jonorato

I STRONGLY recommend this site for practice on how to answer behavior based interview questions: The Master Guide to Behavioral Interview Questions

i would say to those of you that are granted interviews to look over duke's nursing core values. if you can think about what those values mean to you, and how you embody them...you should NAIL your interview. Don't just know what is on this HR handout, really think about how you have/or will embody them as a nurse. Think of good short examples that you can give to how you represent them. They won't ask you directly, "how do you act with integrity?" but maybe something along the lines of "tell us about a difficult situation and how you handled it" excellence - "when was a time you went above and beyond?" The questions are BEHAVIOR based. And your answer does not have to be nursing specific. Maybe you had a difficult table you waited on in a restaurant...how did you handle it. A coworker who said they would do something for you and then didn't. What did you do about it? What was your reaction? https://www.hr.duke.edu/managers/performance/DUHS/forms/Living_our_Values.pdf Have good questions ready for your unit. ex) what's one thing your unit is working towards improving (maybe a EBP or CQI project they have going on). What are you most proud of your unit for? What's one thing you would change? you could easily extend this question out to the whole hospital system... You would be surprised at some of the honest answers you get. I walked away from one unit going, "not on my life would I take a job there" and another going, "Whoa. They're really impressive!" And above all, be HONEST! I got asked in an interview how I take criticism. I straight up told them that I feel anyone who gets helpful feedback probably feels a little sheepish/embarrassed at the bare minimum at first. No one ever wants to be corrected. But I can still hear what they're saying, put my ego aside, take correction w/out holding a grudge or taking it personal & apply what they said to my practice.

i do. i think i just needed to put it out into the echo chamber of the internet. ty

I'm a new grad nurse on a BUSY Cardiothoracic Step-down unit. My 4th week of my 8 wk orientation I started falling apart d/t stress. I had to take an EKG rhythm interpretation class over 8 hrs (self taught on the computer) on a Friday, worked a 12 Saturday (it was a rough one where I was running all day), had Sunday off to study, and then had to take my EKG test on Monday. I did not feel prepared at all. I only learned sinus rhythms, afib, a flutter, VT, and Vfib in school. There was a lot of material to cover. I didn't miss any of my lethal rhythms on the exam, but I missed 1 Q too many...so I failed. Which is fine. I just need to remediate and meet with my CNE in 2 wks to confirm that I do know the material. So now I have plenty of time to study. But after I saw the "fail" on the screen pop up, I just broke down. I sobbed in my CNE's office for 40 mins. She was very supportive. We identified that I was actually about 1 - 2 wks farther along in my orientation skill wise (I came to the floor with a lot of experience). We identified my main points of stress are the classic "time management" and learning how to delegate so I can start concentrating on POC. She pointed out that I was taking on too much and needed to learn how to delegate more. She literally told me to start telling my preceptors, "I'm competent on (w/e skill), could you do it so I can focus on (w/e)." I did not know I could do that! We also identified that my stress comes from me not being able to sit down for 3-5 mins with my preceptor after my first assessment/med pass/dressing change and saying, "OK, this pt had (procedure) done (quick review of what procedure is). This is what we would 'expect' for this type of pt on POD 'x' to look like. This is where they are now. These are our goals today for them. These are 4 possible complications for them...review S/S." I'm pushing for that now. I learned to open my mouth and verbalize that to my preceptors. But when I came home after meeting with my CNE I was still experiencing residual crocodile tears (i had really worked myself up over the past few days). I think I was just tired and PMSing super hard. I called my step-mom/mentor/hero (a CTICU nurse) and broke down again over the phone. After I hung up the phone, my roommate (friend for the past 5-6 yrs) came out of his room and said, "Hey, if you're going to have a phone conversation like that, can you close your door next time? You were so loud I had to turn my show off b/c I couldn't hear the TV over you." I'm literally sitting on the edge of my bed wiping away the last of my tears as he says this to me. I was shocked. I couldn't say anything b/c nothing nice was going to come out of my mouth. Instead I just said, "i'm sorry." This kid just doesn't get it. I want to tell him how much he hurt me and how callus his comment was. But I don't think he even remotely gets what I am doing. Sure he sees that I'm gone for 14 hrs a day...but he doesn't SEE what I do at work. He doesn't know how big my bladder has gotten over the past 4 wks. How I don't sit down for more than 30 mins over 12 hrs. How I give a part of myself to my patients. I don't think I could ever explain that to him either. It's the first time in my life where a friend has not been supportive/understanding of what I am doing. My lease is up in Aug. and I will NOT be living with him anymore. I watch his dog, do his dishes, clean our house, mow our lawn, emotionally support him as he goes to school to get his chemical engineering degree and this is his response?! I just don't get it. What planet are you on?! Part of me really wants to let him have it. Please, tell me again how your 8 hr study group with bathroom/snack breaks whenever you want was so grueling! Please, tell me again how "behind" you are in your school work and then go and take a 6 hr nap or binge watch netflix (nervously i'm sure) for the next 10 hrs. Then get up and tell me tell me how "sleep deprived" you are. I ask again, what F-ing planet are you on and do you need me to send a whaambulance there to pick you up? Ok. Rant over. *mic drop* - Nurses take care of the sick. Family and friends take care of nurses.

