Competent???

Adrena · Nov 8, 2001

We had to do this at our hospital as well *prior* to interviewing although they stressed to us that it didn't matter how we did, the purpose was to gear our orientation to areas that we may be lacking in. The thing is, orientation consists of buddy shifts and that's it, there's no "gearing" it anywhere. Can you tell I'm being sarcastic?

Agnus · Nov 8, 2001

it didn't matter how we did, the purpose was to gear our orientation to areas that we may be lacking in.

The thing is, orientation consists of buddy shifts and that's it, there's no "gearing" it anywhere.

Boy isn't that one familiar. Please, this stuff just makes me sick. It's all just pure BS.

ovr40 · Nov 8, 2001

Thanks to all who have replied! It has helped immensely to see I am not all alone out here! The nurses I work with have rallied me also. Which feels wonderful:D Some of the doctors, especially the ones who are very vocal about nursing, have spoken to me in a positive way. So, I will jump thru their hoops and play their game and get thru this somehow. But I agree with Jay, this is just another BIG reason why nurses need to unite and stick together and quit letting administration CONTROL us and keep us under their thumb. I am soooo glad I found this forum. I feel much better, thank you all so very much. I have run the gamut on emotions these last two weeks and its not over yet! thanks;)

mustangsheba · Nov 8, 2001

When I started nursing school, I had worked assisting MD's for over 15 years and it was difficult for me to switch my thinking into nursing mode. That experience gave me a distinct awareness of the differences in nursing and medical scopes of practice. I haven't experienced these tests personally, but from what you all describe, they sounds way out of line. When the line between medical and nursing scope of practice gets fuzzy, it puts everyone, including patients, in jeopardy. We need to unite to bring this BS to a screeching halt. Somebody out there is probably making a bundle for this little idea. Does anyone know who that somebody is?

CATHYW · Nov 8, 2001

this absolutely stinks!

i can't imagine what bored administrative person, committee, or company would think up such an impractical waste of time!

ovr40, i am well past 40. it sounds as though this test doesn't take into account the fact that, of course, you know you are supposed to call the dr., but in the meantime you are thinking of your patient, and planning the intervention that will keep them holding on until you can get the md on the phone. plus, working icu, i'll bet you are used to standing orders for certain situations, titrating drips, ordering x-rays, etc., and having some data ready when the md calls/arrives. those kinds of tests do not take that kind of knowledge and expertise into account!

just because some sweet young thing (male or female) can answer the scenarios correctly does not necessarily mean that they can handle an actual crashing patient scenario! (don't rag on me folks, i was young once, and loved it, and was a young nurse once, and hated it!)

when i first started in the er, we had a patient crash and code. we got him back. i was the primary nurse, but we had a roomful of people helping. the dr. was calling out orders for all kinds of pushes, drips, etc. when we got finished we had 7 iv's hanging, on pumps. the dr. had ordered the initial doses of meds and then told us to "titrate to effect"-that would be bp, cardiac rhythm, urine output, clear lungs, etc. i got to the icu with the patient as quickly as another 2 nurses and i could get on and off the elevator and down the hall with 7 iv pumps and the patient intubated, and being bagged. we were hot and sweaty from working the code and rushing around so. the icu nurse, spotlessly clean, and with calculator in hand, began to question me as to how man mics /cc's each of the iv's was running at. i looked at her, and told her that i had not been responsible for each of them, that several nurses had assisted, and that they were titrated to effect, by order of the er dr. she looked at me like i'd said dirty words. i told her we'd get him squared away in his bed, and then we'd look at the pumps. she haughtily told me that she had to figure out the pumps. my fellow er nurses and i looked at each other, and moved the patient onto the icu bed. i tried to give report to this girl as we were doing it, and she just ignored me. resp. therapy came and began hooking the man to a vent, and we 3 nurses from the er split. she called er to report me, but everyone there had been involved in the code, and the all stood behind me, and wouldln't take her complaint seriously.i said all of that to say this: we all know that "book learning" is essential. however, book learning should never get in the way of actual patient care! we are all taught the correct way to do things, but sometimes you have to detour, or take a different route to get there. knowing how to do that is called experience!

if your institution wants to adequately assess what the competency of their nurses is, they should have their nurse educators work in each department, and work each shift, observing and questioning folks as they work. they will immediately be able to see who is competent and who is not, and who needs remediation! that is, if the nurse educators are experienced and objective! :confused: :eek:

i guess that you can tell i am hot about this-it absolutely is not right to denigrate nurses under the guise of assessing them. aaargh!

and, ovr40, i absolutely would talk with an attorney about age discrimination/sexual discrimination for that manager cracking on you about menopause! sic 'em girl, and hang tough!:)

VickyRN, MSN, DNP, RN · Nov 9, 2001

There seems to be a tendency in this nation to competency test just about everything and everyone, which isn't necessarily a bad idea, it's just the way it's being done. In my illustrious state, 5th graders in the public schools are being "competency-tested" before they can move on to 6th grade. (I guess the fact that we're 48 or 49th in the nation with SAT scores--they had to do something to save face.) The tests are a joke, and the beleagured school teachers end up gearing their whole year towards the stupid test (no more room for creativity and fun in the classroom). Sorry to digress...

