All About Nursing Care...

Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well, and in all settings.

Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life.

Nursing practice is the actual provision of nursing care. In providing care, nurses implement the nursing care plan using the nursing process. This is based on a specific nursing theory which is selected in consideration of the care setting and the population served. 

In providing nursing care, the nurse uses both nursing theory and best practices derived from nursing research. The nursing process is made up of five steps:-

1. Evaluate 
2. Implement 
3. Plan
4. Diagnose
5. Assess

Nurses are able to use this process from the American Nurses Association to determine the best care they can provide for the patient. There are many other diverse nursing theories as well.

Early History

The first known documents that mention nursing as a profession were written in approximately 300 AD. In this period, the Roman Empire endeavored to build a hospital in each town that was under its rule, leading to a high requirement for nurses to provide medical care alongside the doctors.

The profession of nursing became considerably more prominent in Europe in the middle ages, due to the drive for medical care from the Catholic church. In this period, there were many advancements and innovations that took place, which eventually went on to form the base of modern nursing, as we know it.

The first Spanish hospital was built in the late 500s to early 600s in Merida, Spain, with the intent to care for sick individuals regardless of ethnic origin or religion. Several others were created in the following centuries but their upkeep was neglected until Emperor Charlemagne began to restore them and update the supplies and equipment in the 800s.

Throughout the 10th and 11th centuries, the nursing profession expanded due to changes in rulings in Europe. Hospitals began to be included as part of monasteries and other religious places and the nurses provided a range of medical care services, as was required, even beyond traditional healthcare. This all-encompassing model gained popularity and continues to be responsible for the wide range of duties a nurse is responsible for today.

At the beginning of the 17th century, nursing as a profession was rare due to various reasons, such as the closing of monasteries that housed the hospitals. However, in some regions of Europe where the Catholic church remained in power, the hospitals remained and nurses retained their role.

History of Nursing 

Florence Nightingale was a nurse who tended to injured soldiers in the Crimean War in the 1850s and played a significant role in changing the nature of the nursing profession in the 19th century.

During this time, the role of nurses continued to expand due to the need for their presence on the front lines of wars, where poor hygiene standards often led to fatal infections in injuries. Nightingale campaigned for improved hygiene standards in the hospital attending the wounded soldiers, which drastically reduced the number of deaths from infections.

The profession of nursing was pushed further forward in 1860 with the opening of the very first nursing school in London. This was the beginning of many other schools for new nurses so that they received appropriate training and education before they began to practice on the field.

However, the need for nurses expanded with the world wars in the twentieth century, and many nurses were required to begin providing care without adequate training. Since this time, education institutions for nurses have continued to expand.

The profession has also branched out into various specializations with further education in particular fields of nursing care, such as pediatrics or oncology.

Types of Nursing Specialties:-

1. Registered Nurse (RN)

Registered nurses (RNs) provide and coordinate patient care and educate patients and the public about various health conditions.

Registered nurses work in hospitals, physician’s offices, home healthcare services, and nursing care facilities. Others work in outpatient clinics and schools.

Registered nurses usually take one of three education paths: a bachelor’s degree in nursing, an associate’s degree in nursing, or a diploma from an approved nursing program. Registered nurses must be licensed.

A registered nurse (RN) is a nurse who has graduated or successfully passed a nursing program from a recognized nursing school and met the requirements outlined by a country, state, province, or similar government-authorized licensing body to obtain a nursing license.

2. Cardiac Nurse

Cardiac nursing is a nursing specialty that works with patients who suffer from various conditions of the cardiovascular system. Cardiac nurses help treat conditions such as unstable angina, cardiomyopathy, coronary artery disease, congestive heart failure, myocardial infarction, and cardiac dysrhythmia under the direction of a cardiologist.

Cardiac nurses perform postoperative care on a surgical unit, stress test evaluations, cardiac monitoring, vascular monitoring, and health assessments.

Cardiac nurses work in many different environments, including coronary care units (CCU), cardiac catheterization, intensive care units (ICU), operating theatres, cardiac rehabilitation centers, clinical research, cardiac surgery wards, cardiovascular intensive care units (CVICU), and cardiac medical wards.

3. Certified Registered Nurse Anesthetist (CRNA)

A CRNA (certified registered nurse anesthetist or just “nurse anesthetist”) is an advanced practice registered nurse (APRN) who administers anesthesia and other medications. They also take care of and monitor people who receive or are recovering from anesthesia.

Anesthesia is a medical treatment that keeps you from feeling pain during procedures or surgery. Different types of anesthesia work in different ways. Some anesthetic medications numb certain parts of your body, while other medications work on your brain to induce sleep.

CRNAs can work in several different medical settings, including:

• Hospital operating rooms (ORs).
• Postanesthesia recovery rooms (PACU).
• Emergency rooms (ERs).
• Outpatient surgery centers.
• Labor and delivery units.
• Physician’s offices.
• Dentist’s offices.

CRNAs have specific responsibilities, which include:

• Educating people before and after they receive anesthesia for a procedure or surgery.
• Assessing a person’s physical response to anesthesia.
• Identifying possible risks to the person undergoing anesthesia, including allergies to anesthetics and issues related to health conditions they may have, such as asthma or diabetes.
• Providing precise dosages of anesthesia.
• CRNAs work with surgeons, anesthesiologists, dentists, podiatrists, and other healthcare providers to provide anesthesia care to people undergoing all types of procedures. They care for people of all ages, undergoing all types of surgical procedures.

4. Clinical Nurse Specialist (CNS)

A clinical nurse specialist (CNS) is an advanced practice registered nurse who has earned a master’s or doctoral degree in nursing. They use their expertise to assess, diagnose, and treat patients. But their role often extends into other areas, like health care management and research. 

A CNS’s primary role is to provide quality, cost-effective specialty care. They work in a variety of specialties, including:

• Pediatrics
• Women’s Health
• Geriatrics
• Psychiatric health
• Rehabilitation services
• Wound care
• Pain management
• Oncology
• Critical care
• Emergency room services

Clinical nurse specialists may order tests, make some diagnoses, administer basic treatments, and, in some states, prescribe medications. Beyond this, they may provide expertise and support to a team of nurses. They often help create practice changes within an organization and plans that ensure the group is using best practices and providing evidence-based care.

