Post Interview Notes + Reflection
Background Information: I interviewed Echo Stone, a young BSN graduate, who graduated from Dixon School of Nursing. She is a Pediatric Nurse that cares for patients between the ages of 0-18 years old. She works night shift from 7 P.M. to 7 A.M. at Clearwater Medical. Clearwater is a prestigious hospital maintaining magnet status five years and counting.
Overview of Notes
Q1. “Did the fact that Clearwater Medical has magnet status factor your decision to work there?” A: “Yes. Hospitals have to go through a certain amount of criteria to have magnet status so the fact they do is great to be affiliated with.”
Q2. “Who do you regularly communicate with?”
A: “Patients and family. Depending on the patient’s age, I communicate with the parent. I communicate to the day shift nurses and we give each other reports on each patient. The charge nurse is always a resource to bounce off ideas. I communicate with doctors over the phone or text page them on the computer. I communicate with the Pharmacist when I am missing medication, requesting medication, or asking questions about compatibility with IV medications and IV fluids over the phone or text page.”
Q3: “How do you communicate with your superiors and colleagues? Do you have any insider language?”
A: “For Doctors/care plan, we use abbreviations and medical words. To name some: Tylenol Q6 H PRN (tylenol 6 hours as needed), PIV (Peripheral IV), ABX (antibiotics), VSS (Vital Sign Stable), PT (patient), voiding (peeing), bm (bowel movement), tolerating PO (patient is drinking fluids), NPO (nothing by mouth), etc. I maintain professional language with doctors and make sure I write my name and call back number.”
Q4. “When you get an admission, what kind of documentation do you complete?
A: “If the patient has allergies, meds, belongings from home, assisted devices, flu shots, primary language, prefer written language, contact with tubercolosis, nutritional issues, primary contact and secondary contact, and safety questions). I write a care plan of how I care for them and how I got them settled.”
Q5: “When do you communicate with people outside of the hospital?”
A: “If I need to get in touch with a patient’s doctor who is not a physician in the hospital, I have to call them. If a patient is abused, I have to talk to a member of the child abuse hotline.”
Q6: “How do you record the progress of a patient?”
Q5: “When do you communicate with people outside of the hospital?”
A: “If I need to get in touch with a patient’s doctor who is not a physician in the hospital, I have to call them. If a patient is abused, I have to talk to a member of the child abuse hotline.”
Q6: “How do you record the progress of a patient?”
A: “If a patient has a tylenol overdose, I track their liver enzyme levels and make sure lab results improve for them to go home. I document all their assessments and write progress notes. At 8 p.m., 12 a.m., and 4 a.m. I do assessments on each of my patients. If I have labs due, I complete them at the 4 a.m. assessment. I write two care plans a night- one at 10 p.m. and the second one at 6 a.m. summarizing the patient’s plan of care and any issues. I record everything online in their medical records. I notify the doctor on how they are doing because they communicate the results.
Q6 follow up: “What is considered excess?”
A: “Only document what you did and stick to the medical charting that is required. Do not overchart where you could incriminate yourself. If there was an issue with the parent, write what you did to help improve the situation.
Q6 follow up: “Do you record emotional stuff too?”
A: “If it could compromise the patient’s emotional and mental state, then I record it. If the mom and dad were disagreeing with the plan of care and screaming at the nurse or patient then I would record it.”
Q7: “What approach do you take communicating with a child?”
A: “For an 8-year-old, when putting an IV in I tell them I am going to put a straw into their arm that is going to help their arm have a drink. Taking a 3-year-old’s blood pressure I ask if they like hugs and that their arm is going to get a little hug. Use calming voice and have prizes on the floor to reward their behavior.”
Q8: “What written communication do you perform for discharge teaching?”
A: “Summarize home medications, restrictions with diet or exercise, follow up appointment, any signs and symptoms, when to call doctor, and come back to ER. I document that I discharged instructions with parent and parent’s understanding.
Q9: “How do you resolve conflicts with patients’ parents if they are unsatisfied with the care?”
“Respond in calm manner and hear them out. If I can’t answer the questions or issues that they bring up I ask the charge nurse.”
Q9 Follow up: “How do you document any complaints of parents? What do you not include in it?”
A: “Write progress note stating the issue and who I involved. The doctors don’t like the nurse to name the doctor so I just write resident notified.
Q10: “What approach do you take when communicating to parents who do not know medical jargon?”
A: “Explain it in a general way and do not use abbreviations. Instead of saying your child is going to be npo at midnight, I just say to not eat or drink at midnight.”
Q11: “What according to you, is the most important aspect of communication in your career as a nurse? And why?”
A: “Being able to effectively communicate with the child and parent and keeping them in the loop. As far as the professional side of it, documentation is the most important written form. Because that is our license, we do everything we can to protect our integrity as a professional so we have to record what is necessary in case complaints are filed against me or the hospital.”
I thought the majority of my questions worked well. I asked open ended questions which allowed the interviewee to have freedom to expand her answers. Follow up questions helped gather more specific information. I did well steering the interviewee back in to the main points. This helped me get the answers I wanted. During the interview, I had to be flexible and change the order of questions so it would flow. Some of my moves included leaning in, using hand gestures, nodding head to encourage interviewee, and following the interviewee’s lead to adjust questions.
Some specific questions that provided good answers:
· Question 3: “How do you communicate with your superiors and colleagues? Do you have any insider language?” I liked this question because it includes other people into the world of how nurses communicate with each other about patient’s care.
· Question 6: “How do you record the progress of a patient? What is considered excess? Do you record emotional stuff too?” This question + the follow ups worked well because all the answers provided written communication and showed the importance of documentation.
