break down the points below. Pension fund What is it? It’s a monthly stipend of a set amount, provided by the Public Services Department upon your retirement. In addition to that, you also receive a gratuity payment, and medical/health benefits. Calculation Here we will be assuming that you start work at 20 years old, with a starting salary of RM2,000, and continue working until you retire at 55 with a salary of RM5,600 (3% annual pay increase). Your monthly pension will be your last drawn salary, divided by two. For example, if your base salary is RM5,000 when you retire, your monthly stipend will be RM2,800/mo. In addition to that, you will receive gratuity payment, which is calculated as such: gratuity = 7.5% x 35yrs x 12 months x RM5,600 (final drawn salary) = RM 176,400. RM176,400 will be given as a lump sum, while RM2,800 will be given per month. Again, this is all assuming you retire at 55, with a final salary of RM5,600. Benefits No subtraction from base pay. Unlike EPF, as we will see later, there is no subtraction from your base salary. Guaranteed monthly retirement funding Again, unlike EPF, where your money can be withdrawn for other uses, pension takers are guaranteed to have a monthly source of income. Disadvantages You have to start and end your service in the public/government sector. It might hamper your ability to seek work overseas, better base salaries, or even some chances to study. EPF or Employees Provident Fund (KWSP - Kumpulan Simpanan Wang Pekerja) What is it? EPF is the accumulation of savings generated from deductions of your base salary. Currently, you can choose either 11%, or 8%, as recently announced . This accumulation of money is further grown by annual dividends. On average the dividend is around 6%, depending on the GDP (gross domestic product) of the country. What makes EPF great as long term savings is due to the magic of compound interest. . Your employer also contributes to your fund (12% of your pay). These two things make an EPF account grow substantially when properly managed. 2 accounts Your EPF savings are divided into two accounts. 70% goes into account 1, and the rest to account 2. Account 1 is your retirement funds. Account 2 is withdrawable, under a few conditions: more than 50 years old Housing downpayment for your 1st house housing loan payment education medical costs Hajj pilgrimage Upon reaching the age of 55, you will be able to withdraw from account 1. You will have to choose to withdraw one lump sum, or as a monthly stipend like a pension. Calculation Let’s take the same example as just now. Start work at 20, salary RM2,000, retire at 55, salary RM5,000. Deduction from pay = 11% = RM220 Employer contribution = 12% = RM240 We will assume no withdrawals are made over entire working period EPF annual dividend = 6% The interest adds up year over year, and with the help of EPF’s online calculator , Total EPF savings at 55 years old = RM461,900 It is a marginally higher amount than RM176,400 gratuity you will receive from a pension. Benefits Flexibility. At the age of 55, you can withdraw that money and invest in another scheme, venture, or fund that offers greater returns. Faster growth. As shown, even with a contribution of 11% of your pay, over the course of 35 years it balloons into a large amount of money. Freedom of employment. You no longer have to work within the constraints of the government or public service. You are free to pursue study or work opportunities as you wish. Disadvantages Sometimes things don’t go as planned. You might hit a financial roadblock that forces you to withdraw from your EPF fund. An example of this is a medical emergency. It subtracts 11% of your base salary. 11% might not seem like much, but for people who live paycheck to paycheck, it can be a bitter pill to swallow. Annual dividend from EPF can decrease, depending on economic climate. Making a comparison Monthly funds Assuming that you live until the mean life expectancy age in Malaysia, which is 76 years old. Years to live off retirement fund (pension) = 76-55 = 21 years To make a fair comparison, let’s subtract the gratuity amount of a pension scheme from the lump sum of EPF savings. EPF at 55 years old - gratuity of pension at 55 years old = RM461,900 - RM176,400 = RM285,500 Stipend per month that EPF provides = RM285,500 / 21 years / 12 months = RM1,132.94/month Even if we did not subtract the gratuity value, it would be: RM461,900 / 21 years / 12 months = RM1,832.94/ month It is far less than RM2,600/month from a pension scheme . What if we invest all of EPF savings? Say at the age of 55, you embark on another investment with better returns. We will assume 8%. You pile up all your savings into it. Investment return x EPF savings = 8% x RM 461,900 = RM36,952/year or RM3,079.33/month. It is more than what you’ll obtain from a pension. However you’ll need to ensure that the second investment has better returns than EPF dividends. That in itself can sometimes be a challenge. Conclusion They both have their advantages and drawbacks. It seems like it is up to you to play it well, to ensure you can lead a comfortable life upon retirement. However the main question of choosing either EPF or pension as retirement savings often boils down to your choice of employer. Will you stay with the government sector for another 30+ years? You don’t want to end up with no retirement fund… No EPF or no pension. That’d be the worst. If yes, go for the pension scheme. It is safe, guaranteed, and offers great peace of mind in your golden years. However, with EPF, you are free to take up opportunities that come your way. Countries like Saudi Arabia, Singapore, and Australia are actively seeking out Malaysian nurses with extremely attractive pay. Opportunities for post-graduate education are more limited in the government sector; if in private, you get to choose when you want to do it. You can also fund it with your EPF savings, something you can’t do on a pension. Choose the freedom of choice. Search for high-paying nursing jobs, and overseas 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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For those nurses serving with Kementrian Kesihatan Malaysia (KKM), the start of your work life will present you with one of the toughest choices you’ll make: EPF (Employees’ Provident Fund, also known as KWSP), or choose...

Read More