The four primary roles of a clinical nurse specialist are:

• Expert clinician
• Educator
• Researcher
• Consultant

5. Critical Care Nurse

Critical care nursing involves working with doctors and specialists to assess, treat, and monitor critically ill patients while also providing their basic care.

Critical care nursing is the field of nursing with a focus on the utmost care of critically ill or unstable patients following extensive injury, surgery, or life-threatening diseases.

Critical care nurses can be found working in a wide variety of environments and specialties, such as general intensive care units, medical intensive care units, surgical intensive care units, trauma intensive care units, coronary care units, cardiothoracic intensive care units, burns unit, pediatrics, and some trauma center emergency departments. These specialists generally take care of critically ill patients who require mechanical ventilation by way of endotracheal intubation and/or titratable vasoactive intravenous medications.

Critical care nurses are also known as ICU nurses. They treat patients who are acutely ill and unstable requiring more frequent nursing assessments and the utilization of life-sustaining technology and drugs.

6. ER Nurse

An ER nurse is a nurse that works specifically in the emergency room. They treat patients who are facing traumatic or severe, often life-threatening medical conditions.

Also called trauma nurses, and similar to critical care nurses, ER nurses have a demanding and stressful job. They are called to act quickly to treat patients suffering from medical emergencies ranging from car accidents and suicide attempts to strokes and heart attacks. An ER nurse needs to be trained and ready to take decisive action in any number of critical situations.  

An ER nurse’s primary responsibility is to identify medical issues, determine severity, and provide immediate support to minimize negative long-term effects and, if necessary, even sustain life.

While no day is ever the same for nurses in the emergency room, here are some of the typical duties these nurses perform:

• Triage cases in order of urgency and need.
• Work with ER staff to stabilize incoming patients. 
• Set broken bones. 
• Perform tracheotomies and intubations. 
• Give stitches and sutures.
• Start intravenous lines (IVs). 
• Administer medication—as instructed by physicians.
• Create and maintain patient records.
• Transfer stable patients to other wings.

To become an emergency room nurse, you’ll first need to complete a nursing diploma, associate degree, or a bachelor’s degree in nursing (BSN).

7. Family Nurse Practitioner (FNP)

Family nurse practitioners (FNPs) are advanced practice registered nurses (APRNs) who typically work in primary care settings and treat patients of all ages, from infants and teens to adults and seniors. An FNP’s focus is on health and disease prevention. 

A family nurse practitioner has pursued a higher degree of education than a registered nurse (RN), including specialized classroom-based learning and hundreds of hours of clinical training in family practice. FNPs are trained to treat patients across the patient’s lifetime.

FNPs care for patients’ physical and mental health, teach wellness strategies such as nutrition and weight management and offer preventive care, including vaccination. They have the authority to diagnose and treat injuries, as well as conditions ranging from influenza to diabetes.

Family nurse practitioners work in partnership with family physicians, physician assistants, and nurses in their practices. 

They may also collaborate with social workers and other healthcare professionals depending on their place of employment.

Roles and Responsibilities of a Family Nurse Practitioner:

• Listening to and recording patient health histories.
• Providing thorough physical exams.
• Diagnosing and treating common acute and chronic health conditions.
• Ordering and interpreting lab and other medical test results.
• Developing treatment plans and prescribing medications and therapies, such as physical therapy.
• Teaching basic health care and offering counseling that encourages healthy lifestyle behaviors.
• Referring patients to other health professionals for more complex health and mental health problems (e.g., sending a patient with a fractured wrist or complex back problems to an orthopedist).

8. Geriatric Nursing

Geriatric nursing refers to the care of elderly patients. In this specialty, healthcare providers focus on issues that affect older individuals, such as Alzheimer’s disease and osteoporosis.

Geriatric nurses work at healthcare facilities like nursing homes, hospitals, hospices, and home healthcare service providers to care for elderly patients, who have a higher risk of developing chronic health conditions and diseases such as osteoporosis, arthritis, congestive heart failure, Alzheimer’s disease, cancer, and diabetes. Geriatric nurses help patients cope with and prevent these types of issues.

Specific responsibilities include the following:

• Administering medications and making adjustments when needed
• Creating and evaluating care plans
• Exercising and massaging patients
• Conducting routine physical and mental exams
• Helping rehabilitate patients after injuries
• Watching for signs of elder abuse
• Giving advice on disease prevention and personal safety tips
• Connecting patients with local resources
• Transporting patients to doctor’s visits and other appointments
• Helping patients with daily needs, such as dressing, bathing, and using the bathroom

9. Perioperative Nurse (Surgical/OR Nurse)

Perioperative nursing is a nursing specialty that works with patients who are having operative or other invasive procedures. Perioperative nurses work closely with surgeons, anaesthesiologists, nurse anesthetists, surgical technologists, and nurse practitioners. They perform preoperative, intraoperative, and postoperative care primarily in the operating theatre.

Also known as Operating Room nurses or OR nurses, perioperative nurses are registered nurses (RNs) who work in hospital surgical departments, day-surgery units (also called ambulatory surgery units), clinics, and physician's offices. They help plan, implement, and evaluate the treatment of the surgical patient and may work closely with the patient, family members, and other healthcare professionals.

Duties of a perioperative nurse:

• Provide treatment to patients 
• Perform administrative tasks 
• Monitor patients 
• Provide advice to patients and their families 
• Maintain hospital equipment 

10. Mental Health Nurse

Mental health nursing, also known as psychiatric nursing, is a specialized field of nursing practice that involves the care of individuals with mental health disorders to help them recover and improve their quality of life.

Mental health nurses have advanced knowledge of the assessment, diagnosis, and treatment of psychiatric disorders that help them provide specialized care.

