Had my first intetview, think I bombed some questions. Pick my answers apart please!

[Kam999]

So I am a new grad interviewing in a new grad position in an ICU. Overall I said most of the things I wanted to say, but a few questions just outright stumped me:

Question 1) You see a colleague (nurse) breaking sterile technique on their patient while doing a dressing. What do you do?

My answer: I would ask to talk to this colleague immediately, out of earshot of the patient. I would clarify the situation and tell her what I saw. I would offer assistance to help get supplies to re-establish the sterile field.

Then here's the twist: Then the "colleague" completely denies there is any problem with their sterile technique. What do you do?

My further answer: I said that I would state my concern to the nurse due to patient safety and infections. And that if the nurse continued to deny there was a problem, I would go talk to the charge nurse about my concerns due to patient safety. I wasn't sure if the nurse manager was more appropriate.

Question 2) Your charge nurse asks you to pick up another shift RIGHT AFTER your current one. What do you do?

Answer: I thought that this question had to do with patient safety. I stated that I would evaluate my ability to work another shift, and practice safety under my level of exhaustion. If I found out I was able, I would take the shift, as long as I am in line with the regulations of the hospital and regulatory authority.

Question 3) Your patient has a slightly elevated temperature shortly (a few hours to a day) shortly after abdominal surgery. 3A) What would you do; and 3B) What are the possibilities of what might be going on?

Answer: I totally bombed this one and drew a blank. I wasn't sure if this was a normal finding post-surgery, or whether this was pathological and indicative of infection/sepsis/ complications. Could anyone point me to any resources regarding generic assessment findings post-OP? Or just shed some light on this question?

[Lev, MSN, RN, NP]

Question 1) You see a colleague (nurse) breaking sterile technique on their patient while doing a dressing. What do you do?

My answer: I would ask to talk to this colleague immediately, out of earshot of the patient. I would clarify the situation and tell her what I saw. I would offer assistance to help get supplies to re-establish the sterile field.

Then here's the twist: Then the "colleague" completely denies there is any problem with their sterile technique. What do you do?

My further answer: I said that I would state my concern to the nurse due to patient safety and infections. And that if the nurse continued to deny there was a problem, I would go talk to the charge nurse about my concerns due to patient safety. I wasn't sure if the nurse manager was more appropriate.

This seems like the right response to me. Always go up the chain of command and try to remove the patient from harm, if possible.

Question 2 Your charge nurse asks you to pick up another shift RIGHT AFTER your current one. What do you do?

Answer: I thought that this question had to do with patient safety. I stated that I would evaluate my ability to work another shift, and practice safety under my level of exhaustion. If I found out I was able, I would take the shift, as long as I am in line with the regulations of the hospital and regulatory authority.

The other issue is that it's not legal for an employer to make a nurse work more than a certain number of hours in a row. 16 hours is pretty standard. I would let the charge nurse know that I am working the shift before and depending on my schedule and how much of a need there is I may offer to stay on for 4 hours.

Question 3) Your patient has a slightly elevated temperature shortly (a few hours to a day) shortly after abdominal surgery. 3A) What would you do; and 3B) What are the possibilities of what might be going on?

Answer: I totally bombed this one and drew a blank. I wasn't sure if this was a normal finding post-surgery, or whether this was pathological and indicative of infection/sepsis/ complications. Could anyone point me to any resources regarding generic assessment findings post-OP? Or just shed some light on this question?

An elevated temperature due to trauma and inflammation can be a normal finding after surgery. Atelectasis can also cause an elevated temperature after surgery. Encouraging the patient to ambulate, cough and deep breathe, and use their incentive spirometer will be helpful. Monitor for any increase or decrease in temperature.

[nurseprnRN, BSN, RN]

If you observe a breach in sterile technique you have to intervene right then to protect the patient. You can say, "Your glove isn't sterile there, it touched the sheet," or whatever. You cannot allow a procedure to continue if it's not safe. You have to speak up immediately. Don't ever, ever let your fear about what somebody's going to think about you override your duty for patient safety.

Lev

Generally, though, you would report a temp >38.5C or so, and simultaneously keep watching it every hour, doing the cough-and-deep-breathing thing, and checking any other indications of infection postop. Trends are generally more important than numbers, although of course some numbers can make you sit up and say boy-howdy and you don't need to wait and see which way they go.