VANDERBILT PROFESSIONAL NURSING PRACTICE PROGRAM Interview Questins fr Registered Nurse 3 and 4 Candidates CANDIDATE NAME: INTERVIEWERS: INTERVIEW DATE: Applying fr RN 3 RN 4 QUESTION KEY INDICATORS (example(s) must include) PLANNING & MANAGING CARE 1. Tell us abut a cmplex patient/case r family yu have cared fr, what yu did, r direct anther t d, that significantly impacted the utcmes in this situatin. Prvides leadership in cmplex clinical (3-4) /peratinal (4) situatins Cnsults n clinical prblems (3-4) Initiates cnsults fr anticipated prblems (3-4) Practively manages care t avid adverse utcmes beynd what a cmpetent nurse wuld d (3-4) OR Nurses Demnstrates knwledge f patient histry & uses infrmatin in implementatin f intra-perative care Situatin/task Respnse apprpriate fr RN2 RN3 RN4 Page 1 f 9
PLANNING & MANAGING CARE 2. T ensure the success f VUMC, it is the respnsibility f every emplyee t participate in identifying pprtunities t reduce csts. Describe what yu have dne t ensure r imprve cst effectiveness (r cst/case) in yur area (beynd what is expected f everyne). Mnitrs and adjusts resurce utilizatin fr individual pts. (2-4) Identifies prblem/need & participates (3) r leads* (4) change prcess (usually an area-wide measure rather than fr an individual patient). Examples: RN 3 Evaluates & recmmends changes in par levels & evaluates results (3 4) Develps trays fr area-specific efficiency needs (3/4) Ex. Suture remval tray n carts-> trays being pened just fr scissrs > nw have separate stck f scissrs Develps Guide fr (case) fr OR use that assists staff t knw best prcess as well as supplies fr prcedure (in additin t preference cards) r ther cmparable peratinal prcess change (3-4) Manages time/ helps thers manage time; sees big picture beynd wn assignment & practively cnsults with CN re staffing fr acuity & apprpriate assignments (3-4) Ex. Assign prjects n unit that need t be dne during dwn time Ex. Maximize hw ancillary staff are used t facilitate patient care RN 4: abve examples + Uses data t evaluates results f changes lead/initiated & cnsiders if apprpriate t share with ther areas (4) Evaluates prducts/supplies fr cst effectiveness (4) (Ex. develp evaluatin tl fr new/changed prduct pilt) Nt acceptable fr RN 3 r 4; all RNs shuld be Remving extra supplies frm patient rms Decreasing lab draws Flexing staff ff/n fr census/acuity (when in charge) Situatin/task Respnse apprpriate fr RN2 RN3 RN4 Page 2 f 9
PLANNING & MANAGING CARE/ CONTINUUOUS LEARNING General applicable t RN 3 & 4 Evidence-based practice - use f research t influence practice 3. Evidence based practice must be cntinually verified and updated. Tell us abut the mst recent research yu have RN 3: applied that either verified r challenged yur practice. What as a resurce did yu d with this new change wn practice infrmatin? What new evidence based infrmatin have yu learned in the last 6 mnths and incrprated int yur practice? Surces might be research article(s) site surce, runds, seminars, cnferences, benchmarking, etc. Shares new research infrmatin in practice area and Applies research findings t guide, validate and/r Demnstrates awareness f research underway in PCC RN 4: All abve and Takes lead* in implementatin f a practice change based n research findings Uses infrmatin t initiate and fllw thrugh with a practice change fr practice area. Cnsiders if practice change is applicable beynd area and shares when apprpriate Uses data t evaluate changes lead/initiated * When eval is incmplete at time f interview, make nte t add expectatin fr cmpletin t manager ntice f advancement Situatin/task Respnse apprpriate fr RN2 RN3 RN4 Page 3 f 9
CONTINUUM OF CARE PLANNING 4. Talk abut a patient in yur area with cmplex discharge (r transfer t next level f care) needs and tell us abut hw yu met r cached thers t meet thse needs. Situatin/task Plans frm an in-depth knwledge f disease and recvery prcesses (3-4) Uses resurces beynd the usual and custmary (3-4) Mdels(3)/mentrs (4) thers; i.e. RN 3 acts as a resurce & caches when asked; RN 4 initiates caching/mentring thers t facilitate their develpment in COC planning Examples f referrals Beynd usual and custmary (that demnstrate an in-depth knwledge) are area specific all practices d nt use the same cmmn resurces PT/OT/Speech TDS (Dnr Services) Dietician THP (Highway Patrl) Family Resurce Center Metr PD SW Supprt grups Bereavement Services Ldging Patient Affairs Pharmacy Case Management Child Life Services Hspice Wund team Taxis Pastral Care Language interpreters Davidsn Cty Sheriff Dept Internet resurces (infrmatin & netwrking with thers with same issues) Pharmacy reps with instrumentatin sales equipment Emergency funds Red Crss direct dnr setup Air transprt Tennessee Early Interventin Services (fr develpment/learning delayed) NMDP Natinal Marrw Dnr Prgram Any resurce utside unit (i.e. nursery, medical library) Shriners Hspital referral Hme schl Lin s eye bank (t secure glasses) Embassy wrk (4) Mentring/caching rganizatin care cnference; crdinatin f multiple resurces (4) TDS (if it is an anticipatry cntact) Palliative Care Services Respnse apprpriate fr RN2 RN3 RN4 Page 4 f 9