@theophania i did my externship this summer on 4300. i stayed on as a "once a month" CNAII after. I can't speak highly enough of the manager and the unit. I got floated to their sister unit (8300) for a shift and had a great experience. If you're offered the job I promise you are going to be super happy working there. Both units are super supportive. best of luck! @GolferBSN, BSN congrats! You'll be working with a bunch of my amazing classmates who also got hired in the CTICU. I think there's about 5 of them. All amazing, super friendly, smart people! @nursinghopeful03 If you don't have ICU or ED experience, don't waste your time applying for those positions. Per recruitment, to get an interview with those units you must have experience (clinical rotation/preceptorship/capstone/work in those units/externship). Duke does not look at your GPA. Although if it was really good I would list it. There is a survey, I forget what all is on it, but you get points for each section. Work for Duke now = point, worked at Duke before = point, did an externship = point (duke offers a summer externship – PNA), currently working = point. For your resume, make sure you include the specific patient populations with the units you list (i.e. med/surg – bariatric surgery, urology, ortho….or w/e your pt population was) along with how many clinical hours you did in each unit. List the units you did clinical rotations in that you are interested in working in first. They required 5 references this year. We did not have to include it in our initial application, they sent a link to an online reference site they use once you were granted an interview. If you do get an interview all questions are behavior based and related to their core values. Get familiar with their core values…make a little sheet about what they mean to you and how they embody them. Actually, I made a nice document that showed just that & handed it to them at the end of my interview. It certainly had a wow” factor. Hope that helps you. @drewberttt HOLLA! I'll be kicking it on your sister unit, 3300! Guess we'll be giving/receiving report from @theophania! HA!

oh, just to clarify one other thing - daily wts & monitoring I/O are listed under "assessments". My professor is looking for something that I would physically "do"

