INTERVIEW KAISER – Flashcards

- I'm a recent graduate of San Jose state. where i concurrently pursued a degree in both nursing and biological sciences. The reason i chose to continue to pursue nursing is because upon being accepted to the program I loved the patient interaction i received in the nursing clinical setting. I am partriculary interested in maternal newborn health and labor and delivery because of the strong bonds formed with the patients and their families as we work closely with them to during this important life event. - THus my background has been focused on preparing myself to become a great L&D RN. Specifically, ( - I am excited to continue on this path and I feel that what have done up to this point has prepared for this position. -

-assess and gather as much information as possible about the tasks that need to be done -For example, i assess level of difficulty, when the deadlines are, whether or not similar task can be grouped together - Use this information to devise a plan and prepare myself to handle the situation and get things done in the most timely and effective way - Example- ----CLINICAL Situation- there was a time where I participated in the management of four observation rooms used to triage patients. It was a challenging situation for me because prior to that experience I had been accustomed to seeing about 2 patients per night. However that night, patients were being discharged, admitted, and seen at such a fast rate that it was difficult for me to keep up and organize all the information. ---- The way I handled the situation was first i maintained my composure so as to not stress out or worry pregnant moms who can probably easily be stressed out and then i assessed how i can get things done efficiently so as to not overwhelm myself even more. For example, I tried to work as quickly and efficiently as possible, such as charting immediately instead of waiting till i finished everything to chart. grouping similar task and also collaborating with my preceptor in the division of tasks. Also, i asked my preceptor for tips during our break, From that experience. i definitely tested my prioritization and time management skills. and I was just happy to have survived that night without any incidencts.

- My strenght is my adaptability, effective teamplayer, diligence in accomplishing goals. -I feel my main strength is my focus and determination in succesffully accomplishing the goals I have set out for myself. - For example, one of the personal goals i have set for myself and also something i feel is one of my greatest accomplishments was completing my dual major and dual minor while maintaining a balance between my professional and personal life. It was something that was definitely challenging and took a lot of discipline, and i was met with a variety of challenges and I also encountered discouragement form authroatitative figures. (Ex- nurse advisor consistenty pushed me to drop my second major and kept telling me that i couldn't do it.) - However, despite these challenges, by focus and persistence and maintaining a positive attitude i was able to completed both my majors and graduate with honors.

-I tend to over think things, especially when i learn something new, i tend to really want to get it right and so i'll spend too much time thinking about it in my head -There were times that this has hindered my ability to perform with the quickness and efficiency that many situations require - for example (CLINICAL EXAMPLE)- I had a patient during my preceptorship that came in with a precipitous delivery and when everyone who was available , including myself, came in to assist with the delivery, but since everything that i had learned was happening in fast forward, and i because i was too busy thinking "Ok whats my priority, what needs to be done" as opposed to of actually doing something , I made little contribution the team effort as i should have and would have wanted to. - However from this experience I was able to improve other emergency situations where I i mae th effort and

-I know that i want to be in a position orwhere i am promoting women's health more specifically promoting a healthy pregnancy outcome. therefore my short goal would be to work for a hospital such as this where I can learn and function effectively as part of a team of members that are also dedicated to optimizing womens health. -My long term goals would be to expan my education by obtaining an advanced degree focused on womans health and use the knowledge and experience gained over the years to move up in the field. ((Im not completely sure which program I would specifically want to pursue. I would assume that after some time of working and being in the field I will know what best fits me and can be most beneficial to the facility i work for.

As I've mentioned I've always seen myself working in the health field. . But to be completely honest with you - honestly I didn't really know which career i wanted. and to be completely honest nursing probably wasn't my first choice, - but when i got accepted to the nursing program , and learned more about the what nursing is. i fell in love with the patient interaction that nursing provided me with. and I'm most happy when I can use my skills and knowledge to have a positive impact on someone. and thats exactly what we do as nurses. We utilize our knowledge and skills and compassion to promote and optimize the overall-well-being of our patients.

The reason i want to pursue a career in labor and delivery is because i want to be a great nurse that provides excellent care. And i personally believe that in order to be an excellent nurse one must not only have the appropriate nursing skills and competencies but must also be passionate about what he or she is doing which is how i feel about maternal newborn health. - the reason i am so passionate about this particular field is because as an L&D nurse, I would have a crucial role in such an important life event, the brith of a child. with L&D nurses we work as a team to do what is necessary to ensure the safe delivery of the child. Furthermore i love the relationships and bonds we form with the families and i find it extremely rewarding seeing how appreciative they are of the work we do.

