Your Most Challenging Experience?

canesdukegirl, BSN, RN · Jul 23, 2011

Thanks for the reply. It was hard for me, as I have no doubt was difficult for you as well. These patients make us better nurses, because we learn how to rein in our emotions and concentrate on the patient.

Interviewers ask this question because it tells so much about a person. If I had asked this, and a candidate's reply would have been, "I see challenges all the time, and I overcome them. It's just me. I am strong. I can handle anything.", I would have been less inclined to hire them. The answer is too 'pat' and the candidate did not provide me with a specific example.

I would be more interested in an answer that entailed a specific scenario and what problem solving skills the candidate took to overcome the challenge.

Thanks for posing the question, OP. It is always refreshing to be reminded of my challenges, and to be cognizant of how I must continue to remain introspective.

eriksoln, BSN, RN · Jul 24, 2011

Dealing with a nurse who was my friend when I started and then turned on me when I started to take more control of my position and progress forward as charge nurse. >.>
Patient-emotional wise my most challenging experience would most likely be taking care of a detox who suddenly turned on me and told me I had murdered her whole family and was keeping them in a garbage bag on the roof. Even though I knew she wasn't in her right mind I was down right angry with her. Luckily it was the very end of the day and I was able to walk away from the situation and cool off.
Patient-health status wise I would say it was the 90+y/o pneumonia patient that I had for four hours from admission to death. She was a DNR and the lack of humanity some of my support staff showed was extremely frustrating. (RT would walk in when I would call pleading them to fix the BI-PaP because her sats were in the 60's and they would look at me, right at her bedside, and say "isn't she a DNR?" I understand I needed to let her go, but the lack of compassion for the situation was so frustrating for me. This was also my first patient loss in my then three year career.
I am sure there are many other situations out there, but those are the ones that currently stick out in my mind.

I'm suddenly, with no explanation, very afraid of you.

Can you provide proof? Are you sure you.............didn't..........................well..................

N/M, you might come after me. Move on, nothing to see here. I have no living relatives or friends so don't waste your time.

Tait, MSN, RN · Jul 24, 2011

I'm suddenly, with no explanation, very afraid of you.
Can you provide proof? Are you sure you.............didn't..........................well..................
N/M, you might come after me. Move on, nothing to see here. I have no living relatives or friends so don't waste your time.

I promise, with the paper charting we still do, my alibi was air tight!

Whispera, MSN, RN · Jul 24, 2011

I have lots of them, but the worst was one evening when I was working as the only staff person and two patients tried to kill themselves at the same time (psych unit). I tackled the one hacking at her wrists and held her arms apart, and yelled to the other patients to get the one hanging herself out of the shower. As luck would have it, their attempts were within about 20 feet of each other. I yelled for other patients to go get help at the next unit. We really worked together (staff and patients) and it was ok after the shaking stopped.

No one died. I wanted to jump out the window, and did not want to go back to work the next day.

nola1202 · Jul 24, 2011

getting up in the morning to go to work...how I handle it? Grumble, grumble gr:yawn:ouch, don't talk to me till I have my coffee.

nola1202 · Jul 24, 2011

ok seriously, I was new to psych nursing. We had a 2 way radio to call for help. The patient seemed ok and I got her something she wanted across the room, I forgot to bring the radio with suddenly her eyes narrowed and she pushed me against the wall and put her hands around my neck but not squeezing. I hadn't had CPI training yet, so I just told her very quietly, looking into her eyes that she was scaring me. For just a second her eyes cleared and she looked concerned, she then grabbed my hand and ran across the room and we hid behind the bed, I stayed there for a minute and asked who we were hiding from,

she told me the the SS (WWII Germany) I told her we were in a safe house and they were gone, she heaved a sigh of relief and lay down on the bed. I ever so quietly and slowly backed up and got that radio back in my pocket..I didn't tell anyone what happened because I was afraid they'd tell everyone what an idiot I was! A home health Nurse did some very quick thinking when she made a home visit to one of her regular Psych patient's, apparently he went off his med's/

He closed the door, locked it and told her to take off her clothes. He started to take his pants off. She said "Oh" Before we do this, let me run to the car and get a condem. He let her out, she ran to her car, locked the doors, drove up the block and called 911. Talk about brave, and quick thinking. I'm in awe of her.

Long Term Care Columnist / Guide · Jul 24, 2011

Without a doubt, I'm smack in the middle of my most challenging situation ever, right now.

There is a resident in my assisted-living community who is, quite literally, street-rat crazy. Only in his mid-50s, he has been diagnosed with an astounding array of psychiatric illnesses including schizoaffective disorder, paranoia, narcissistic personality disorder, borderline personality disorder, PTSD, depression, anxiety, and worst of all, factitious disorder---or, more familiarly, Munchausen's syndrome. You want my honest opinion? I don't think even the DSM-IV has a diagnosis for what this man is.

I won't go into his bizarre behaviors, the living like an animal in his little apartment and only coming out at night, the freak-outs, the criminal history, the hospitalizations, or the fact that he should NEVER have been admitted to an assisted living community (and was admitted only over my strenuous objections). I won't belabor the time-vacuum nature of his needs and his self-harming behaviors like clawing his own face to make it bleed (and then claiming the staff did it) and burning his scrotum with cigarettes. I won't even go into detail about how desperately he wants to be admitted to a psych unit, and how stubborn every healthcare facility within a 100-mile radius is in refusing to deal with him after a full decade of his abusing the system.

No, I won't bore everyone with the frustration of being unable to get this man out of my building. (Nobody will take him, but who can blame them?) He's failed every placement he's had, and the street is literally his next stop because my state doesn't have a system in place to take care of people like him.

No, I just want to share the frightening responsibilities involved in caring for the biggest drain on public resources---to say nothing of both my work AND personal time---that I've ever seen in my lifetime. The staff call me day and night to report the latest strange behavior and ask what they should do about it. And he is decompensating both physically and psychiatrically in front of my eyes every. single. day., but there is no place for him to go. I don't even think he'll even find a place after he finally succeeds in killing himself, because Heaven doesn't want him either and Hell is afraid he'll take over.

And yet.........I'm angry at the system for failing this man, especially now that he is in a totally inappropriate living situation and no one---not even his doctors---will even see him anymore, let alone help me find a better placement for him. No matter how sick he is or how many appointments he's canceled, he's still a human being and he doesn't deserve to be put out in the street like garbage. Yet we can't have him in the building barging into other residents' rooms and scaring the bejeebers out of them, and we can't manage his incredibly complex needs, and we can't stand by and watch him deteriorate before our eyes.

Yes, this is far and away the most challenging nursing situation I've ever faced, or ever expect to face. I didn't sign up for this, and even though I keep asking questions, no one else seems to know what to do either.