What makes me so incensed is that these so-called NURSING "competency" tests are based on the MEDICAL MODEL!!! The PBDS thing seems to be catching on, with hospitals comparing their scores (our unit scored "low" compared to the "national average"). Who has had the audacity to think up these rigid tests, with their narrow-minded applications, written from a MEDICAL PERSPECTIVE, and then use them to judge nurses with YEARS of experience. Who developed these tests and what standards did they use? Are they research-based and proven to be an accurate standard of competency? These are compelling questions to which we must demand an answer. And yes, we had better get control over our profession before it is too late. Since our economy has turned sour, it is possible that we will lose any advances we have made in the past few years. This new testing system is NOT a good sign :(

VickyRN, MSN, DNP, RN · Nov 9, 2001

Check out this website. Its content is VERY INSULTING to the profession of nursing. I am very alarmed at the wording and also their self-anointed power to declare who is COMPENTENT and who is not ACCORDING TO THEIR OWN STANDARDS. Arrogance gone to seed!!!:

http://www.pmsi-pbds.com/

PERFORMANCE MANAGEMENT SERVICES, INC.

PBDS IS...

The competency solution to bring you into the next century

The system of choice for over 300 hospitals

The only system of its kind to reliably assess and validate employees' ability to do the job

A system designed to facilitate work redesign, improve productivity, and prevent and reduce risks related to competence / performance

A system that is driven by patients and customers' needs

For information, please contact us at: (714) 731-3414

H2obabe54 · Nov 9, 2001

Especially noted to OVR40: the "test" that you were given is being treated as if passing is a requirement for your continued employment by your employer. The response of your employer to "remediate" your nursing knowledge appears to have caused you a great deal of mental (and possibly physical, as well) distress, to the point where you are questioning your own competency and abilities. You may have cause for legal action, including workers compensation coverage for counseling, discriminatory action against you, and more. I strongly sugest that you contact an attorney to discuss these concerns and your best response to these "threats" against your continued employment in this facility, self-esteem, confidence, and your proven ability to practice nursing in a safe and competent manner. Best of luck! Employers do not have the right to use punitive remedial action in response to a non-practice based error during orientation. This is the face of discrimination.

RNforLongTime · Nov 9, 2001

My first hosiptal job 4 years ago used the PBDS system--we had 4 days of this! As far as I can remember, I did pretty well in most of the scenarios, I didn't pick up on some obscure diagnosis. They then expected me to look up the correct information and return it to them---well I never did and I worked there for 3 years!

It was very stupid and didn't really test my knowledge base. How am I supposed to "guess" what is wrong with someone given only 45 seconds worth of information!

Good Luck

lever5 · Feb 13, 2002

PBDS is not research based, It first appeared as Baxter's test. I have not been able to find out any information on this. Dorthy Del Bueno came up with the test in the mid 80's. She had geared the literature to appeal to the management. (how much money they might save by using this test) This is why non-nurse accountants are backing this. There is one article (study) done by someone else on the PBDS and the rest are written by Dorothy.

The articles are not peer reveiwed. She is a Phd, but she is also a partner in the company that distributes the test. So "does this mean the license is not a reflection of being a competent nurse?"

I came in to a facility that uses PBDS as a traveler. Another traveler (who did not feel good) took the test with me. We both failed, the facility has their rules. We were allowed to repeat the test after one more days orientation. Meanwhile, no pay from our companies. The other travelers checks started bouncing, she got sicker,..... we repeated the test, I do not know how she did but I passed. Oh, if you fail your out. Fired, kaput. I do think there is something illegal about drawing nurses to your facility, signing a contract with them, putting them in debt, and then not giving them the job. What do you think? :confused:

hoolahan, ASN, RN · Feb 13, 2002

BRAVO Cathy Wilson!! I LOVE what you said in blue!! How can they ever test that kind of competency???

I have no experience with the pbds crappola. I doubt it will ever come to homecare either. We already have to deal with the OASIS, the cursed 30+ page admission assessment for the gov't. That is bad enough everyday!!

Daveddrn · Feb 23, 2006

I agree with what you have all said RE: Performance Based testing. Does anyone know where I can find anything to use in order to prepare for this nonsense????

daveddrn