I have to do a nursing care plan for a Long Term Care (LTC) pt. I have submitted my work 2x and gotten it back each time saying that I need different interventions. I have exhausted my brain, text books and the internet for help. Before I email my professor and ask to meet 1:1 for assistance I thought I would seek any assistance I could get here first. Any help is greatly appreciated. I am really trying to push myself and think critically. Per my professor I cannot list any "teaching" as an intervention b/c "by this time they know their disease and don't need additional teaching." (i.e. teach pt not to strain when defecating) I also cannot list any diet interventions - low sodium, high fiber, decreased caffeine intake. Also per my professor interventions #1-3 will always be the same: #1 will be all of my assessments #2 any labs I would monitor #3 are meds I would administer So I can't list anything that would be r/t those 3 interventions. i.e. Prevent constipation by increasing fiber & water intake (if not contraindicated). Again, I'm looking for help with my priority interventions for a pt in LTC. My data & ND/PC are approved Medical Dx: CHF, coronary atherosclerosis, HTN, hyperlipidemia, Hypokalemia, DM, Neuropathy in DM, Parkinson's Dx, Dementia w/out behavior disturbance, Generalized pain, Constipation, Depressive disorder, Hallucinations, Anxiety, & Edema Physical Assessment: VS. T. 98.F, P. 64, RR 19, BP 130/70. A&O x3 Pain 0/10. HR RRR, S1 & S2 heard. Peripheral pulses +2 & symmetrical. Bilat LE edema +1 - wearing TEDs. Airway patent. BBS clear bilat, Resp RRR, symmetrical, without exertion. Denies SOB or chest pain. Strong nonproductive cough without secretions. No appearance of cyanosis. Cap refill ND #1: ineffective airway clearance r/t narrowing of bronchioles and stasis of secretions 2˚ multiple comorbities (concept: Oxygenation & Inflammation) Interventions (the first 4 were approved the fifth one needs revision) all assessments that I would preform all labs that I would monitor all meds that I would administer per orders TCDB every hour Previously submitted interventions that were rejected: Provide adequate periods of rest, elevate HOB ≥ 45˚ (not appropriate for LTC), turn q2h (not appropriate for LTC), monitor & assess activity tolerance (moved to intervention #1), monitor pulse Ox & maintain O2 sat ≥ 92% (moved to intervention #1 and not appropriate for LTC) ND #2: Decreased CO r/t altered contractility, preload & SV 2˚ multiple comorbities (concept: Perfusion) Interventions (thank jebus I got all 5 on this one!) all assessments that I would perform all labs that I would monitor all meds that I would administer per orders provide adequate periods of rest throughout the day and after activities Encourage active ROM exercises. ND #3: PC: Decompensated CHF r/t worsening alteration in contractility, preload, &/or afterload 2˚ multiple comorbities (Concept: Perfusion) Interventions (#1-3 were approved, need help with #4 & 5) all assessments that I would preform all labs that I would monitor all meds that I would administer per orders Not approved: refer to cardiac rehab program Not approved: provide pt with advance directive information to consider ND #3 interventions are giving me the MOST trouble. I literally have exhausted my NADA txt book for help. *tear* Thank you in advance for any help or push in the right direction. I am more than welcome to hints as I will benefit more from a shove in the right direction than someone just handing me the answer! But if you want to hand me the answer I'm fine with that too! HA!

i worked as a CMA in urology and we did it all! straight cath, place foleys, draw blood, run UA's, assist with procedures (cystoscopy, prostate biopsy, vasectomy, etc). We did NOT do phone triage, the RNs handled that. We scheduled pt's for office visits, obtained preauthorizations, called back "normal" lab results, called in Rx, organized paperwork for surgeons. Man, I wouldn't change it for the world! Prepare to see & do a lot! Take every opportunity to absorb as much info as you can & seize every opportunity to practice your skills or learn new skills! Treat every day like it is a job interview, you might just get offered a job at the end. Be prepared to run b/c it's a fast paced environment. Let us know how you like it. :)

I'm a nursing student who spent her first 5 yrs as a CMA in a top 10 nationally ranked urology office. :) We ALWAYS used sterile technique. I do not think it's out of line at all to ask for an inservice. People get lazy or trained wrong. I shudder to think of the lecture that I would've gotten if my surgeon, lead nurse, or boss saw me do that...which I wouldn't do. @bugya90 straight cathing is most certainly not out of our scope. We are taught sterile technique. I have performed more straight caths, placed more indwelling foleys, suprapubic catheter changes, performed CBIs, etc then I care to admit to. We assist with minor surgical procedures that require sterile technique all the time. During vasectomies I was right in there with the surgeon acting like a scrub tech. I can't tell you how many different types of "sterile"/clean (i call them clean b/c they're done in the office). I've even gone to the OR to help with difficult prostate biopsies b/c the OR nurses weren't trained on them & the surgeon requested it. CMAs can do A LOT of clinical interventions. (sorry if I sound defensive or full of myself...I had my nursing program tell me I had to get my CNA 1 b/c "how much clinical experience can you say you really have as a CMA?" I was completely offended. I would've been more receptive to something along the lines of, "there are a couple of skills you need to learn that are different from your CMA skills"...bedpans & linens. I am just really proud of all that I've learned as a CMA over the years.) Now that being said, it is up to the discretion of the physician as to what they are willing or want to let CMA's to do since we operate under their license. (a physician must be present in the office in order for us to even take vital signs)