A mental health nurse is responsible for the:

• Assessment and evaluation of the patient’s mental health
• Development of a treatment care plan
• Consultation with other health professionals about the treatment plan
• Provision of care and psychotherapy treatment
• Maintenance of medical records
• Support and education to the patients and their family

11. Nurse Educator

Nurse educators begin their careers as registered nurses (RNs). After receiving an advanced nursing degree, these individuals choose to teach new nurses valuable skills by becoming nurse educators. 

Nurse educators are valuable members of the healthcare committee. They have extensive and comprehensive knowledge of how the healthcare system functions. They also understand the needs of patients and are aware of theories of teaching and learning. 

Nurse educators need to have all of the certifications of a registered nurse, including a Bachelor of Science in Nursing. In addition, they will need two to five years of clinical experience, an understanding of the administrative and organizational considerations that influence caregiving, and an advanced nursing degree. 

Some of the most common responsibilities of a nurse educator include: 

• Teaching clinical skills and patient care
• Instructing hospital research
• Guiding students through clinical rotations 
• Designing and evaluating the program curriculum 
• Researching related topics 
• Maintaining clinical skills and certifications 
• Demonstrating communication and collaboration 
• Following legal and ethical teaching practices 

12. Nurse Manager

A nurse manager is an individual in a medical setting with the decision-making power to influence daily operations. They can advocate for improved patient care by optimizing certain processes that a hospital or healthcare organization fulfills every day.

As a nurse manager, you will make decisions that positively influence how hospitals and clinical organizations perform daily. From nurse scheduling to immediate patient care, you’ll work to provide patients with the best possible care. The role of a nurse manager offers an ideal blend of managerial and patient care responsibilities, where you’ll manage nursing resources without removing yourself completely from patient care floors.

The exact responsibilities of a nurse manager can include:

• Creating department schedules that identify when nurses and other staff members will work.
• Supervising nursing staff members as they serve patients, address patient conflicts, communicate with family members, and perform all other necessary aspects of their positions.
• Providing patient care through all of the processes required by comprehensive bedside nursing.
• Solving any issues in current clinic operations.
• Collaborating with staff in other departments to ensure that patients receive the best possible care, from intake through release.
• Recruiting and training new nurses.
• Improving the efficiency of all healthcare organization processes.
• Organizing facility records for quick recall and future reference.

13. Nurse Midwife

Nurse midwives provide care to women across the lifespan, including during pregnancy and the postpartum period, and well-woman care and birth control.

Nurse midwives practice in hospitals and private practice medical clinics and may also deliver babies in birthing centers and attend at-home births.

duties and responsibilities of a nurse-midwife:

• Provides professional reproductive and gynecological health care. 
• Works independently or collaboratively with other medical practitioners.
• Promotes the concept of minimal intervention. 
• Provides health surveillance from pregnancy to breastfeeding. 
• Promotes wellness through health education.
• Provides appropriate intervention for any impending health hazard.
• Diagnose and treat ailments. 
• Consult with or refer their patients to specialists when necessary. 
• Provides primary health care services for women throughout their lifespans.
• Fever complications.

14. Nurse Practitioner

A nurse practitioner (NP) is a nurse who has advanced clinical education and training. NPs share many of the same duties as doctors. They perform physical exams, diagnose and treat diseases and other health conditions, and prescribe medication. A nurse practitioner must have a graduate-level degree of education.

NPs provide patient-centered care. They focus on disease prevention, living a healthy lifestyle, and understanding your health concerns. An NP can serve as a primary care provider or as a specialty care provider focusing on a specific group of people. They work in a variety of healthcare settings, including:

• Physicians’ offices.
• Clinics.
• Hospitals.
• Emergency rooms.
• Urgent care sites.
• Nursing homes.
• Colleges.

They may work independently or with doctors to provide a full range of healthcare services. Nurse practitioners:

• Take and record medical histories and symptoms.
• Perform physical examinations.
• Order diagnostic tests, such as laboratory tests or X-rays.
• Analyze test results.
• Diagnose and treat illnesses, diseases, and other health conditions.
• Create patient care plans.
• Prescribe medication.
• Write referrals for specialists.
• Counsel people on how to stay healthy.

15. Nursing Administrator

Nurse administrators supervise nurses and other healthcare team members. They recruit, hire and train nurses. Other responsibilities include building work schedules and conducting performance reviews.

Nurse administrators—sometimes called nurse managers, nurse directors, or chief nursing officers—do not get directly involved with patient care. However, their job duties most assuredly affect patients’ experiences and outcomes. Administrators keep their staff motivated, oversee or provide needed training, and ensure that regulations are met, if not exceeded.

Because they operate in managerial roles, nurse administrators have to have solid business sense, exhibit strong communication skills, and be masterful at time management. In addition, they must possess an extensive medical background and training.

Nurse administrators are responsible for:

• Maintaining the budget and reporting on financial matters.
• Serving as a liaison between nurses and other hospital workers, including executives.
• Establishing policies and procedures and ensuring staff is in compliance.
• Developing a strategic vision for the hospital or department.

16. Oncology Nurse

Oncology nurses are registered nurses who take care of either cancer patients or those with the potential of developing cancer. Oncology nurses work with physicians and other medical professionals to prevent, diagnose, treat, and manage cancer symptoms, as well as provide palliative care. 

Oncology nurses can work in various healthcare settings—essentially anywhere that treats cancer patients.  Some common places oncology nurses work include hospitals, doctor's offices, outpatient care centers, hospices, cancer centers, clinics, and nursing homes.