· Question 7: “What approach do you take communicating with a child?” It yielded an effective response because she described the approaches she personally uses to get on her patients’ level.
· Question 11: “What according to you, is the most important aspect of communication in your career as a nurse?” I like this question because the answer explains how crucial documentation is in nursing.
If I conducted a similar interview again, I would spend more time sharpening certain questions to avoid confusion. A couple questions that were confusing when asked and needed clarifications/elaborations:
·Q5: "When do you communicate with people outside of the hospital?" This was one of my least favorite questions because it felt dull.
·Q11: "What is the most important aspect of communication in your career as a nurse?" This yielded a little confusion but after I expanded on it it she understood.
For future reference, I would review the article “10 Tips” that discusses clarity as the “most important characteristic of good business writing,” (10 Tips). Tip 10 in the article cautions “making exceptions about formality when corresponding with coworkers” and to “drop the formality a notch” (10 Tips). I struggled balancing a formal and casual tone with my interviewee. It was strange to maintain a professional demeanor with someone I know well. I had to remind myself that it was a professional interview and not a conversation. I also struggled with maintaining the right amount of eye contact while trying to get as many notes as possible. Next time, I will ask to record it so I can give my undivided attention to the interviewee.
Q6 follow up: “What is considered excess?”
A: “Only document what you did and stick to the medical charting that is required. Do not overchart where you could incriminate yourself. If there was an issue with the parent, write what you did to help improve the situation.
Q6 follow up: “Do you record emotional stuff too?”
A: “If it could compromise the patient’s emotional and mental state, then I record it. If the mom and dad were disagreeing with the plan of care and screaming at the nurse or patient then I would record it.”
Q7: “What approach do you take communicating with a child?”
A: “For an 8-year-old, when putting an IV in I tell them I am going to put a straw into their arm that is going to help their arm have a drink. Taking a 3-year-old’s blood pressure I ask if they like hugs and that their arm is going to get a little hug. Use calming voice and have prizes on the floor to reward their behavior.”
Q8: “What written communication do you perform for discharge teaching?”
A: “Summarize home medications, restrictions with diet or exercise, follow up appointment, any signs and symptoms, when to call doctor, and come back to ER. I document that I discharged instructions with parent and parent’s understanding.
Q9: “How do you resolve conflicts with patients’ parents if they are unsatisfied with the care?”
“Respond in calm manner and hear them out. If I can’t answer the questions or issues that they bring up I ask the charge nurse.”
Q9 Follow up: “How do you document any complaints of parents? What do you not include in it?”
A: “Write progress note stating the issue and who I involved. The doctors don’t like the nurse to name the doctor so I just write resident notified.
Q10: “What approach do you take when communicating to parents who do not know medical jargon?”
A: “Explain it in a general way and do not use abbreviations. Instead of saying your child is going to be npo at midnight, I just say to not eat or drink at midnight.”
Q11: “What according to you, is the most important aspect of communication in your career as a nurse? And why?”
A: “Being able to effectively communicate with the child and parent and keeping them in the loop. As far as the professional side of it, documentation is the most important written form. Because that is our license, we do everything we can to protect our integrity as a professional so we have to record what is necessary in case complaints are filed against me or the hospital.”
Reflection:
In the interview, we discussed Echo’s job description, duties, communication techniques and approaches among interdisciplinary professionals, and verbal/written communication she performs on the day to day. I also wanted an honest and real perspective on the emotional and physical factors that the nursing profession holds so I asked a couple personal questions at the end. Overall, I thought the interview went well. I learned a lot on how Echo communicates day to day as a nurse verbally and in written form. It provided a new perspective of nursing that I am grateful for.I thought the majority of my questions worked well. I asked open ended questions which allowed the interviewee to have freedom to expand her answers. Follow up questions helped gather more specific information. I did well steering the interviewee back in to the main points. This helped me get the answers I wanted. During the interview, I had to be flexible and change the order of questions so it would flow. Some of my moves included leaning in, using hand gestures, nodding head to encourage interviewee, and following the interviewee’s lead to adjust questions.
Some specific questions that provided good answers:
· Question 3: “How do you communicate with your superiors and colleagues? Do you have any insider language?” I liked this question because it includes other people into the world of how nurses communicate with each other about patient’s care.
· Question 6: “How do you record the progress of a patient? What is considered excess? Do you record emotional stuff too?” This question + the follow ups worked well because all the answers provided written communication and showed the importance of documentation.
· Question 7: “What approach do you take communicating with a child?” It yielded an effective response because she described the approaches she personally uses to get on her patients’ level.
· Question 11: “What according to you, is the most important aspect of communication in your career as a nurse?” I like this question because the answer explains how crucial documentation is in nursing.
If I conducted a similar interview again, I would spend more time sharpening certain questions to avoid confusion. A couple questions that were confusing when asked and needed clarifications/elaborations:
·Q5: "When do you communicate with people outside of the hospital?" This was one of my least favorite questions because it felt dull.
·Q11: "What is the most important aspect of communication in your career as a nurse?" This yielded a little confusion but after I expanded on it it she understood.
For future reference, I would review the article “10 Tips” that discusses clarity as the “most important characteristic of good business writing,” (10 Tips). Tip 10 in the article cautions “making exceptions about formality when corresponding with coworkers” and to “drop the formality a notch” (10 Tips). I struggled balancing a formal and casual tone with my interviewee. It was strange to maintain a professional demeanor with someone I know well. I had to remind myself that it was a professional interview and not a conversation. I also struggled with maintaining the right amount of eye contact while trying to get as many notes as possible. Next time, I will ask to record it so I can give my undivided attention to the interviewee.
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