Oh my gosh! I love you for posting that journal article & the added info! I saw the same thing on medscape. I'm such a hound for medscape and additional info. My clinical classmates always laugh and roll their eyes when I start talking about a "journal article I read last night" or "new evidence based practice says". It's a good thing they love the nerd in me so much!

do NOT get your CMA. I'm a CMA. It's all out pt private office settings. Being a CMA will NOT help you get a job at a hospital. CMA's do a lot of clinical work (especially if you land in a good practice that does minor surgical procedures in office)...or at least I got to in my practice with the specialty I was in. But it is a TON of office work too! Plus CMA's typically work 9-5 Mon-Friday (think out pt office hours) I would't trade my experience for the world, but it doesn't sound like the right path for you right now. Furthermore when I applied to nursing school they still made me go back and get my CNA I. After the first semester we had learned all the skills to complete our CNA II. So now I have that too. I would have to say that for a hospital setting, there is NO better training you can have for nursing school then your CNA. My suggestion to you is to continue to put in applications at hospitals for a CNA I while getting your CNA II. That's what almost every student who needed/wanted a job in our nursing program did. I would look into taking programs at a local community college. GL

ditto to everyone else. I'm 2 semesters away from graduating and my advice to you is beyond buying school supplies, ENJOY YOUR FREE TIME WHILE IT LASTS! If you just had to do something I would brush up on your CNA skills, review how to take vital signs (fun family activity), & get a book on medication calculations. Other than that, I hate to tell you but there is no way to prepare. Again, enjoy your free time until you start!

yes, reverse trendelenburg is head up feet down. trendelenburg (aka "shock" position) is head down feet up. pretty sure my prof. just misspoke.

HANG IN THERE! when I started nursing school I had 5 years of experience as a Certified Medical Assistant (CMA) in out patient surgical practices. I also came from a huge physics and biochm background. I was on fire in clinical & lab, yet I almost flunked my first semester of nursing school due to lecture! No matter what I tried for studying I just couldn't get a handle on the NCLEX style questions. It came down to the final for me to sink or swim. I don't know how I did it, but I reached down super far and FORCED myself to pass that final. Grp studies for finals work really well. Everyone pick their strong area and teach it to the other students. You would be amazed what you wrote down and your friend missed during lecture or vice versa. Set a timer when you study. 1 hr on this, 15 min break, 1 hr on that so you're not getting mentally fatigued or spending too much time getting wrapped up in the details of one topic. Do not getting wrapped up in what's already happened, your grades are your grades and there is no changing that now. Your job now is to keep moving towards that final. YOU CAN DO IT! I would HIGHLY suggest getting ATI & Silvestri NCLEX-RN Examination books. I also would STRONGLY suggest that if you have a test review session after you take exams, that you pay close attention to the rationale as to why you got your answer(s) wrong. I found that when I would make a quick note on my exam indicating my rationale, I could compare it to my prof's rationale & see if we were thinking the same thing. If not, then I learned why I was wrong. If that's not something your program offers, I would ask if your prof would do a 1:1 exam review with you to go over your rationales. Keep digging! The first semester is the hardest by far, but you can do it.

Thank you so much for the response! My program is in the US and we learned how to place NGT our first semester...so I was also confused why she said the provider would place it. I would've thought that I, or another RN, would be placing it instead of standing around waiting for the provider to show up. Sometimes it's hard as a nursing student when prof's say stuff and you're like, "wait, what?" Then I go home and start thinking about what they said and how it doesn't make any sense at all...but I'm a nursing student and they are a seasoned 40 yr + RN. But I'll at the very least ask her for her rationale and see where she goes with it. Maybe she just misspoke or something. Her actual quote on the pt positioning was "reverse tendelenburg" with their "head down & feet up" which is trendelenburg. It's ok though, i knew what she meant. I can't imagine having to say the correct thing every time for 3 hrs. with all those students ready to pounce if you say the wrong thing!