There is a variety of specializations within the field of oncology nursing. Some common specializations include:

• Pediatric Oncology
• Radiation oncology
• Surgical oncology
• Immunotherapy
• Genetic counseling
• Hematology
• Chemotherapy/infusions
• Gynecological oncology
• Bone marrow transplantation
• Breast oncology  

Oncology nurse responsibilities might include:  

• Monitoring a cancer patient's condition
• Running various tests and evaluations
• Managing symptoms in cancer patients
• Administering medication to cancer patients
• Helping to manage the side effects of treatments, such as chemotherapy 
• Administering chemotherapy and other treatments like infusions 
• Educating patients and their loved ones on a particular type of cancer, treatment options, management plans, and lifestyles adjustments during cancer treatment
• Assessing a cancer patient's mental and emotional needs
• Helping create a plan of action for a cancer patient's care 
• Advocating for cancer patients and their loved ones  
• Recording a patient's health history, monitoring their vital signs, and maintaining clinical documents 
• Caring for cancer patients after surgery 
• Coordinating with other healthcare providers

17. Orthopedic Nurse

Orthopedic nursing is a specialty that focuses on musculoskeletal diseases and disorders.  These orthopedic issues include conditions like arthritis, bone fractures, broken bones, joint replacements, genetic malformations, arthritis, and osteoporosis.

Orthopedic nurses are familiar with traction, casting, mobility devices, and pain management.  

Orthopedic nurses work in hospital units, offices, and outpatient care clinics. They work with a wide age range of patients and care for both men and women. 

An orthopedic nurse spends time encouraging patients to increase their mobility, educates them about how to protect their joint and bone health, and implements strategies to minimize their pain and complications.

18. Pediatric Nurse

Pediatric nursing is a specialization of the nursing profession that focuses on pediatrics and the medical care of children, from infancy to the teenage years. This is an important field because the health of children is distinct from that of adults due to the growth and development that occurs throughout childhood.

Pediatric nurses usually work in a multidisciplinary team with other health professionals to provide the best medical care possible for children. 

Some pediatric nurses also choose to specialize further in a particular field of children’s health, such as anesthetics, oncology, or neurology.

Individuals well suited to a career as a pediatric nurse are likely to have the following traits:

• Cheerful and friendly
• Good communication skills with people of all ages
• Organized and able to follow complex treatment plans
• Works well under pressure
• Patience and willingness to adapt
• Interest and love for children

Pediatric nurses may work in a range of environments, including hospitals, private pediatrician clinics, nursing homes, schools, government agencies, and social services.

19. Public Health Nurse

A public health nurse is a registered nurse (RN) who advocates for positive changes in population health. This exciting career gives nurses the opportunity to work directly within communities to educate people and give them the tools they need to improve their health outcomes.

In general, the responsibilities of public health nurses include:

• Recording and analyzing aggregate medical data
• Evaluating the health of patients and creating treatment plans
• Monitoring patients for any changes in condition
• Delivering top-quality care alongside physicians
• Educating patients about available support services and helping them access care
• Emphasizing primary prevention in order to avoid disease or injury before it occurs
• Working with public health officials to help underserved communities gain access to care
• Developing a relationship with patients and following up to track progress
• Referring patients to other providers as needed
• Assessing health trends in communities
• Managing budgets of public health programs

A principal goal of public health nursing is to address the health disparities within marginalized communities by focusing on the environmental, physical, and social determinants of health.

Where Do Public Health Nurses Work?

• Government organizations
• Nonprofit organizations
• School systems
• Community clinics
• Outpatient clinics

20. Travel Nurse

Travel nursing is a nursing assignment concept that developed in response to the nursing shortage in the United States in the 1970s. This industry supplies nurses who travel to work in temporary nursing positions, mostly in hospitals. 

Travel nurses can also work abroad. Common jobs for travel nurses include:

• Hospitals
• Clinics
• Community health center
• Private practices
• Rehabilitation facilities
• Nursing home

Working as a travel nurse has many perks. Here are some of the benefits of travel nursing:

• Assistance in obtaining passports/work visas (if working internationally)
• Bonuses
• Choice of location
• Competitive pay
• Free housing
• Higher-than-average pay for RNs
• Medical, dental, and vision coverage
• Retirement plans
• Selection of hours/shifts worked
• Travel reimbursement

Some personal characteristics that serve travel nurses on the job include:

• Ability to learn quickly.
• Resilience to persevere in challenging contexts. 
• Flexibility. 
• Comfort with working in new environments.
• A strong support network.

21. Neonatal Nurse 

A neonatal nurse is a nurse that works specifically with newborn babies typically in their first month of life. Most often, neonatal nurses work with infants who face specific challenges right after birth including birth defects, heart problems, prematurity, and more.

Neonatal nursing is one of these subspecialties that allow nurses to be qualified to work with newborn babies and their mothers. Neonatal nurses focus their work on caring for newborns and sometimes focus on premature babies who are in the NICU.

The main work of neonatal nurses is to help mothers during birth and after the birth of their child. They perform traditional nursing duties like checking vital signs and monitoring patients, performing tests on newborn babies, performing neonatal tests throughout a woman’s pregnancy, and helping patients decide on an effective care plan for patients. 

Medical Laboratory Technology (MLT)

Overview:-

• Medical laboratory technology is the branch of medical science responsible for performing laboratory investigations relating to the diagnosis, treatment, and prevention of disease.

• It has been said that 80% of medical diagnoses are made or confirmed by laboratory values.    

• Healthcare professionals do not know what the term medical technician means. 

History of  Medical Laboratory Technology:-

• In the early 19th century  French soldiers were attacked by yellow fever. A large number of French soldiers died as a result of infection by an organism for which the means of transmitting the disease were not understood. 

• Researchers discovered that transmission to humans occurred chiefly by the bite of an insect vector, a mosquito, and lead to the development of a vaccine in the early 20th century.

• In the 1930s a great deal of attention began to be focused on the clinical laboratory. not only for infectious but also for other metabolic tests for diagnosing diseases.

• At the beginning of clinical testing to diagnose disease states and to assess the effectiveness of treatment or recovery the physician performed his own tests in the patient's home.

How Medical Laboratory Technologists Work:-

MTs work in labs and usually must spend a lot of time on their feet. They're required to wear masks, gloves, goggles, and other protective equipment while they work. They must also use procedures that help mitigate their risk of coming into contact with infectious materials.

Those who work in a hospital or other facility that is open 24/7 may be required to work evenings, overnights, weekends, and holidays.

Types of Medical Laboratory Technologists:-

• MLTs who work in small laboratories may perform a variety of tests, but those employed in larger labs may be more likely to specialize in one area.

