INTERVIEW PREPARATION

In order to help you prepare for your interview, please find below some questions you may expect to be asked.

GENERAL QUESTIONS
1. Can you please tell me about your current and previous experience? / What is your management experience (teaching junior staff and student nurses)? Over these seven years since I finished my degree, Ive been working in several areas and I have learnt a lot and I have achieved many skills such as good communication with patients and relatives, solve problems in my work environment. I have learnt to dealt with different people, colleague, relatives and patients, overall chronic patients (chronic kidney disease in hemodialysis, COPD), patients with heart disease, stroke patients and Ive worked in E&A too. In brief, I have more than 4 years of experience in several areas such in Neurology, Cardiology, General Medicine, Renal unit (overall hemodialysis I have a good training to work in as you can see in my CV, but the most important thing is that I could be suitable in any ward that you need. As you can see I have adaptability skills (actitud para el cambio). Im able to assess basic needs, planification, deliver and evaluation of the patients care

2.

Could you tell me a little about yourself? What kind of an employee are you? Describe your personality: I come from Caceres, a beautiful and small wall city in the west of Spain, 300 km far from Madrid. I finished my degree in nursing from University of Extremadura in 2005 and I started to work in Madrid for 3 months. After I was working in several hospitals from my region until 2009. Since 2009 I was working between Asturias, Extremadura and Madrid, anywhere if I got a job, but all this kind of job were substitutions for illnes, pregnant or holidays, I didnt mind because I wanted to work. In this way, I consider myself as a active person, always prepare to work because I love my job and I enjoy with that. In my spare time, I did some voluntary work in ambulance at Spanish Red Cross while I have been studing my degree, It was unpaid but at least I was getting some more work experience. About my training, I believe in continuing profesional development and longlife learning, so that. Im always taking continuing education of nursing to offer the best care, and I have done some courses about neurology, nephrology, cardiopulmonary resuscitation, dialysis, electrocardiography... because I like learning and updating every day. I would like to develop my knowledge and I look forward to become a nurse at your Hospital.

3.

What are your greatest strengths? I consider I am well-qualified, well organized, motivated, minded (dispuesta), hard-worker, punctual, quick-learner, team-player, and positive attitude, I like to think on the best way to solves the problems. I love learning new things, deal with patients, I usually get on well with everyone that I meet. I am patient and I work very well with all kinds of people and under pressure.

4.

What are your weaknesses? Sometimes, I can be stubborn, but that just means I want to get things done right, If I dont know something, I like answering to someboby or look for some information in protocols about something that I concern, I like to be sure before to do something wrong. Sensitive in all the ways of my life, but Ive learnt to open an emotional umbrella and try that any problem that I have in my work environment affect to my personal life. Ive learnt to switch off during the time Ive been working as a nurse. I think that nobody is perfect, Im not perfect, but Ive realized that Id be suitable for this job because I have considerable experience in many areas as a nurse.

5.

Why did you / do you want to leave your previous job? Im out of work at the moment, I would like to work in a stable employment because in Spain Ive only been working in a temporary job, with short turn contract. Im interested in this job because would be for a long run.

6.

Have you ever been fired or asked to resign? No

7.

Why have you held so many jobs? Because Ive only worked in a temporary job with short turn contracts.

8.

What do you know about healthcare system NHS and private? NHS set up (establecer) with compulsory (obligatorio) national insurance payments, its free to people who live in UK and Its one of the most popular and supported public institution in the country. It belong to the Welfare System (social care, pensions, unemployed).

It delivers (entrega) a thorough (exhaustivo) healthcare to all permanents residents of the United Kingdom. There are primary care (including access to general practitioners, screening programmes, maternity care, mental health) and secondary care in hospitals and through to care of chronically all people. Private sector runs hospital, many psychiatric hospitals and specialist clinics. Also provides much of the occupational health services for industry and many private company, and run hundreds of nursing homes and other care facilities for older people. It is considerable smaller than the public. Both have a fantastic healthcare system.

9.

