Interview Questions for possible Advanced Critical Care Practitioners

The Department of Health said that the advanced practitioner role was made up of 28 elements grouped into four themes;
  1. clinical care/directing practice
  2. leadership and collaborative practice
  3. improving quality and developing practice
  4. developing oneself and others.
The practitioner will, therefore, need knowledge of;
  • diagnostics
  • therapeutics
  • biological, social sciences and pharmacology
  • consultation and clinical decision-making
  • complex reasoning, critical thinking
  • reflection and analysis
Advanced nurse practitioners must be aware that if they take on a role previously done by a doctor it should be done to the same or better standard
The international Council of nursing defines an advanced practitioner as ‘a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for advanced practice’.
So some of the questions that occur to me are:
What are the driving forces behind this new role?
They need to be aware of why the role is being developed, the European working Time directive, and modernising medical careers should be something they can reflect upon. Hopefully, they will comment on the junior doctors spending less time in the intensive care unit during their training and consequently the role of the critical care practitioner helps provide some consistency.
Jr doctors may complain that you will take away from their learning activities-how would you respond?
The best answer to this complaint from junior doctors is that yes, initially they will take away from their learning opportunities, however in the longer run, they will be there to help provide those learning opportunities. As the practitioner becomes competent themselves they can help in the teaching of the juniors when the registrar is otherwise engaged for example. They will also eventually be part of the formal teaching program for the junior doctors. So whilst they may take away from some learning opportunities this is only in the short term.
Why is Masters level education considered to be necessary for an advanced practitioner?
The candidates need to understand that they are expected to become diagnostic in their approach and also to understand how to be more critical in their own approach as well as developing the roles of others. This is something that is highly encouraged during Masters level education, and in their written work they will next be expected to be critical of current research and the methods that are being used. In the longer term they will be teaching at Masters level and hopefully producing pieces of research which will influence future practice. This process can only take place if they can show an awareness of the strengths and weaknesses of the current evidence base.
How will they cope with role uncertainty?
As this is a new role within your trust both they and their colleagues may initially be unsure as to what they are there for. They will fall between the cracks of medicine and nursing/whatever profession they come from and as a consequence, their role may be a little unclear initially. Have they given this some thought? Having spoken with any other practitioners currently working at this level to find out what their role entails and how they fit into their team? A positive answer to this question I think demonstrates that they have given it a lot of thought.
Becoming a practitioner with all the academic work involved is made even harder by being unsure of why you are there in the first place.
How will they establish a supportive team for when it becomes hard?
 
They need to be able to bond with their new trainee colleagues as quickly as possible. One of the most valuable resources support wise will be those people who are going through the same pains as themselves. It is highly likely they will be attending the same study days together, writing the same assignments and attending the same OSCEs. 
 
Are they aware of the other practitioners out there working hard to create a community? Do they know the role of the National Association of Advanced Critical Care Practitioners? Do they know the role of FICM?
 
What do they think they can offer to the rest of the team? What difference will be advanced critical care practitioner make?
Here I would expect them to talk about;
  • consistency
  • a long-term member of the team
  • providing a teaching bridge between nursing staff and medical staff.
  • Identification of and research into new ways of working
  • networking with other practitioners both within the trust, nationally and internationally.
  • differing perspectives developed from their previous career path
  • integrating previous experiences and expertise.
One final question I have asked that many interviews and whose answers often surprise and disappointment me is ‘imagine we want you to learn a subject, but we cannot provide you with any time at work or any financial resources to access courses. What can you do to make this learningpossible‘?
Certainly from my experience nurses struggle with this question as it never seems to occur to them that there are a whole world of resources out there from either libraries or indeed via the Internet. I am a great proponent of using the Internet to help one learn. To me, this question will give you some insight into whether the potential practitioners are expecting to be merely spoonfed all their learning or whether they are more ambitious and forward thinking and will go and find the information for themselves. Indeed hopefully, one day, they will provide that information for future practitioners to use.

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Jevon

Jevon

Possibly the book I most highly recommend for nurses to use as their pocket guide. Phil Jevon is a practitioner in Walsall and has produced an easily read, pocket sized tool. You can click on the picture above  to purchase this excellent book.
Talley and O'Conner
Slightly less 'weighty' than Macleods but still with lots of useful detail and information. The latest copies also have a CD with good, well narrated examples of clinical examination.
Macleods
This title is 'Highly Commended' in the 2006 British Medical Association Awards! 'an incredibly thorough book which is very well illustrated - a must in a book explaining how to perform examinations' - ("Medical Student Review"). This book will show you how to: talk with a patient; take the history from the patient; examine a patient; formulate your findings into differential diagnoses and rank these in order of probability; and, use investigations to support or refute your differential diagnosis.