PBDS casualty

[ring4tx]

:imbar I am a recent casualty of PBDS. This is an insane way of getting rid of good nurses with valuable experience! Why weren't we in formed that this part of orientation was "do or die"? They said it's not supposed to be used as a means to get rid of any one, but after I failed the initial test, I became scrutinized. The nurses that were my preceptors were no help at all. I was told that if I chose to take the re-test and failed, that I would be "black-balled" as a nurse.

I used my nursing books for reference as well as my Internship notebook as tools to fill out the scenarios and was told it wasn't good enough. When I filled those out, I wrote on front and back and literally wrote a book on the darned thing.

I've had nothing but good things said about me during my whole medical career.

And now, suddenly it's implied that I'm "not up to their standards". So, I find myself in the job market again and I'm sure PBDS will raise it's ugly head. At least this time, I'm more prepared for it.

[bagladyrn, RN]

PBDS has been around for 25 years. Used by about half of all magnet hospitals & hospitals all over the nation.

It is different from any of the other 'tests' that have mentioned by previous posters. It has NO 'forced choice' questions (true/false, multiple choice, matching, etc). All responses are completely free text, right from the nurse's brain. Responses are then rated by a human being. In our case, we have raters who underwent a year of training by PBDS in order to become competent in the qualitative analysis methods that have to be used. Anyhow - results are intended to be used to customize orientation. It helps us avoid wasting time on things that the nurse doesn't need. Our preceptors have been trained to apply 'socratic' techniques that promote critical thinking instead of the old 'show me how" orientation process.

We have data - tons of it - that shows PBDS makes a huge difference in overall nursing comptency & patient outcomes. It is an established part of our overall Risk Management / Clinical Quality program.

Using PBDS for travelers can be problematic, depending on how the travel company has arranged it. They know up front whether a hospital uses PBDS or not, and they need to convey accurate information to the travel nurse so they are not taken by surprise. Travel nurses are expected to hit the ground running, without any additional development at the expense of the client hospital.

There are no 'study guides' for PBDS. The most important part of hte assessment consists of 10 short videos (3 to 5 minutes). You will watch the video and respond to:

1. Identify the patient problem - just one, don't list everything that could possibly be wrong. Stick with the most obvious one. The videos aren't tricky. Include info about why you think this is the problem.
   
2. Explain how you are going to manage the problem - specific interventions. They don't have to be in order, but be sure to insert some words that indicate how you are going to prioritize them
   
3. Explain why you are choosing the interventions... what is your thought process?

Remember that your responses will be read by a human being. Make sure you include everything - the raters do not have crystal balls to infer what you meant. So, for example - rather than write - "notify MD", you need to write "notify MD of elevated BP & increasing drowsiness" . You don't have to write a book, just don't omit details that indicate what you are thinking.

Travel nurses will be assessed using the PBDS baseline for the unit in which you are supposed to work. If you do not have sufficient experience in that area, it will definitely show up in the assessment.

Relax, the vast majority of our travel nurses sail through PBDS without any problems. You don't have to be an expert. Just show that you can react appropriately to keep the patient safe.

No, this is NOT an unbiased test. I have taken it several times and passed it each time,(mainly because I know how to "answer to the test, not reality") but will not take a contract requiring it again unless it is in my home state.

The test is evaluated based upon your years of experience, so this is why new grads tend to pass more than experienced nurses - the expectations are lower. There are two ways the test can be graded - either by being sent to the PBDS organization or it can be graded "in house", so no real consistency in evaluating. Experience is no assurance of passing this test - I know of good nurses with many years of experience who do not do well on this and it is NOT a reflection of their ability or knowlege!

I firmly feel that if a hospital wants to use this as a pass/fail for travelers, it should be offered in a proctored setting at their home area - before they have spent the time, money and energy to drive thousands of miles to an assignment.

Many of the people administering the test, usually HR people, are unaware that it is an elimination test for travelers. I've explained this to several after I passed the test (so they would understand that the objection was not "sour grapes") and let them know that many good travelers would bypass their facility simply on the basis of this test.

There are sites which do give some good information on the test, not posted by the PBDS organization. Try doing a search on PBDS as I don't think I can post the sites here.