Since nurses interface with patients and ask them questions that often expose their vulnerabilities, they often recognize when patients are in difficult or dangerous situations without directly being told by the patient. Such situations can include but are not limited to domestic violence, sex trafficking, child abuse, Munchausen by Proxy and even social circumstances such as homelessness. When a nurse recognizes these situations, they have a moral, ethical, and sometimes legal obligation to take action. The interviewer is asking this question to determine what types of situations the candidate has recognized in their past career and how they have responded. To successfully answer this question, the candidate should identify a specific situation when they identified and assisted a patient who was in a difficult situation and describe the outcome.
"In my nursing education program, I have learned about the many difficult situations patients could be facing, how to identify them, and how to respond, but I personally have never encountered such a situation in my work or real life before. However, in one of my classes, we have participated in case simulations where we work in pairs to practice such scenarios. While my partner acts out a scenario, I listen and attempt to identify the circumstance and determine which course of action to take. These simulations have helped prepare me for how I will react when I encounter a patient who is facing a difficult situation in their real life."
"A few weeks ago, while I was triaging a patient in the ED, I asked the patient to verify her address, which is something we often do. However, the patient gave me a different address that was previously documented in the system and on her paperwork. When I asked the patient if she had recently moved, she denied doing so and I noticed tears welling up in her eyes. At this point, I recognized that the patient was likely homeless. However, rather than bringing it up, I simply offered her a list of community resources that contained contact information and locations for shelters, community resource centers, and other resources. Once the patient had this list, she began crying, thanked me, and told me she would be contacting the shelters, as she did not know so many resources existed that could help her."
"In my current job in the inpatient OB/GYN unit, nursing staff members are required to screen patients for domestic violence and sex trafficking upon transferring them to the unit. While I ask the questions on the screening tool, I recognize that the patients are unlikely to tell me the truth at the time, especially if their abusers are with them. I typically watch how the patients respond to the questions and if I become suspicious, I take the women to the restroom, turn on the shower so no one can hear, and ask them what is going on. When I did this a few months ago, the patient confided that she was being abused by her husband, so I immediately reported it. Before the patient left the hospital, she had a restraining order issued against her husband, and she felt safe leaving with her baby."
"A few months ago, at my job in the outpatient pediatric clinic, a patient, who was approximately 15-years-old came in asking for an STD test. The young lady did not have a parent or guardian with her, did not have insurance, and she was not an established patient of ours, but she did have an older man with her who was directing her every move. The patient initially approached our adult medicine clinic for the STD test, but since she was underage, reception sent her to the pediatric unit. I knew something was not right about the situation, but I could not directly come out and ask, so when I was taking the young lady to the restroom so she could provide her urine sample, which was the only time I was alone with her, I handed her a tiny piece of paper with the sex trafficking hotline phone number on it and said to her, 'If you need this, put it in your shoe where he is unlikely to look, if you don't, leave it on the counter so I know you are safe." When I went into the restroom afterward, there was no paper on the counter, so I assumed she took the number, and I made a report to child protective services."