From my experience working in Kaiser santa clara and as a kaiser permamante member myself It has become most evident to me the dedication the company and the healthcare providers that make it have to optimizing patient, and employee well being. -For example, I am so impressed by the vast amount of wellness information and resources provided to both members and employees such as the resources available as part of the healthy workorce program. - In addition i greatly admire that the facility encourages patients to take an active role in their care and is supportive of patient preferences such as offering midwife services.

I have extensive knowledge and experiencein the field tht has given me a strong foundation for which to build upon. Most notably my recent preceptroship in the labor and delivery unit of kaiser santa clara. Aside from my professional background, I have the personality and drive necessary for success. I'm passionate about labor and delivery , excellent and eager learner, a great team player, and with everything I do, I always push myself to higher levels of performance. So with me you not only have someone with the experience and learning capabilities to meet your expectations, you have someone who is motivated and committed to exceeding them. - Ex- with all my tutors I've always spent extra hours and put in the extra work necessary to make sure that they not only understand the material but they got positive results as evident by improved grades. With my patients I will spend the extra time and and put in the extra work to make sure their experience is a positive one and they feel included in their care.

-excellent team player- everything we do is a team effort and in order to be most effective as a team, every member should be respectful of the other and be able to communicate effectively. -My adaptability and ability to thrive in challenging environments. For example. i always try to come prepared. " I find that this is very useful in the clinical setting especially the labor and delivery setting because as i've come to learn from my senior preceptorship. even a labor that seems to be very uncomplicated can become an emergent situation and so having this strength helps me to anticipate any problems or complications that may arise and be prepared to handle it. (ex: how I prepare myself- diligently studying so I have the theoretical knowledge that facilitates my critical thinking and decision making. In the Clinical setting I maintain situational awareness to allow me to anticipate any complications or hazards and plan ahead sO I can intervene appropriately. For example I keep my room organized and prepared such as eliminating visible safety hazards, or knowing where I put everything. I found that this has been very helpful in emergency situations because we are not wasting time trouble shooting or looking for supplies or dealing with IV messy cords and things of that nature) - lastly- my passion, enthusiasm for this field lends to my general positive energy and ability to motivate others to have the same enthusiasm thus contributing to the overall productivity of the team

- ambitious- I never settle and am always pushing myself to improve - diligent- i am hardworking and persistent when it comes to accomplishing my goals and attaining positive results - considerate- because in all that i do i always consider how my actions impact those i interact with. For example when providing care to my patients I always consider what type of care I would like to receive if I were the patient or what type of care I would want for my family to receive. And i try to embody these characteristics as much as I can when working with my patients. Same applies to those I work with. I try to always consider the nurses who come after me or those that assist me. I try to keep my room very organized and clean and try to work as efficiently as possible and get as much done as I can because I wouldn't want the next nurse to have to clean up after me or make anyone elses job harder than it should by not doing my job right.

I try not to dwell on it and not be too focused on the negative but make the effort to look at it more positively. Every experience in life including disappointments and failures are learning experiences. Through trial and error a conscientious person can eventually discovers what works and what doesn't. so in a sense it better prepares you for success in the future. -a time that i failed was when i did not contribute to team effort -

I really do appreciate and welcome any feedback whether it be negative or positive because it helps me in my self evaluation and growth. One example of negative feedback I received was during my pediatric clinical rotation. I was told by my clinical instructor that I was not interacting or relating with some of my patients as well as I should. In the beginning it was difficult for me because I was so accustomed to working with adults but eventually was able to improve on this. for example i had a patient who was initially not very receptive to me, he refused treatment,but just by trying to und