PATIENT AND FAMILY EDUCATION Operating Rm Nurses are exempt frm patient and family teaching: mit this questin LifeFlight Nurses are exempt frm patient and family teaching; LF shuld reprt their invlvement in cmmunity educatin, EMS, and/r referral hspitals emergency practitiners educatin. 5. Describe a challenging patient/family educatin situatin. What did yu d r cach thers t d t prepare the patient/family fr the prcedure r fr discharge? + Discuss any alternative educatinal resurces yu have used with a patient. Give an example f a nn-cmpliant, resistant r cmplex patient r ne with significant barriers t learning and then hw yu vercame/tried t vercme the challenge(s) Barriers t learning Language/cmmunicatin barriers ther than freign language Educatin barrier (cannt read/write, slw learner, distracted by pain) Lcatin barrier (i.e. hmeless, distance) Resurce barrier (n family, mney) Cmpliance barrier (des nt fllw regime) Psychlgical barrier Emtinal r cultural barrier One example situatin: Cmplex wund requiring dressing changes at hme. Pt will have t be taught. Family nly visits spradically. Pt very anxius/fearful f dsg change. Limited financial resurces. Describe alternative strategies used (beynd patient educatin printed materials and EZTV) RN 3 standards: Rle mdels & is a resurce t thers fr cmprehensive teaching Develps an individualized teaching plan Evaluates utcmes Revises as apprpriate based n utcmes RN 4: Cnsults and leads* team in develping, evaluating, revising pt/family ed. materials Identifies need fr and develps r revises materials (cllabratively) Cnsiders pssible applicatin t r impact n ther areas and cllabrates with and/r shares when apprpriate Situatin/task Respnse apprpriate fr RN2 RN3 RN4 Page 5 f 9
PROBLEM SOLVING 6. We are all bligated t find a slutin t any prblem a patient r family member may have. Many times these prblems are clinical. Describe a time yu were a resurce t anther (cmpetent) team member dealing with a cmplex clinical prblem. Addresses cmplex patient (3) /systems (4) prblems Facilitates prblem reslutin (3-4) Leads* thers in prblem slving prjects (4) Situatin/task Respnse apprpriate fr RN 2 RN3 RN4 Page 6 f 9
PROBLEM SOLVING & COMMUNICATION/COLLABORATION 7. Think abut an utcme in yur area where yur leadership made a difference. What specifically did yu d t influence that utcme? Situatin/task Examples: RN 3 Participates in develping/revising standards Mdels & is a resurce t thers fr effective cmmunicatin/cllabratin Precepts new nurses, huse staff, students RN 4 abve + Leads* in develping/revising standards Mentrs thers in effective cmmunicatin/cllabratin Mentrs new preceptrs Acts t reslve actual and ptential systems, knwledge and behavir issues Respnse apprpriate fr RN2 RN3 RN4 Page 7 f 9
COMMUNICATION & COLLABORATION 8. All f us have experienced cnflict r at least a difference f pinin with anther. Tell us abut a time yu had a difference f pinin/cnflict at wrk, describe the situatin and exactly hw yu handled it. RN 3 & 4 Manages differences f pinin independently and directly Apprpriate time, manner, place Privacy, private place, deals directly and keeps within need t knw grup nly Cntrls emtins; desn t escalate; cls dwn first if necessary Listens t understand ther s pint f view/psitin Clarifies prblem cllabratively Clearly defines prblem frm all perspectives befre prblem slving Hnest/uses data Differentiates difference f pinin frm cnflict Tries t understand wn and thers reasns fr their psitin Des nt just qute plicy, but explains why Lks fr anther way; explres ptins t find cmmn grund cllabratively Restates and cnfirms agreements Fllws up t ensure reslutin If ging up chain f cmmand, tells persn yu are ging t d s RN 4 Facilitates and mentrs cnflict reslutin fr thers Situatin/task Respnse apprpriate fr: RN2 RN3 RN4 Page 8 f 9
CONTINUOUS LEARNING 9. Describe hw yu have been invlved in the quality imprvement prcess f yur clinical area. RN 3 - participates Identifies issue r participates in wrk n an already identified issue Cllects data (RN 1-4) Decides n apprpriate actin (cllabratively) & implements Disseminates infrmatin re change within affected area Evaluates change Assess if change achieves gals RN4 as abve and May lead* prject Leads = takes a leader rle, may c-lead, act as the champin, cmmitted t see prject thrugh; may seek help and/r cnsult with available resurces re prcesses, systems t navigate t achieve Evaluates change(s) Uses data driven prcess fr evaluatin And fllws thrugh What did yu d with eval results? Cnsiders the applicatin f this change r its impact n ther areas -> cllabrates/shares as apprpriate (e.g. Practice Cmmittee, Crssrads ) Nt acceptable fr RN 3-4: Once change has becme a standard f practice in the practice area, i.e. via staff meeting, Unit Bard, preceptr, manager, r cmmunicatin bk; and/r smene else initiated the change it is nt acceptable as yur quality imprvement initiative Examples: Stpped using markers n IV bags Use f O2 t decrease pain Situatin/task Respnse apprpriate fr RN2 RN3 RN4 *RN 4 must demnstrate leadership in research (# 3) and at least 2 f 5 ther areas. See questins #2, 3, 5, 6, 7, 9 fr specific areas. Vanderbilt University Medical Center, Department f Nursing Page 9 f 9