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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 Finding a new job can be very tiring, and time-consuming. It can be difficult to schedule some time to your job-seeking activities. However, the end of the year is a period of time you don’t want to miss if you want to maximize your chances of landing that precious new job. Here are four reasons why: 

  1. Employers are getting ready for the New Year  

   

 Traditionally people wouldn’t advise you to hunt for a job at the end of the year, when employers have maxed their yearly budgets and are just closing the financial year with some wrap-up activities. 

 But growing evidence seems to suggest otherwise: as employers return from the holidays with a renewed vigor, new goals, and new KPIs, they are more inclined to act upon your application immediately. 

  2. Employers have plans for 2018  

   

 Whether its a big hospital, a small clinic, or a humble retirement home, everybody uses the last few weeks of the year to reflect back on their performance in order to stay afloat. It is normally during these periods of time that they make the decision to allocate budgets to hire new staff… 

 So get to applying! 

  3. You’re ready to apply for one  

   

 The best time to apply for a job is also whenever you feel you’re ready. 

 When you want new experiences, new training, different exposure, or an increase in salary… you know it’s time to go. 

 So update your resume, acquire new skills, and hunt for that job. 

  4. You’re starting to feel miserable at your job  
 
  
Find yourself feeling unnaturally tired? Even if you’ve been getting enough sleep? 

 If you’ve been exhibiting signs of stress due to your current job like fatigue, headaches, migraines and depression, it’s probably a sign that you should cut your losses and look for opportunities elsewhere. 

 Don’t think it’s your fault for not being able to fit in… sometimes the shoe just doesn’t fit.

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 Think about working in Australia. The salary of nurses are one of the highest in the world. They have a large, interesting country with endless things to explore. The quality of life is great; it is second best globally. People live outside a lot more than they do here, are laidback, and friendly. 

 Working overseas, while initially scary, can be one of the best decisions you ever make. Being outside your comfort zone forces you to grow as you are tested by challenges that not many people will get the opportunity to go through. 

 Depending on where you go, it can be very different from back home. This change in environment builds confidence as a result of changes in your perspective. Not only will it look good on your resume for future career opportunities, a new country is a land of endless discovery that you can make during your downtime after work. 

 Want to work as a nurse in Australia? Read on to find out. 

  About Australia  
 Register with NMBA  
 Apply for skills assessment with AMNAC  
 Get on AHPRA online public register  
 Pass the AMNAC skills assessment  
 Living in Australia  

 About Australia 

 Because it was geographically isolated as an island for millions of years, many species can only be found on the Australian sub-continent. Australia is a rapidly advancing country: it is the 13th-largest economy, and is ninth on the list of income-per-capita. It ranks highly in terms of quality of life, healthcare, education, economic freedom, civil liberties and human rights. An influx in migration from all over the globe to Australia has resulted in the country becoming a rich, diverse, and friendly melting pot of cultures and ideas. 

 Register with NMBA 

 The process of migrating to Australia for work as a nurse involves a few regulating bodies. In a nutshell, in order to practice nursing, you’d have to register with the Nursing and Midwifery Board of Australia (NMBA). This board handles your qualifications, and deems your education to be relevant, meeting Australian standards. Then you have to apply with the Australian Nursing and Midwifery Accreditation Council, or ANMAC. This body takes into account your work experience, and handles your migration to Australia. It is possible to be accepted by the NMBA, but rejected by the ANMAC. 

 The suggested pathway is to register with the NMBA first. For registration, they will assess you on three things: 

 
	 Criminal history
	 
		 English language skills (a recent result of tests like IELTS or TOEFL is needed) 
		 Recency of practice. You need to clear this part if you’ve already been practicing as a registered nurse here in Malaysia. Recent grads without prior work experience need not do this step. 
	 
	 
 

 Apply for skills assessment with AMNAC 

 Once this is done, and approved by NMBA, you then apply to AMNAC for a skills assessment. This is the application that will approve your migration to Australia. 