• Microbiology technologists work with bacteria and other microorganisms.

• Immunology technologists concentrate on the immune system and its response to foreign bodies.

• Blood bank technologists collect, examine, classify, and prepare blood for transfusions.

• Clinical chemistry technologists work with body fluids and analyze their chemical and hormonal contents.

• Cytotechnologists examine cells under a microscope for abnormalities that may lead to cancer.

Medical Laboratory Technologist vs. Medical Laboratory Technician:-

• A medical laboratory technologist and a medical laboratory technician work in related occupations and the terms may be confused, but there are a number of differences.

• Because technologists must earn a bachelor's degree, they have a much more extensive theoretical knowledge base than technicians, who need only an associate degree. 

• When it comes to job duties, technicians collect, process, and analyze specimens. They perform lab procedures and maintain instruments. 

• Medical laboratory technologists conduct the same procedures technicians do but also execute sophisticated analyses. They evaluate and interpret the results, conduct research, and develop new methods.

Other Duties and Responsibilities of Medical Laboratory Technicians Include:-

• Records of the test results in the lab's record book or daily file

• Collecting, preparing, and storing specimens

• Explaining lab testing procedures to patients and other clients

• Receiving, examining, and approving samples collected by physicians, nurses, and other medical professionals and ensuring that the right type, integrity, and quantity of samples are presented for the ordered tests.

• Preparing various lab reagents and standard volumetric solutions for use in a variety of tests

• Maintaining a clean and safe working environment

• Standardizing testing procedures to ensure consistent reliability and usefulness of test results
• Calibrating equipment, developing standard operating procedures, and determining correct reference ranges for various tests

• Using automated equipment and computerized lab instruments capable of performing several tests at the same time.

There are many Medical Lab Tests including:- 

• Blood Banking Tests —Typing, antibody screening, and cross-matching that are used to identify and prepare blood components that are compatible with transfusion.

• Chemistry Tests —Those tests for the measurement of electrolytes, glucose, lipids, proteins, hormones, enzymes, trace metals, drugs, and toxins.

• Cytogenetic Procedures —Techniques for chromosome counting and identification of abnormal chromosomes and disease genes.

• Cytology Procedures —Staining and examination of tissue samples in order to identify cancerous changes within cells.

• Hematology Tests —Tests to count and classify blood cells, and diagnose blood diseases including coagulation disorders.

• Histology Procedures —Cutting, staining, and mounting of specimens for microscopic examination by pathologists.

• Immunology Tests —Tests that are used to determine a person's ability to resist infections, diagnose autoimmune diseases, allergies, and infectious diseases, and determine tissue compatibility for organ transplantation.

• Medical Laboratory Technician —A clinical laboratory worker who may perform all levels of testing including quality control monitoring, specimen processing, and other laboratory operations.

• Medical Technologist —A clinical laboratory worker who performs all levels of testing, evaluates laboratory methods, verifies results, detects and resolves analytical problems, performs quality assurance, and consults with physicians and allied health professionals regarding laboratory services.

• Microbiology Tests —Those tests for the isolation and identification of pathogenic bacteria, yeast, fungi, parasites, and viruses and antibiotic sensitivity testing.

Where can we work when we finished our MLT Studies?

• We can work as “Medical Laboratory Technologists’’ in private sector hospitals letter on we can promote to “Lab charge, Lab Supervisor or Manager”.

• We can work as “Medical Technologists” in the government sector,  diploma holder    “Technicians” join the government sector.

• We can work as “Research Assistants” in research laboratories and research project letters and we can promote to “Scientific Officers”.

• We can work as “Quality Control Officers / Managers”  in clinical laboratories.

• We can join Public sector colleges and universities as “Lecturer or MLT”.

• We can join “Pharma Companies, Genetic Research Lab, Drug Testing Lab, Marketing Manager”.

What is the average salary of a Medical Laboratory Technology graduate:-

A Medical Laboratory Technology graduate can earn up to Rs 30,000 (LKR) per month. This can go up to Rs 50,000 (LKR) per month with an increase in the experience of the candidate.

MLTs who are employed in public healthcare facilities receive higher salaries compared to those who work in private hospitals, clinics, and diagnostic laboratories. 

MLTs who work in metropolitan areas also receive higher salaries than those who work in non-metropolitan areas.

The work environment of medical laboratory techs:-

Medical laboratory technicians work in a range of settings, including the following:

• Hospital laboratories
• Commercial laboratories
• Diagnostic laboratories
• Blood and organ banks
• Fertility centers
• Biotechnology companies
• Pharmaceutical companies
• Public health organizations
• Research facilities
• Reference laboratories
• Medical equipment sales companies

Skills to become a successful medical laboratory technician:-

In addition to the technical skills you will acquire in school and an aptitude for science, you will need the following soft skills to become a successful medical lab technician:-

• Reading comprehension: You must be good at understanding and following physicians' written instructions.

• Attention to detail: Precision is of the utmost importance when performing testing procedures.

• Critical thinking: This skill allows you to determine your options when solving problems or making decisions, compare them and then choose the one with the most positive outcome.

• Problem-solving: You must be good at identifying problems and solving them as soon as possible.

• Active listening: You must have excellent listening skills to effectively communicate with patients and fellow medical personnel.

• Dexterity: You must also be skilled with your hands because you work closely with needles and precise lab instruments. You must handle these tools effectively.

• Physical stamina: You must have physical stamina because you will work on your feet for long periods while gathering samples. You may need to turn or lift disabled patients to collect samples for testing.

How to become a Medical Laboratory Technician:-

Here are the typical steps to follow to become a medical laboratory technician:

1. Earn a high school diploma or equivalent.

2. Pursue post-secondary education.

3. Obtain state licensure.

4. Obtain certifications.

5. Pursue continuing education.

Branches of  Medical Laboratory Technology [ MLT ]

Which type of test is performed in MLT labs?

• Examining and analyzing body fluids and cells.
• Determine the chemical content of fluids.
• Look for parasites, bacteria, and other microorganisms.
• Match blood for transfusions.
• Test for drug levels in the blood.