What do you know about the Hospital / Group? Royal Preston Hospital belongs to Lancashire Teaching Hospital, one of the largest (grande) and highest performing (gran desempeo) trusts in the country, providing district general hospital services to 370,000 people in Preston and Chorley, and specialist care to 1.5m people across Lancashire and South Cumbria. The hospital has around 700 beds, operating theatre complex, outpatient suites, and education facilities. This Foundation Trust provide care from three facilities: Chorley and South Ribble Hospital, Royal Preston Hospital, the Specialist Mobility and Rehabilitation Centre. Royal Preston Hospital provides a full range of district general hospital services including Emergency Department, critical care, general medicine including elderly care, general surgery, oral and maxillo-facial surgery, ear nose and throat surgery, anesthetics, childrens services, womens health and maternity, and several specialist regional services including cancer, neurosurgery and neurology, renal, plastics and burns, rehabilitation, and the major trauma centre for Lancashire and South Cumbria. We have recently been accredited as the regional major trauma centre for Lancashire and South Cumbria and are working towards (hacia) expanding our range of specialist services. Our participation in national and international research programmes. The countrys leading cancer trial patient recruiters, demonstrating our commitment (compromiso) to developing new and progressive treatment which improves health outcomes (resultados). Our medical undergraduate programme, in partnership (asociaciacin) with Manchester and St Andrews Universities, delivers excellent education and training for young doctors, enable (permitir) medical students and staff to develop their skills and knowledge. Governors are elected by patients, public and staff, or nominated by some of our partner (socio) organisations.

10. Why do you want to come to the UK? I have always wanted to work in the UK and nowadays is a good moment because I am young, I dont have any obligation, Im not married I dont have children therefore I want to live a new experience, improve my English, develop my knowledge and get experience as a nurse. I have heard a lot of good things about the healthcare system in the UK and I could learn too much there because work as a nurse in England is different than in Spain, I think, nursing in the UK involves caring for the whole person (holistic care). Ive been living in England the last month and I feel very happy, sharing experience and culture with native people, at the moment, I knew that I want to work in England, I didnt mind the weather, the food, now, I know that Ill be able to live in England well.

11. Why do you want to work for the hospital? I applied for this post because in my opinion its a great chance to work in a hospital in the UK. I am excited to this opportunity that you are offering me. I was checking the website of the hospital, and I found out (averiguar) something that I love it, you are a teaching hospital and I think, in one hand, this is important to improve and learn new knowledge and other hand to help a new student to achieve new skills and ability. I consider this post as a challenging opportunity and I know that it could be a rewarding experience for me. You have got an education centres include state of the art human simulation facilities, libraries, seminar rooms and lecture theatres, to provide some of the best learning environments in the country. I wish to have a job that gives me professional progress as well as creative satisfaction and stability. Requirements (requisitos)

12. What did you do to prepare yourself for this interview? First of all, in November, when I started to register with NMC, I began to improve my English with an online course, watching film, listening the radio, surfering on internet English website. Then, in January, I took a intensive course of "English for nursing" with Baker Street. During February, I was taking a intensive course in Margate (England) with BKstreet too. Finally, when I arrived to Spain, I applied for this job and I started to prepare all the question that you sent me by mail, other questions for the interview that I had, I checked the website of the hospital, NMC, RCN, nursinglink, NHS nursing career, testandcalc... etc

13. How is this job different from the other positions you have interviewed for? Why does this job interest you? Why do you want this job? What are you looking for in a new job? I was checking the website of the hospital, and I found out (averiguar) something that I love it, you are a teaching hospital and I think, in one hand, this is important to improve and learn new knowledge and other hand to help a new student to achieve new skills and ability. I consider this post as a challenging opportunity and I know that it could be a rewarding experience for me. You have got an education centres include state of the art human simulation facilities, libraries, seminar rooms and lecture theatres, to provide some of the best learning environments in the country. But another important thing is I can get a good contract for a long run and maybe, I could promote if I work hard. Im looking for stability in my life and in my job

14. What kind of contribution do you think you could make to our organization? What can you offer the unit? Why should we hire you? What makes you different from other candidates? What value can you add to this company as an employee? What do I need to know about you to get an accurate picture (imagen exacta) of what makes you tick? Why do you stand out (destacar) from everyone else? First of all, I love my job and enjoy working with patients. I always have great relationships with my colleagues. I have almost 4 years of experience in several areas such in Neurology, Cardiology, General Medicine, Renal unit (overcoat hemodialysis I have a good training to work in this unit as you can see in my CV, but the most important thing is that I could be suitable in every ward that you need. You can find in my candidacy that Im well-prepared, responsible, adaptable to situations and I am willing to learn anything. Therefore I think you should hire me because I will promote my best of care.