 They have five criteria to submit: 

 
	 Proof of identity 
	 English language proficiency (similar to NMBA criterion) 
	 Educational equivalence (whether or not the nursing degree or training is the same standard as AMNAC’s standards) 
	 Professional Practice 
	 Fitness to practice. 
 

 Get on AHPRA online public register 

 If you’ve graduated from Malaysia, you would have to complete some further training. This is because you do not meet Criteria 3- Education equivalence. Hence you would not be suitable for a skills assessment from AMNAC, which prevents your migration. 

 To get over this hurdle, you need to be on AHPRA’s online public register, which determines that you are fit to practice, and that your education and training are both deemed usable for their healthcare system. 

 This training can be in the form of a bridging program or something similar. Contact the Dept of Immigration and Border Protection for a visa to go to Australia to complete your training. 

 Pass the AMNAC skills assessment 

 Then there’s only left the final step! AMNAC will approve your application to go through their skills assessment. Once that’s done, they will issue a Letter of Determination. If you are suitable for migration, congrats! Head back over to Department of Immigration and Border Protection website to start the visa process. 

 Living in Australia 

 Australia has seven of the top 100 universities in the world so great place for education. Also, each year Australian Government provides approx $200 million dollars in scholarships for local and international students. It’s a good opportunity to raise your children there. 

 Australia is a safe, multicultural, friendly and harmonious society. It has a comparatively very low crime rate and strict gun control laws providing a safe place to live. 

 Medical insurance, healthcare facilities and doctor’s prescription medications are cheaper than many developed countries. So you can have a peace of mind whenever misfortunes happen. 

 Halal food is relatively easy to get in the larger cities. Lately the vegetarian movement has been very well-liked with the local populace. Regardless of your dietary needs, Australia is open enough to accommodate everyone. 

 Conclusion 

 Migration to another country can be scary. There are no certainties. No guarantees. You’d be leaving familiar environment behind, and embracing the change that will happen. Be proud of yourself for taking this next big step in your career. 

 As the world gets smaller and more connected, employers are more in need of healthcare practitioners who are open-minded, culturally-exposed, and competent to meet the needs of 21st century challenges. 

 You stand to gain a new skillsets from experienced specialists who work in challenging environments. It will solidify your confidence - and compassion. That compassion will come from the realization that despite differing borders and flags, we are still one big family. The realization that we’re not so different after all, and that access to health care is a basic human right. 

 Start applying for nursing jobs overseas with MIMS Careers. Just signup, input your details and resume, and you will be able to apply for those job posts with a single click. Not only that, you can save jobs you are interested in for later viewing. 

 Can’t find what you’re looking for? Set up job alerts so we can notify you of new employers that meet your search criteria.

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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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 A close relative of mine is a young nurse. Two years ago she started taking care of this nice lady who was partially paralysed; her breathing muscles would no longer function autonomously, hence a tracheostomy was done so she could breathe. The condition left her bed-ridden on bad days, and wheel-chair bound on good ones. 

 She cared for the lady to the best of her abilities, for about 18 months. One day the lady started feeling cold. She was sweating and shivering at the same time. She went unconscious, and had five cardiac arrests within 36 hours. 

 After unsuccessfully trying to stabilize her blood pressure, she died of heart failure. The young nurse was devastated. It wasn’t her own mother, but it might as well seemed like it. It was her first patient death while working as a nurse. It affected her so much she found it difficult to work for the next week. 

 This experience is shared by many nurses in the country. How nurses bond with their patients depends on circumstances and the length of time they provided care to them. A strong bond between patient and nurse is essential to effective nursing, but when death happens, it can deal a very significant blow. 

 The first death of your patient can massively impact you as a nurse. So will subsequent ones. 

 It is extremely important that this doesn’t mentally compromise your ability to do your work. 

 How can you, as a nurse, deal with it? 