Four types of laboratory biosafety level

Level 1 – least level was no threat during the deal with the sample.

Level 2 – moderately affect the worker but is curable in short-term treatment.

Level 3 – may cause serious or lethal disease via aerosol transmission simple inhalation of particles or droplets. Require long-term treatment.

Level 4 – extremely dangerous and pose a high risk of life-threatening disease. Treatment is not available.

Other names for Medical Laboratory Technology

• In India, it is called MLT also CLT [Medical/ Clinical Laboratory Technologist]
• But in foreign named as MLS/CLS [ Medical / Clinical Laboratory Scientist ]

 

Differences between Medical Laboratory Technology & Medical Laboratory Scientist?

• Technician- a person who has done diploma or certificate.
• Technologist -a person who have done bachelor's degree at least, and a technician works as a technologist. A technologist's position is above that of a technician.

Professional Role & Ethics of MLT?

• Follow all the safety precautions
• Test reports should be given to an authorized person
• Practice proper professional skills to avoid mistake
• Don’t disclose the personal information
• Keep in touch with the latest development in the field
• Dedicate towards profession to benefit mankind
• But it plays an important role in patient care by providing timely. Accurate reliable test results to health -care team members.

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CARDIAC CATH LAB EQUIPMENTS

X-Ray Generators:- 

The X-Ray generator produces X-Rays when an electrical current is applied to it. The X-Ray generator could be a device that acts because of the primary control mechanism for the whole fluoroscope. It’s through the X-Ray generator that current is allowed to flow into the thermionic vacuum tube. The fundamental function of adjusting the voltage differential and current of the tube is controlled automatically to keep up optimal contrast and brightness. 

Generator types utilized in fluoroscopy include single phase, three phases, constant potential, and high frequency. High-frequency generators provide superior exposure reproducibility, with the foremost compact size, lowest terms, and lowest repair costs. As a result, high-frequency generators are commonly utilized in new radiographic equipment. X-rays could also be generated in either an eternal or a pulsed mode. Automatic brightness control may be a standard feature of the bulk of contemporary fluoroscopes. Through this method, mA and kVp are constantly monitored and adjusted to optimize the image.  

X-Ray Tube Assembly:-

The majority of x-ray tubes found in current cardiac cath labs contain only two focal spots. The little spot will have a nominal size of 0.5 to 0.6 mm with a kW rating for one exposure of 40 to 50 kW. The big focal spot is going to be 0.9 to 1.2mm in size with a kW rating of 80 to 110 kW. The massive focal spot kW rating should be reasonably matched to the utmost kW of the generator. It’s used for cine or digital image recordings. 

The tiny focal spot is employed primarily for fluoroscopy. The tiny focal spot is additionally the proper choice for cine or digital image recordings of young children. The most common anode diameter provides a 100 mm diameter focal track. This diameter provides an affordable compromise between the specified tube loading and also the delay required to accelerate the anode rotational speed from low speed [approximately 4000 revolutions per minute (rpm)] used during fluoroscopy to high speed (10,000 rpm) used during cine acquisitions. The surface of the anode is usually a tungsten-rhenium alloy; the rhenium is added to smooth the surface of the anode and to cut back the loss of radiation output. 

The body of the anode is sometimes graphite, which increases the warmth energy that can be stored without damage thanks to increases in temperature. The specified small anode angle could be a compromise between field coverage and the warmth capacity rating of the tube. A minimum of a 9-degree angle is important to hide a 9-inch field of view (FoV) image intensifier at a Source Image Receptor Distance (SID) of 30 inches. 

The anode chilling rate should be a minimum of 400,000 heat units per minute (HU/min). Units with medium to large workloads should be equipped with circulating liquid (oil or water) heat exchangers to more efficiently and quickly convey heat from the anode body of the encircling atmosphere outside the tube. This exchanger typically quite doubles the warmth dissipation rate of a fan-cooled housing which is often 100,000 HU/min. This accelerated cooling allows the cardiologist to continue the case, mixing fluoroscopy with cine acquisitions without a forced delay. 

Tube Stand:-

The tube stand supports both the electron tube housing with the collimator and therefore the image intensifier with the imaging chain. It’s designed to keep up the alignment of the central ray for the x-ray beam to the middle of the image intensifier while the angle of the central ray changes within either the coronal or transverse plane of the patient’s body. This cranial-caudal or lateral rotation of the X-ray tube and image intensifier provides the required compound imaging angles required to minimize superposition within the image of the tortuous coronary arteries. 

The cardiologist places the anatomy of interest at the intersection of the 2 orthogonal rotations, the isocenter, to forestall the movement of the anatomy across the FoV of the image when the compound angles are adjusted. Translational movement of the image intensifier parallel to the central ray is accomplished by providing a variable focal spot-to-image receptor distance (SID) of a minimum of 90 to 120 centimeters (cm). 

This enables the positioning of the input plane of the image intensifier near the exit plane of the patient no matter the patient's thickness or compound angle to reduce magnification and geometric unsharpness within the image. The stand should provide extra movement (e.g. Rotation about its floor or ceiling support) to permit the equipment to be quickly removed from the vicinity of the patient when emergency access is required. Collision guards or slip clutches are provided to forestall further power-driven motion of the stand upon contact with the patient or other stationary objects.

Patient Table:-

Floor-mounted special procedure table tops in cath labs are typically supported by a pedestal base with motorized vertical motion sufficient to position any part of the patient’s body at the vertical isocenter of the imaging plane. The tabletop should be wide enough to support the patient, but narrow enough to permit the positioning of the image intensifier adjacent to the exit plane of the patient during lateral imaging. 