My idea of a leader is embodying the qualities that inspire others to reach their full potential thus making them more effective in collaborating within a team that is working to achieve a common goal. I posses these qualities and make my greatest impact through motivating others. For example, a time that I displayed leadership is during one of the days I volunteered at the open clinical skills lab at my nursing school. This is basically a place where current SJSU students can practice, get help on, or get checked off for their hands on clinical skills. On this particular day I was in charge of checking off students for their competency in hanging IV bags, piggy backs, priming and backpriming. While checking them off I noticed that somewhere along the line, everyone started their skill by putting gloves. I became curios on why that occurred and stopped the person and asked all of the students what their rationale for putting the gloves on were. None of them could really give me a solid answer until one person honestly came forth and said, "Well because the person in front of us did it." That's when I realized they weren't really learning it they were just imitating the person before them. So I gave them a motivating speech. Basically I told them it isnt wrong for you to see what the other person is doing but you shouldn't really be relying on them because you are here to see if you are competent in performing the skill not if the person in front of you can do it. In the clinical setting you will not have someone to copy, of course you will have people to help you and and demonstrate it to you if you need help, but why not take advantage of your time here and actually learn how to do it and practice it. I know you are suppose to get your list checked off but that doesn't mean I wont check you off if you decide to practice first instead of doing it correctly on your first try. In fact im here to help you and I encourage you to do that so I can check you off on a skill that you actually feel comfortable and competent in performing" From that I had a lot more people asking me for tips and a lot of students who were already checked off asking if they can practice and get my feedback. So overall, by providing them with honest feedback and investing my time to actually helping them improve rather than just checking them off, I displayed leadership by catalyzing a positive change in these students and inspiring them to take the initiative to better themselves.

I completed my senior preceptorship in the Labor and Delivery Unit at Kaiser Santa Clara, an experience that had definity given me a stronger labor and delivery nursing foundation. My education gave me an idea of what to expect in labor and delivery, but my preceptorship training actually gave me an invaluable opportunity to experience first hand what it takes to be a labor and delivery nurse. By physically working in the labor and delivery unit I was to apply and practice what I was only reading about in school. I learned a lot and was exposed to a lot of different things For example, In the short time that I worked on the floor I was exposed to so many different aspects of labor and delivery and so many different patients including patients with scheduled C-section, vaginal delivery, natural delivery those diagnosed with gestational diabetes, pre-eclampsia, among others. being apart of the collaboration efforts to implement appropriate nursing interventions in response to emergencies such as an emergency C-section or shoulder dystocia gave me an idea of what to anticipate when I encounter them again. With practice I became more competent in interpreting fetal heart rythms. Was able to actually manually operate and see obstetric instruments such as the vacuum for vacuum assited deliveries, FSEs, IUPCs, external fetal heart monitors, and so much more. It was definitley a linvaluable experience that made me feel more confident and prepared to take on the future challenge of training to be a L&D RN I highly enjoyed being part of such an efficient team. The healthcare team in this unit demonstrated excellent teamwork and superior communication as demonstrated by their ability to respond quickly to emergency situations in a timely and efficient manner and was also seen in the way they interacted and respected each other's individual roles. What I liked the least was that I would have wished to have more independence than they allowed. For example I wasn't able to access the charting for triaging patients. Also although my preceptor made every effort for me to work indepdently, I wasn't allowed to have my own patient.

----CLINICAL Situation- there was a time where I participated in the management of four observation rooms used to triage patients. It was a challenging situation for me because prior to that experience I had been accustomed to seeing about 2 patients per night. However that night, patients were being discharged, admitted, and seen at such a fast rate that it was difficult for me to keep up and organize all the information. ---- The way I handled the situation was first i maintained my composure so as to not stress out or worry pregnant moms who can probably easily be stressed out and then i assessed how i can get things done efficiently so as to not overwhelm myself even more. For example, I tried to work as quickly and efficiently as possible, such as charting immediately instead of waiting till i finished everything to chart. grouping similar task and also collaborating with my preceptor in the division of tasks. Also, i asked my preceptor for tips during our break, From that experience. i definitely tested my prioritization and time management skills. and I was just happy to have survived that night without any incidencts.

I believe nursing is the practice of applying specific knowledge, skills, and attitudes into the promotion and optimization of all aspects (physical, spritual, emotional) of an individuals health and well-being/. -A good nurse has a strong and well maintained theoretical knowledge base combined with the necessary experience to enable them to efficiently critically think, anticipate risks, and implement appropriate nursing skills and interventions. -In addition he or she must also be compassionate and non-judgmental thus having the ability to not only accomplish tasks but can also provide humane care patient centered care in all situations. Lastly a good nurse is an integral member of the interdiciplinary health team, and tus should be able to collaborate and communicate effectively with patients, families, and other members of the mutlidisciplinary team in the promotion of a safe, healing, and humane patient and work environment.

My academic background combined with what I have learned through my clinical experiences, especially my nursing preceptorship qualifies me for this position. For example i have been exposed to many different patients and experiences and have learned a great deal in my preceptorship that I feel has prepared me to take on the challenge of training for this position.