 1. It’s okay to feel emotions. Embrace it fully. 

 You are human. You are in a compassionate profession: the very basis of nursing started on the principle to relieve pain, assuage suffering, and provide help to those of ailing health. 

 It is okay to feel overwhelmed at first, especially when you have cared for the patient for so long. 

 Empathy is good for your job, it makes you a better nurse, but it makes loss more painful. 

 Allow yourself some time to feel, and understand your emotions. 

 Your line of work is to care for people, the noblest of all human traits. Your grief on the death of your patient means that you have done your job. 

 2. Try to accept the death happened. 

 Some wards have it harder than others for this. 

 A geriatric ward would have the oldest, most needy patients. Conducting CPR on these patients can be cruel, especially if you or your team are not willing to “let go” of the patient. 

 However, death in these parts of the hospital would be a routine part of the day. It is wise to accept it, so you can continue giving out the best care to the other still-living patients without letting it affect the quality of your work. 

 Accept their deaths, and the fact that you have done all you could to alleviate their suffering. Know that you have done your best to keep them comfortable and retain their dignity. 

 3. Remain in control and neutral if breaking the news to the family. Don’t add to the problem. 

 It is okay to share your emotions with the patient’s loved ones. 

 Respect the family; if they do not wish you to partake in their grief, then kindly leave them alone. They have also gone through much, just like you. 

 Some relatives will blame the doctor/nurse for causing the death. Don’t take this to heart. The Kubler-Ross model of grief lays out five stages, and anger is one of them. 
Find your own ways to vent, either through support groups, family, or colleagues. 

 4. Talk about it. Don’t bottle it in. 

 One of the best things about being in the nursing workforce is that you’re surrounded by people who have gone through similar experiences too. 

 Death is prevalent amongst healthcare professions, and sometimes just talking to a senior can help a lot. 

 Find someone you’re comfortable with. It can be a senior nurse, a matron, or even your other colleagues in the ward. 

 Ask them how they managed to overcome such periods of distress. Pour out whatever you’re feeling to them; it is very likely that they have felt everything you are feeling right now. 

 Talking about it helps you make sense of what you’re feeling. By articulating it into words, you can pinpoint exactly what’s bothering you, and help you to come to terms. 

 5. Realize that these things happen. 

 Things happen. Death is part and parcel of the life in a hospital. Some areas will be more prone to dealing with death than others, like the ER, surgical ward, the ICU. 
You might find yourself poring over the moments that led up to the death in your mind, going over what you could have done better, what you could have done differently. 

 This leads to a general feeling of guilt. This can be very destructive to your well-being, and can affect the performance of your work to other patient who also need your care. This is not a good coping mechanism if it jeopardizes the health of your other patients. 

 6. Believe that you are making a difference. 

 The death of a patient does not equal to failure. 

 How you deal with the patient’s relatives is an extension of how you treated their late relative. 

 For all the grief that you may be feeling right now, the patient’s family has it harder. 

 Showing that you cared provides a monumental difference, and leads the family to a safer path of acceptance. 

 Conclusion 

 The trait that sets humans apart from other species is our ability to empathize for our fellow brethren. 

 Other fauna have demonstrated this to a certain degree, but only humans have been able to take it to their very core, make it into their reason to live, and deliver it back to their community. 

 Nursing is more than just facts or skills or the amount of certifications that you can obtain to move your career. It is founded on empathy; the ability to understand others’ suffering and pain. 

 During times when you feel overwhelmed or devastated by the loss of your patient, stand firm and be proud of who you are, because nurses do things that not many will have the capacity to accomplish. 

 You will find your way to deal with it as you become more experienced, and become better at learning what is the best way to help families cope with grief over time. 

 Steel your heart, adjust that uniform, and carry on providing the best that you can give to your other patients.

How to Cope with Death and Loss, as A Nurse

A close relative of mine is a young nurse. Two years ago she started taking care of this nice lady who was partially paralysed; her breathing muscles would no longer function autonomously, hence a tracheostomy was done so she could breathe. The...

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