How would you have answered this interview question?

Sounds like the interview question is designed to see if you'd address the 3 problems, by priority

1. pain

2. neglect

3. irate family member/dissatisfaction

I assume that 2 and 3 are being treated as the same problem

~faith,

Timothy.

Pain med first, then deal with the family. Your patient's care and comfort are your first priority, always.

In the scenario, rather than giving the family the supervisor's name, I think I would have called the super to come talk to the family right then, to try and de-escalate the situation.

I agree deal with the pain and evaluation of the surgical site first. Then I would deal with the family by involving the super or charge and then document everything.

They interviewer understands that you are a new nurse, so please don't fret about possibly sayign the wrong thing. There are many other units in that hospital and every state has hospitals in pretty much every city. You learn by trying. Don't worry. I have answered some questions pretty badly and still had job offers.

Thanks for all your responses!

I would do this:

Ask the family member to leave so I can do a quick assessment on the patient. Check the chart and make sure the patient CAN get the medication (right order, time, dose etc), and check their vital signs to make sure their BP isnt too low etc. to make sure they are OK to get the med they are ordered. As soon as possible after that I would give the pain med and make sure the pt himself is comfortable, set up with call bell etc and let the family member in. I would then let the nurse manager know that there is an angry pt and family member. Document in your notes what happened. If the fault is due to the previous shift, then an incident report may need to be written up.

Generally these questions you can never answer exactly right. They want to get you thinking. If they say you are wrong about your order of things, then at least have some sort of explanation for why you would do that before the other thing etc. to make it sound like you are knowledgable. Then admit that yes, they are right, you would absolutely do it their way, blah blah blah. And state out loud what the point is they are trying to get across. Pain needs to be addressed. But you shouldn't give a medication to a patient you've never assesssed... so if you are walking in first thing that is important.

Sorry for the long answer... good luck anyway!

When entering the room your eyes should direct to the patient first. I would assess the patient, intervene with something for pain even if I needed to call the md for a 1 time order and have the secretary call the nursing supervisor to meet you on the unit to discuss the situation for family intervention.

Good luck...

Good answers! I would also check around the ORIF for signs of compartment syndrome.

"You come on shift. You receive report. You check on your patient with ORIF. The lights are off in his room. He's agitated and states pain 10 on a scale of 10. He's sweating and (some other symptom related to pain....can't remember). He says he's been pressing the call button all night long. He says someone came and turned off his light but did nothing else. His call button is stuffed under his pillow out of reach. Family member has just come to visit and is irate demanding to know your name and who is your supervisor, yelling "heads will roll"!

OK, to be fair, I never looked at anyone else's answers because I didn't want to be influenced by them, so if this is a duplicate or supremely wrong, forgive me.

Now that I've read it, I can easily see that this is a very familiar scenario, one that I dealt with as follows:

I stopped the relative in her tracks by saying, "I'll give you all the information I can in just a few minutes, because right now, this minute, I am going to get this man some pain medication." Turning to the patient, I'd say, "I'm going to get you some pain medication right now, and AFTER I medicate you, you can tell me what happened, but first thing you need is some relief."

I would then go check the chart and with any luck at all, the patient may have some pain medication. If the order was insufficient and the patient had to wait at all, I'd call the doc for a breakthrough pain order, and then go into the room and explain the situation to them while I had the cell phone in my hand waiting for the callback.

Usually, the family and the patient really will jump the staff until the pain med is given--and they have every right to be upset--then after it's given and the patient is getting some relief, they usually calm down and can talk about what happened rationally.

That's when I can try to sort out what happened, and offer an explanation or two, and show them the charge nurse's and manager's phone numbers posted on the wall if they'd like to discuss it further.

Hope that helps.

oooh, & if you do fill out an incident report.... NEVER document that in your notes...

Assess, medicate, then make the mad people happy.

I remember an interview question when I was a new grad where i was asked to prioritize ten items in order of how I would handle them. Part of the correct answer was that you didn't freeze up, that you were able to answer the question and defend your answer. Can you think on your feet...

In real life, its always patient care first. I have said to irate family members as I'm simultaneously checking out the patient and getting ready to get them a pain med if available, that I can either help their beloved or I can talk with them. Which would they like me to do first?

Smile, it does gentlely slow down the family and makes them think...