A situation where I utilized my critical thinking skills was when I had a patient who had an elevated blood pressure. She was not diagnosed for pregnancy or pregnancy induced hypertension but I knew they could be possibilities so the first thing I did was double check my finding by re-taking the blood pressure. I asked the patient if her blood pressure is usually at this range and she said only since she got here. So I decided to assess for any other accomanying signs or symptoms of preeclamspia such as absent deep tendon reflexes, changes in vision, headache, edema. All which were absent in this patient. The next step I took was checking her chart to see if it can give any other useful information and I noticed that she had elevated AST and LAT lab values which as ive learned were signs of elevated blood pressure. I went to report the abnormal findings and my assessment to the doctor who said that the labs were inconsequenstial and to suggested I recheck the continue to monitor the blood pressure. When I went to recheck, using my critical thinking skills and knowing that proper blood pressure cuff size in relation to the size of the patient is important in accurate blood pressure readings, I decided to change her to the larger cuff size because she was somewhat of a bigger person. And when I did this her blood pressure reading fell down from 150.90 to about 130/70 .

...It is very important for me to obtain a job where I am constantly challenged and thus always growing, learning, and improving. Also my ideal job is one in which I can work with and contribute to a collaborative team that is committed to providing quality patient centered care. - WHAT MAKES A GOOD SUPERVISOR TO YOU- a good supervisor should be one that can motivate his or her team. Maintains professionalism . Be knowledgeable and a reliable resource. Have excellent problem solving skills, Can effectively plan, prioritze and time manage. And who demonstrates genuine concern for those she is supervising for example by allowing them to voice concerns without being judgemental, and assessing their performance and providingf eedback.

Whenever I am unsure of anything I try to assess the situation and gather as much information as I can to help me better understand the situation. Also I make sure to ask questions or reference a concrete resources such as patient chart. Confusion breeds error and I'd rather ask a question and seek clarification than have to deal with negative consequences or compromise the safety of my patient.

With all conflict i stop and try to assess the situation, take an objective stance and do not try to personalize the issue.

Conflict among coworkers can compromise the effectiveness of the team so I would definitely want to make the effort to resolve the problem. I am not the type to deal with things amongst people. I would rather handle it professionally and deal with it in private and try to discuss it with her and assess what exactly the issues are so we can get to the underlying cause of the problem and together try to find a solution. However If we cannot find a common resolution amongst the two of us then I would try to mutually seek advice from the chain of command starting with the supervisor, charge nurse.

If I find myslef in a situaiton where I am overwhelmed My first priority is patient safety I think in order to keep patients safety in mind and prevent patient harm its important to be able to recognize when thigs are beyone your control seek appropriate action including maintining professionalism and composure so as to not overwhelm the patient and ask for help - However, if it is something that can be handled i think the best way to handle a potentially overwhelming situation is take the time to reevaluate it and see what needs to be done to complete the task at hand such as through prioritization and delegation.

A difficult patient I once had was a paraplegic patient I had during my medical surgical rotation. Upon receiving report, I learned he was hated all nurses and was just a grumpy guy. I ttried to not let that comment influence my judgement but when I cared for him he was continously saying negative comments all the time, acting angry, complaining about the care, and badmouthing everyone who interacted with him. But I tried to put a littleperspecitve to it and kept in mind that if I was in his situation I might not be in such a great mood eiher. I maintained my composure, did not let the things he said compromise the care I was providing. Eventually, by maintaning my positive and caring attitude and giving him the best care I would give anyone else, He eventually calmed down and was so much more agreeable as he realized that I actually cared and was trying to help him. I ended up being assigned to him again when I rotated to the spinal cord unit a couple weeks after and when the nurse tried to introduce us. He intervened and said "Oh I know geraldin, shes going to be a great nurse" It made me so proud that I was able to hear that from him and that I overcame the challenge

In everything we do in the healthcare feel we are contributing to t a team. even by just completing our individual role as nurses . However, i believe the most effective team players are those that have excellent communication and collaboration. I believe i am an excellent team player because I always maintain communication in the team - positive assertion- voicing concern when something is questionable -

An area I feel I improved on is my assessment skills. Well as a nurse it is really crucial to communicate any changes from baseline or deviations from baseline assessments for the purpose of immediate interventions and prevention of adverse outcomes.. Knowing this also because the majority of my patients that were first assigned to me were generally low acuity my assessment findings were primarily within normal limits, So, whenerver anything deviated from baseline, as an excited nursing student trying to do everything right I would I would immedietly report ANY abnormal findings that I would come across but the problem with this behavior was that I was getting ahead of myself and not making a throrough assessment and gathiering all the information such as lab values or other symptoms that would comfrim my assessment. I realized the problem when I couldn't answer further questions Throughout my nursing undergraduate studies I have learned to improve on this by gathering as much information as possible to communicate a more complete picture of the pt to whomever I was reporting to. For example, I had a patient who was admittedto determine he had a sudden increase in vital signs. I made sure to gather all findings and ask for any other new symptoms and called the physician who came immediately to further evaluate the pt. It felt really good being able to answer all the questions that the physician asked with confidence.

