Any info on PBDS? - page 3

One of the head honchos at a local hospital (a BIG university-affiliated teaching hospital) is coming to our small community college to discuss with all of us nursing instructors the "merits" of... Read More

  1. by   rsharpe
    the results were in.... i rated at an experienced level... but failed the test itself. The hospital that i am currently working with uses the tool as it should be used, to find purported weakness and uses it as a tool to direct you to more inservice and training, not as a hiring or firing tool.

    The test itself has weaknesses:

    1. In real life, you do not have a specific 1 minute window in which to make a diagnosis and action plan. We as professionals, use all of our resources while attempting to assist our clients. We collaborate with fellow nursing staff, our doctors, our supervisors and the family/patient themselves in making a plan of treatment.

    2. You cannot use a standardized test to "grade" a nurses competency. Our experience is senority based, department based and environmentally based. It is normal to assume that nurses from large urban hospitals will see and experience more than those from a rural small town hospital. But that does not make them " less qualified to nurse their clients" than any other.

    3. Some people are simply put, poor test takers. We, and yes I include myself here, can verbally wipe the floor with a four point oh student in regards to my nursing skills, but I cannot sit and take a test to save my soul. Why?... who knows...

    4. Some hospitals take this test as a literal hire/fire tool, when in fact it was not meant to be designed that way. It simply met a JACHO standard that stated that hospitals needed a tool to test competency. All hospitals are required to offer education to its employees. This, I am sure at first, seemed an excellent way to provide for that. But never should it be taken as a way to hire new nurses.

    I am a seventeen year vet with excellent ratings on job performances on every job I have ever undertaken. I am eligible for rehire in all previous jobs. I have managed most of the past said employment opportunites in one form or fashion. I am caring of my clients and continually get written about to the directors for my attitude while caring for the patient and families i am blessed to work with . Where is that determined in PBDS?

    The test also didnt take into account that I had worked off one job, moved an entire household, bought uniforms for the current one and slept 1 hour because I had exactly four hours in which to get to the orientation in the first place. You can imagine how tired I was after driving over 200 miles and working a 12 hour shift the night before and trying to get to my new orientation.

    As a previous manager, do I still feel the PBDS is a useful tool? Absoluetly. But I caution managers and organiztions to use the tool as it was designed, as an evaluation tool only.

    I find it extremely unrealistic to hire/fire nurses based on this tool alone. I would also like to see the stats on how many of those nurses that passed, stayed with the hospital that tested them, what their job performance reviews were, and retention status -vs- those nurses that didnt pass.

    You would have to place them in experience categories as well to determine a realistic value.

    Wouldn't that make one heck of a research project. * winks*

    and just an aside note: when i went in to get my results, the instructor of the orientation asked me... R, were you asleep when you took this test? I mean, you recognized the problems, but your management made us laugh a little... It seems i was so tired that i managed the conditions in a very hilarious way. But the good news, is I am still currently employed and have been asked to manage a shift all within two weeks of being there. Scarey thought isnt it? from a nurse that isnt competent? Thank heavens the director worked with me at a previous place for 2 years and knows what a "workhorse" i really am in my profession. So do not get discouraged.

    And to the nurse that was asked to be moved to a new floor, i present this to you. What other reason, besides this test, was given? I would ask my manager the following questions.

    1. What was my last performance rating?
    2. Have their been any complaints from coworkers or patients regarding my competency?
    3. Did you have concerns on my performance prior to this test?
    4. May I have all the following in writing please?

    What that tells me, is that the manager is not competent to perhaps grade my performance in the first place. What does this make her look like?

    another aside and for KarenRn: when I asked to retake the test the next day ( after I had actually slept), I was told that the cost for testing travel nurses was three hundred dollars per test, six hundred for permanent.

    I cannot verify that, so you may consider it hearsay. But its a start. You can ask your education director at your local hospital what the cost is for testing new hires vs travel nurses.

    Travel nurses do not take the full test, only parts of it. So it makes sense.
    Last edit by rsharpe on Sep 24, '07
  2. by   EmmaG
    I was told that the cost for testing travel nurses was three hundred dollars per test, six hundred for permanent.

    That's when I'd be packing my bags...

    I took the test on my last assignment. My take on it is that someone who is a relatively new grad would have an easier time with the test. They tend to think in a linear fashion...first do this, then this, then this, etc.

    I'm not sure how to explain it, but I'm sure those with a few years experience will understand what I'm getting at... when a situation arises, there are numerous actions I will take, often simultaneously. I don't stop to think these through, because I have the experience to know what needs to be done. It's like driving... when you're learning, you consciously think about every move you make behind the wheel, while with experience, it becomes almost reflexive.

    I was instructed before the test that I needed to list ALL interventions in the order I would do them (and what orders I'd anticipate to be given), and give the rationale for each one. That forced me to stop and consider everything I would do, including those actions that have become automatic. Which I could do, but given the time constraints of the test made it pretty stressful. Does that make any sense lol?

    I passed, but was marked down on a couple of things. I disagreed with HER rationale for counting these answers as lacking. One was assigning priority to a diabetic with a normal fasting sugar. I said "medium", explaining I'd administer the am insulin and then make sure the patient ate their breakfast. She said it was "low", not considering the fact that if the patient didn't eat, it could quickly become a "high priority".

    The other comment she made gave me flashbacks. Regarding a patient with tumor obstructing her ureters and blocked nephrostomy tubes; while my answer consisted of determining patency of the tubes, administering pain meds, alerting the doc, preparing the patient for an emergent CT and replacement of the tubes, she said I should have offered "diversion techniques for pain control" and "allowed the patient to vent".

    "I know your kidneys are blowing up to the size of watermelons, but let me dim the lights, put on some soothing music and you can tell me how you really feel"

  3. by   caroladybelle
    The reason that some places use it is because MDs don't want to bothered about "useless" issues, and in community hospitals, the MDs do not routinely report off tto each other.

    Which means when you page Dr. X in the night, chances are he doesn't know squat about the patient, and you have to spoonfeed him the info along with the orders that you need.

    Yet these same MDs will get ticked at the DNP or NPs at "Usurping" MD practice.
  4. by   oldnurse1990
    Pure and simple, it's a management tool.
    If your hospital wants to start you out as uneasy so that they have power over you, then they do it. There is so much puffiness coming out of the proponents, and no real research to back it up. Listen to what they say and how they say it--every time. It's the "I'm a great nurse and want to cut out all of the weak ones." attitude. Little do they know about real leadership and staff development. When are nurse educators going to understand that they need to build confidence in people, and if they need to learn more, confidence is the basis they should start with. People don't learn well when they are depressed about how they are treated and feel inferior. People learn well when they are treated with respect.
    I've come across this too often, even from PhD nurses. One would think they would rely on evidence, but they don't. It's just their "feeling" of tough nurse/weak nurse: a borderline personality dichotomy that should be fought against. These are the old school "bully" nurses. That attitude needs to die a hard death. Listen to what first year nurses say and are still saying today. They are put in danger and the patients in danger (when there aren't supportive leaders) to learn and need all of the help they can get and helpful attitudes they can get.