The length of the table must be sufficient to comfortably support a tall adult, with some additional room. The composition of the many tabletops is often carbon fiber material. This composition provides the strength required to support a minimum of a 350-pound patient cantilevered from the pedestal support while minimizing the attenuation of the diagnostic x-ray. The tabletop must “float” with regard to the pedestal when electromagnets are released to permit axial and transverse motion of the tabletop relative to the isocenter of the imaging equipment. The longitudinal and transverse motion of the tabletop respectively should be at least 100 cm and 30 cm

Control Console:-

The control console for a cine system should have the flexibility to pick both fluoroscopic and cine technique factors. For fluoroscopic operations, there should be selection switches to vary from continuous to pulsed fluoroscopy. Pulsed fluoroscopy should be available from 30 pulses per second to a minimum of 7. 5 pulses per second. For all modes, the utilized kVp and mA should be displayed on an easy-to-read display indicator. Moreover, the cumulative fluoroscopy time should be displayed and a “5-minute (of elapsed fluoroscopy time) buzzer” should clearly be heard in both the procedure room and also the control booth. It’s also helpful to own a fluoroscopic lock switch that may “hold” a specific combination of “kVp/mA.” 

The utilized FoV of the image intensifier should even be clearly displayed on the control console. Some units allow manual selection of kVp/mA during fluoroscopy additionally to the Automatic Brightness Control (ABC) of fluoroscopy. The cine controls typically have a gaggle of pre-established programs from which to pick appropriate technique factors. In general, cine frame rates from 15 to 60 fps should be available. Adult cardiac cine is typically performed at 30 fps and pediatric frame rates range from 30 to 60 fps cine pulse widths are typically 2 to 10 msec. The X-ray tube potentials should start above 60 kVp so as to limit the patient radiation dose and may go up to 120 kVp. Cine tube current values generally range from 50 to 800 mA. 

The ABC system automatically adjusts some combination of kVp, mA, and pulse width during cine operation to take care of the appropriate image quality. For cine, there should be several pre-programmed technique factors using different frame rates, starting kVps, starting pulse widths, and cine run durations. The control console should, at a minimum, display the cine kVp and mA(s) on an easy-to-read alphanumeric display. The sunshine levels exiting the image intensifier could also be indicated during cine filming as a relative check of proper cine film exposure. There should even be a button to mechanically advance the cine film (“jog” button). 

Finally, the control console should have an indicator to indicate the amount of film left within the cine film magazine. Digital imaging systems need similar function-related buttons. There should even be an “x-ray on” indicator and/or a door interlock indicator.

Grids:-

Cardiac imaging often employs lateral oblique projections that attenuate the x-ray beam and produce a big number of scattered photons. The scattered photons tend to scale back the contrast of coronary arteries and obscure the visualization of smaller arterial vessels and branches. Hence, the utilization of appropriate grid(s) to get rid of much of the scattered radiation leads to a contrast improvement and a capability to work out smaller vessel sizes. The usage of grids may lead to a rise in radiation dose to the patient by an element of two to 4 times. 

The best grid would offer a high percentage of primary radiation transmission and a high percentage of scatter radiation attenuation. The grid should be circular in shape so as to properly fit the image intensifier and to make sure the alignment to the central ray of the x-ray beam is necessary to forestall the grid cut-off of primary photons. Usually, carbon fiber interspace material is used so as to enhance primary radiation transmission. 

Although parallel and crossed grids are employed in the past for cardiac studies, the foremost common grid for these studies may be a focused grid. So as to accommodate a spread of SIDs, low grid ratios are utilized. Typically, grid ratios of 4:1 up to 8:1 are used. The focal length of the grid depends upon the x-ray tube/image intensifier mechanical web being used. 

Modern cardiac imaging systems typically have the capability to vary the SID from 80 cm up to 120 cm. The grids should have a usable focal range that accommodates these variations. It’s important to possess the grid lines mounted perpendicular to the TV raster lines to avoid interference patterns. Because the grids are stationary, thick grid lines would obscure small vessels. 

Therefore, thin grid lines with a high number of lines per inch are usually employed. Finally, there should be a mechanism to simply remove grids for physics/x-ray service test procedures. This feature also allows the removal of the grid by the operator when air gap techniques are wont to geometrically magnify the pediatric patient’s small anatomy within the image.

Television System:-

Digital recording of fluoro and cine images is usually taken from the television System. Hence, the television system should be designed to provide appropriate image quality for these studies. Foremost, the television system for cardiac studies should exhibit minimal persistence of the images so that frame rates up to 60 fps can be accommodated. This feature is termed minimal lag and must be measured with a dynamic test, such as the spinning spoke patterns.

Digital Imaging Systems:-

The challenge with digital imaging is the sheer volume of digital data. Typical diagnostic cardiac catheterization procedures in adults involve the imaging of 5 to 10 runs of a 6 to 7-second duration each with 30 fps. Thus, each patient study contains 2000 or more images. The minimum specifications of a 512 × 512 matrix and a pixel depth of 1 to 1.5 Bytes (8 to 12 bits) to capture the transmitted x-ray intensity data result in each image and also the entire study containing about 0.25 to 0.39 and 500 to 750 Megabytes (MB) of information, respectively. 

While the improved spatial resolution of 1024 × 1024 matrix is preferred, the larger matrix size has the disadvantages of increased quantum mottle and/or radiation dose to the patient still the maximum amount larger data rates and total image data. The info acquisition rates for a 512 × 512 matrix are typically 7.5 to 12 MB per second which is adequate for 60 to 90 MHz; for the 1024 ×1024 matrix, the information rates would be fourfold greater. Bi-Plane Cardiac Cath systems double the information acquisition rates that will be handled. 

For these reasons, most current equipment utilizes the 1024 × 1024 matrix only at lower frame rates of imaging; whereas, the 512 × 512 matrix is routinely used for many clinical studies. The spatial resolution of digital systems is set by the image acquisition equipment (e.g., video system), the matrix size, and therefore the image intensifier FoV. Generally, the calculated spatial resolution is capable of half the matrix size/FoV in millimeters. For a 512 × 512 matrix with a 150 mm FoV, the calculated spatial resolution would be about 1.7 LP/mm. The 1024 × 1024 matrix size would increase the spatial resolution to about 2.5 to 3.0 LP/mm. while these values for spatial resolution are but cine film imaging, digital systems have improved dynamic range, image processing capabilities, noise suppression, and networking and have image storage/display advantages. 

