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 Client Required Testing Agency/Travel nurses are frequently asked to prove their competency in their area of specialty. Clinical One does require initial testing at the time of hire and prior to the first assignment, which encompasses multiple choice questions on general clinical knowledge and medication administration. In addition, a client facility may also require additional competency evaluation prior to working at their hospital. Should an agency/travel employee fail their testing, the end result is usually termination from the facility. The following is some basic information on some of the different testing methodologies that our clients are using along with some tips on how you can be successful when asked to take these exams.
And just what is PBDS? Over 500 hospitals currently are using the PBDS system not only to assess new staff nurse hires but to also assess the competency of the travel nurses assigned to their facility. Traditionally the PBDS is used as tool used to assess nurses during orientation in order to help develop an individualized orientation plan for them based on the learning needs gleaned from the assessment results. However, for travel nurses, the PBDS is used to determine competency, and failing the test often results in termination of the travel contract. PBDS evaluates interpersonal skills such as customer relations, conflict resolution, team building, and those types of issues. However, the majority of the assessment looks at critical thinking skills. The program begins with a baseline assessment that consists of a number of exercises in one of four clinical areas: med-surg, critical care, neonatal ICU, and OB ( a tele/IMC nurse would see med surg scenarios) The exercises are done with different formats. Some are pen and paper, some are pictures, but the majority are video vignettes. Basically you are provided with a scenario, played out in the form of a video. Based on what you see and hear, you need to make judgments on what is the probable “diagnosis” and what actions you would take in that situation. In the critical thinking exercises, various scenarios depicting common clinical situations and complications are presented. Assess the situation as if it was your own patient in that situation. What would you do? Nurses are asked to define the problem, offer a solution and its rationale, as well as prioritize its need for action. This means that the nurse is asked 4-5 questions based on the scenario just viewed in the video. These questions usually include probably medical diagnosis, initial nursing interventions and actions to be taken in response to the scenario. Interpersonal skills are evaluated by presenting different situations in which a nurse must give a response. Using the example of startling statements, in one situation a physician says, "I don’t know why the administration of this hospital won’t hire any decent nurses when there are plenty of girls out there." Upon completion of the assessment, it is rated by comparing the employee’s answers to model answers that were developed and validated by nurses at the facility. Core to the PBDS program, this rating system is not a trivial process. Here are some other potential “scenarios” that you might see as well as the medical diagnoses that you should be aware of:
What would you do if...
Things to consider in responding to these scenarios are what you MUST do, SHOULD do, and what you COULD do.
Be familiar with the following medical diagnoses and nursing actions to be taken for these situations including rationale:
Most importantly, don’t forget to include nursing actions that may seem automatic or obvious. An example would be a patient with a high digoxin level, exhibiting symptoms of toxicity. Your first action would be to hold the digoxin. Another example might be a patient, receiving IV heparin, suddenly starts vomiting blood. You would shut off the heparin drip.
OhioHealth – Grant Hospital Agency personnel will review clinical scenarios and exhibit, in written responses, the ability to recognize clinical problems, describe anticipated medical and nursing management, rationale for actions, and recognition of events of urgency. Described below are PBDS segments that may be administered. This is determined by the traveler/agency personnel’s work assignment.
An individualized summary and orientation action plan is developed and reviewed with the participant during orientation. Further questions or follow up regarding PBDS is managed through the TRIGA she representative for each hospital. The Performance Based Development System’s company website provides helpful information about the basis for the assessment. www.pmsi-pbds.com Some helpful hints for orientees at OhioHealth:
Banner Hospital System also administers multiple choice competency testing at the start of your assignment. This testing is more traditional and tests knowledge more so than critical thinking skills. For Med-Surg nurses the test has 2 parts – medication administration and disease management. The medication administration section includes calculation of dosages, IV drips, and some adverse side effect info. The disease care and management includes questions about lab values (normal and abnormal) including ABG interpretation, renal disease, sepsis, cranial nerves and neuro signs, SIADH, cardiac output (what effects CO), and even a question about dopamine. The Banner Tele and ICU nurses are required to take an additional rhythm interpretation test which not only includes interpreting cardiac rhythms but also their treatment, risks, and pathology
Baylor (TX) Testing
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