Rural Nursing-when working by yourself

[Sandra11]

hi there,

i'm currently looking for rural jobs in northen canada...and one of my interview questions was:

1. if you were left alone and a patient came in and needed assistance, what procedure would you follow to assess him/her?

and my answer was:

i would start by addressing his/her main medical concern starting with a brief general survey which includes (general appearance, behavior, posture, hygiene, mental status, speech, height, weight, hearing, vital signs and nutritional status) and then a proper head to toe assessment.

if for example i would get a trauma patient i would perform a trauma assessment which includes assessment and inspection of airway, breathing, circulation, neurologic status, environmental control ( removing clothing and keeping patient warm),full set of vitals, provide comfort measures, head to toe assessment, and inspection of posterior surface. if i require further assistance i would contact any other available health care providers including the md.

does anybody have any good answers/suggestions for this question?

[nikki_nurse]

In my experience, it depends on the patient's condition.

We have two RN's as well as two RPN's (only on day shift) working at our hospital with the MD on call. If it was a trauma patient coming in, I would have a co-worker call the MD. If I did not have a co-worker, I would do a quick assessment of ABCs, vitals, get them hooked up to whatever equipment they need (oxygen, cardiac monitoring etc) and then call the MD.

If it was not a trauma situation and the patient is coming in to the emergency room with a minor complaint (ie using the ER as a walk-in clinic which unfortunately happens a lot) I would do a complete assessment of their complete, as well as their vitals and history, as well as getting a med list before calling the MD.

Its tough working by yourself but hopefully where ever you are working, there is at least another set of hands to be documenting or calling the MD.

[Nurs4NursIntl]

ah...critical thinking at its best:)...Not really a trick question, but an initial scan of the situation will reveal if you need help/backup/more advanced care and should be dialing a phone or starting some breaths/current CPR protocol - a la carte you need a plan and priorities...then get to the work of assessment at whichever level is appropriate...don't forget to include your and the pts. safety...Good luck! Did you get the job?