You are caring for a patient on your inpatient unit, and after making a call to the physician hospitalist on staff for support, you learn that the patient's medication regimen needs to be changed. Tell me the first steps you take.
While many individuals may believe the first step a nurse should take in this situation would be to give the patient the new drugs that were verbally ordered by the physician, this is not the case. The first step the nurse should take after receiving the verbal order by the physician is to document the medication change in the patient's electronic medical record. Documentation errors are very common among nurses, and these errors include failing to document medications, procedures, and/or nursing actions. Because nurses are extremely busy and often distracted by multiple tasks and demands, it is important for this type of information to be immediately be documented in the patient record. To effectively answer this question, the candidate should indicate that they would document the changes in the patient's medication regimen before administering medications to the patient. A more successful answer to this question would include specific details from a similar situation from the candidate's nursing career where they ensured changes to the patient's care regimen were documented before administering care to the patient.
"I actually dealt with a similar situation last week. It wasn't medications in particular, but I had to call our hospitalist because one of my patient's pulse ox was getting very low, and I was beginning to worry about him. Once the hospitalist learned about the patient's condition, she ordered oxygen for the patient, and the first thing I did was document the verbal order in the patient's medical record. I knew if I didn't document the order immediately, there was a chance I would get busy and forget, which could have detrimental consequences for my patient."
"This is a scenario I encounter all of the time as an inpatient nurse. In my current hospital, we have physician order entry, so the physicians often enter their medication orders themselves. However, there are still times when a physician will need to give a medication order verbally. If the physician gives the order verbally to me over the phone, I will enter the order into the EMR under her name, repeat back the order out loud to verify all of the info is correct, and then sign the order. Then, once pharmacy has verified the order on their end, I will be able to pull the medication from the Pyxis machine in the medication room and take the appropriate steps to administer the medication to the patient."
Community answers are written by other candidates practicing this set. Reading how others frame the same question is one of the fastest ways to sharpen your own.
Anonymous Answer
Once I learn that the patient's medication regimen needs to be changed, I would verify the orders with the doctor then immediately document them.
Chad's Feedback
You are definitely correct that the first step you need to take is to document the medication change. However, situational questions, such as this, are best answered by providing a story example from your past experience. For instance, tell the interviewer about a time where you ensured changes to the patient's care regimen were documented before administering care, and use the STAR (Situation, Task, Action, Result) formula as the framework for your response. This method will ensure that you provide the interviewer with a compelling answer that proves your ability to perform in this particular scenario. We have a guide that you may find helpful - https://www.mockquestions.com/articles/5 Behavioral Based Interview Questions You Should Prepare For/
Anonymous Answer
I would call back the doctor let them know which medications need to be adjusted and why I felt they needed to be adjusted presenting BW, vitals, previous medication interactions, allergies changes in condition. Utilize SBAR and have the patient chart in front of me, as well as the online system open to view labs. My first step is to gather information prior to calling the doctor because they need to know how the patient originally presented how things have changed and recent data collected to aid in their decision process. I remember the first time as a new nurse calling the doctor when a patient was experiencing pain that was not controlled by their current pain medications and I had only didn't cycle a new set of vitals, I didn't have the MAR in front of me, I only had a brief history that I remembered off the top of my head. I felt very disorganized on that call and ever since I make sure to be prepared prior to calling the doctor. This way they get a clear picture of the patient and the patient's needs are met appropriately.
Cindy's Feedback
Good use of example and explanation. By filling in the "whys" you are showing that you have a good grasp of the underlying reasons for your actions.
Anonymous Answer
First, I would read the medications that were ordered back to the physician to make sure they are correct. Next, I would put an order on the computer and write the order on a physician's order sheet. I want to be as precise as possible in order to prevent a medication error that could be detrimental to the patient.
Marcie's Feedback
Great! Making sure to be careful so as not to make a mistake when it comes to medication is important, and the interviewer will appreciate that you take care not to make any errors. You might also mention double-checking the medication orders after you enter them into the computer and write them down. At the end of your response, consider reminding the interviewer that you are the type of person who is detail-oriented, organized, and patient-focused. Good job!
Anonymous Answer
I would get their diagnosis, labs, latest vitals, and allergies in SBAR format before calling the MD. If I had to do a verbal order, I would write it, reverify it with MD, then document it in their eMAR. I would look up the med and its action/ side effects etc. if I wasn't familiar with the drug. I would explain the medication to the patient before giving it and verify my 7 rights.
Stephanie's Feedback
You do a great job of clearly outlining the initial steps that you would take in changing a patient's medication regimen. I suggest adding a concluding sentence that emphasizes the importance of safety and attention to detail when handling patients' medication needs. This is an opportunity to leave your interviewer feeling very confident in your ability to navigate any tricky situations involving patient medication.
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