- A situation i encountered was during my L&D preceptorship. I was sent into the delivery room of another nurse to help with the newborn upon delivery. - While

- patient who had epidural - based on my assessment of her behavior she was not receiving adequate pain relief - as a paitientadvocate i collaborated with with the anesthesiologist to ensure that my patient received proper pain management - for example, i reported the finding immediately - anesthesiologist increased the dose - still not having good pain relief, but the anesthesiologist stated it was too late to start a new epidermal because she was already 9 cm dilated. -asked what our options were and she said that she receives pain relief when she pushes the demand dose button but she is not pushing it enough. - turned out she thought the patient demand dose button was only to be pressed by the doctor and she didn't fully understand the purpose of it. so i made sure to continue to educate her until she understood how to properly use it to maintain proper pain relief.

- patient came in for post date induction - experieicng variable decelerations throughout shift - monitors were not picking up, upon adjusting her external monitors noted a deceleration down to the 50's, at that time my preceptor also noticed and came rushing in to help while i immediately pressed the staff assist button which allowed for even quicker intervention as the team collaborated to ensure interventions were implemented quickly. - In the end the fur rate returned to baseline

- i maintain my composure in all situations. I behave according to hsptial policies and procedures, standards of practice and ethical guidelines. I maintain a groomed appearance. And I communicate and interact with my patients and fellow team mates with dignity and respect.

A mistake I made was giving a pitcher of water to a patient who requested water when they were NPO. when i realized my mistake, I quickly went into the room to correct the mistake, apologized for having to take the water away, and asse. Then I reported it to my clinical instructor because I wanted to be maintain my accountability for what I had did. Luckily, she said it was OK since it appeared he only took a few sips of the water. One thing with making careless mistakes such as this is that it helps you to not make the same mistake again. Now I try to always be aware of orders and I have not made a careless mistake like that again.

I provide patient centered care by not only providing my patient and her family the quality care that I would want my own family to receive, but also treating her as an active member of the team by making every effort to include them in the plan of care. For example by assessing individual preferences and being supportive of them, being considerate of their birth plan, always communicating with the patient through patient education and informing her before doing anything. I try to include them in what im doing such as letting family members help bathe the baby, letting them see the placenta.

Change is inevitable in life. If we did not change we remain stagnant and do not improve. therefore i welcome change and the challenge that comes with adapting to the change. The same applies in the clinical setting such as in labor and delivery. the status of the laboring woman can change at any moment and an effective and skilled nurse must be quick in adapting his or her plan of care to the situation.

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I would prioritize based on what is required for each task to be completed. Generate and implement a plan of action that enables me to dedicate the appropriate amount of attention to each task allowing me to efficiently get my tasks done thoroughly and efficiently as opposed to quickly and half-hazardly.

I would maintain a professional demeanor so as to not escalate the situation. Encourage him or her to voice their concerns, listen and acknowledge what they are saying and try to find a common ground and the best solution. If I find that the problem cannot be resolved between us then I would mutually seek adv

What is the recent history of this department in terms of growth and type of work?"

- where my skills and talent are utilized and my potential is fully exploited for contibuting the progress of the hopsital (Ex: As a biology major i have grown to value research (as a ultimate source of knowledge and innovation), so I would love the opportunity to participate in research activities within the hopsital setting) - It is important for me to work as an integral member of a collaborative team with open communication and mutual respect. - a job where i am being challenged and where i have the opportunity for long term professional and personal growth with the facility.

I had my preceptorship in L&D kaiser santa clara, which gave me valuable learning experiences and the opportunity to work hands on with laboring patients and their families and work as part of a team in a fast paced and challenging environment. The knowledge I gained (list them) prepared me to take on a position as a labor and delivery RN.

I would actively listen to the complaints, reassure them that as a teeam we are doing all that is possible to provide them with the best care. And if they had concerns that are well-founded andneed to be addressed I would do so immediately.