Hence, many cardiac cath labs are utilizing digital cine image acquisition. Most current digital cine imaging is completed by digitizing the video signal from a high-quality camera. The analog signal from a piece of television equipment goes to a data converter (ADC) and so it’s transmitted to the digital storage buffer for temporary storage. In the future, one can expect analog television cameras to get replaced by CCDs which will directly acquire the image as a digital image. Moreover, the image intensifier and TV camera are also replaced by a right away radiation detector/imaging system in a very few more years; such systems are currently under development and testing.

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CATH LAB

The Cardiac Catheterization Laboratory, also known as the “Cardiac Cath Lab,” is a special room where doctors can perform minimally invasive tests and procedures to diagnose and treat cardiovascular disease. 

Surgery performed in a cardiac catheterization laboratory almost always involves small flexible tubes called catheters, which can be used in place of surgery to access the heart and blood vessels. 

The catheter lab has special imaging equipment that is used to view the arteries and check the flow of blood in and out of the heart. This information helps the care team diagnose and treat blocked arteries and other problems.

 CATH LAB

Cardiac Catheterization is Used to:-

• Assess or confirm the presence of coronary artery disease, valvular heart disease, or aortic disease 
• Assess myocardial function 
• Determine if additional treatment is needed (for example, interventional surgery or coronary artery bypass graft, or CABG, surgery

During cardiac catheterization, an elongated tube called a catheter is inserted into a plastic introducer sheath (a short hollow tube inserted into a blood vessel in the leg or arm). With the help of a special X-ray machine, the catheter passes through the blood vessel to the coronary artery. 

A contrast agent is injected through a catheter as it passes through the heart chambers, valves, and main vessels. This part of the procedure is called coronary angiography. Coronary artery disease is narrowing or blockage of the coronary (heart) arteries. After interventional surgery, the coronary arteries are opened, increasing blood flow to the heart. 

The digital photo of the contrast material is used to identify the location of coronary artery stenosis or blockage. Additional imaging procedures called intravascular ultrasound (IVUS) and fractional flow reserve (FFR), can in some cases be performed in conjunction with cardiac catheterization to obtain detailed images of the vessel wall. Currently, these two imaging procedures are only available in specialty hospitals and research centers. 

Using IVUS, place a miniature sound probe (transducer) on the tip of the coronary catheter. The catheter passes through the coronary arteries and uses high-frequency sound waves to generate detailed images of the inner walls of the arteries. IVUS produces accurate images of the location and extent of the patches. 

Uses FFR to pass a special wire through the artery and administer a vasodilator. This test functionally performs a very high-quality stress test on a small section of arteries.

Cardiac Cath Lab Procedures.

1. Cardiac Implant Closure Device:- The percutaneous closure of the patent foramen ovale (the opening between the heart chambers) is done using a special closure device connected to the catheter.

Cardiac Implant Closure Device

2. Cardiac Stent:- A small wire mesh tube (stent) is inserted into the blocked artery to restore blood flow to the heart muscle.

Cardiac stent

3. Cardioversion:- A catheter is placed in the heart to locate and map small clusters of heart cells that cause the abnormal rhythm. Send a signal along the catheter to silence the cells, which results in an abnormal rhythm.

Cardioversion

4. Catheter Ablation:- A catheter placed in the heart locates and maps the small groups of heart cells that cause abnormal rhythms. The signal is sent along the duct, silencing the cells and causing the abnormal rhythm.

Catheter Ablation

5. Coronary Arteriogram:- A coronary arteriogram is an operation in which a very thin catheter or tube is passed from the groin, neck, or arm through the artery to the coronary arteries that surround the heart. The doctor uses the catheter to inject a contrast medium into the blood of the coronary arteries. The dye shows up on the x-ray and highlights the coronary arteries. X-rays are called angiography. It’s an X-ray examination of the coronary arteries. The catheter is placed in the coronary arteries to evaluate the arteries and pumping chambers of the heart.

Coronary Arteriogram

6. Electrophysiology Evaluation:- A study to understand the origin of heart rhythm disorders. The small catheter enters the heart through the femoral artery or brachial artery and is used to test the electrical system of the heart. It can induce the patient’s abnormal heartbeat for diagnosis and treatment.

Electrophysiology Evaluation

7. Electrophysiology Syncope Study:- A test to diagnose the cause of syncope. While monitoring the ECG and blood pressure, the patient’s bed is tilted from a flat position to an upright position. Once the individual’s response is recorded, treatment can begin to prevent a recurrence.

8. Internal Cardioverter Defibrillator Implant:-  A small device implanted in the chest that can be used as a pacemaker or to generate a slight electric shock when needed to restore a normal heart rhythm.

9. Angioplasty:-  The healthcare provider uses fluoroscopy during surgery. It is a special type of X-ray, just like X-ray “film.” When the contrast dye passes through the artery, it can help the doctor find the blockage in the heart artery. This is called coronary angiography. 

10. Rotoblation:- Rotablation (Rotational atherectomy) may be a complex and also the most challenging technique in coronary intervention utilized in patients with heavy calcification in coronary arteries (hardened arteries) to deliver stents in position to enhance blood flow. it's essentially a drilling technique with the assistance of a special diamond tip burr, which rotates at a speed of 150,000 to 200,000 rotations per minute. This drilling technique clears the within of the arteries to assist pass the balloon and stent easily. The tubes or catheters employed in this method are bigger than the conventional catheter.

Cardiac Catheterization Risks

Cardiac catheterization is usually safe. But as with any procedure that involves getting into your body, there are risks. Your doctor will discuss the risks with you and will carefully reduce your chances of developing these risks. Risks may include: 

• Blood vessel perforation 
• Air embolism (when air enters the blood vessel; this can be fatal) 
• Allergic reaction to the dye 
• Bleeding 
• Thrombus 
• Contusion 
• Seizure 
• Kidney infection from dye 
• Stroke 
• Uneven or irregular heart rhythm (arrhythmia)

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