15. What do you like most about your present job? What do you love about your job? What makes it interesting to you? Which of your past jobs did you like the most? When were your most satisfied in your job? I really enjoy working with patients and providing care. I especially like working with elderly patients because they can teach you so much, but in another way, I like working with young people too. I love to work with chronic patients because I can teach the best way to improve their health promotioning good and healthy life style.

16. Which of your jobs was the least interesting? Why? What do you like least about your present job? I love my job in all the way, and I always try to get the best of my job. Maybe, the worst part of my job could be working with children, Ive never worked with children, but Im very sad when they are sick. Another things that I dont like about my job, deliver bad news to the patients and relatives or see as a young people die. From my point of view, a nurse has to get used to live close to the death, its important that we have good skills to switch off, we must be empathy but we mustnt involve too much.

17. Where do you see yourself in 10 years? What Are Your Career Goals (objetivos)? Firstly I want to get a lot of experience in the position Im applying for this job because I want to promote during my career and keep studing to try being the best nurse. I like UK, maybe I could be living there for a long long time, but I dont know, I prefer to think in this important moment, and go step by step, but all my goals go around to improve my knowledge to give the best care properly. 18. Can you give me an example of where you have done something extra special in order to satisfy a patient? When I was working in a General Medicine, I took care a young girl 38 y-o who was suffering from terminal cancer, She was in her last day, she had a lot of family but, as you know, its not allow more than 2 relatives in the room. I told with security man and with my staff colleague and we allow that her parents, sister and husband would be with her, finally she died but close to her family. Another funny example was in Fresenius, Carnival and Christmas time dressed up

19. Give an example of a staff conflict that you have encountered and tell me what you did?. Describe a specific experience working in a group or team situation where there was interpersonal conflict. Describe how you approached (enfocar) the conflict, what worked well, and what didnt. What was the outcome (resultado)? Tell me about a complex problem you had to solve and walk me through your thinking as you solved it. Describe a Time You Worked with Someone You Did Not Get Along With. When I started to work in a nephrology ward, I met my new colleague of the nurse staff, I always like to read protocols and policies, and ask some questions and doubts to my colleague if I dont know how can I do something when I begin to work in a new ward. I dont know why but my colleague for the first time didnt mesh with me, she didnt answer my issues, It was a awkward (oquird) situation, and before that the things were getting worse, I spoke with her, and I told her, I didnt meet you and you didnt meet me, I dont know what is your problem about me, Id like you told me about,

because its better for you, for me and for our work environment, she didnt know what happened with me, but since then, we began to work well together, she helped me and I helped her. I believe that talking a problem through with someone will help solve the issue

20. How do you normally handle crises? In stressful situations I will try to keep calm and work the most effectively for the best care of my patients because If I am nervous I will not work well so I think its very important to manage these situations. Stressed cannot interference with the care of the patient. I think that if we work in team and with protocols knowing what we have to do, its better to handle stressful situation.

21. How do you normally handle criticism? 22. Describe Your Biggest Failure. What Did You Learn? Describe a situation when you felt you were unfairly (injustamente) criticized. What did you do? In my first job, when I finished my degree, once made a crucial error with a intravenous antibiotics. I was finishing my shift and I had to put a intravenous antibiotics for two patients when my colleague arrived for her afternoon shift. Firstly, we prefer to talk about what happened during my shift, finally I told her that I needed to finish with the medication before I go, she told me, you dont worry, Ill put it, I told her which antibiotic was for female patient and which was for the male patient, I felt she didnt hear me, and before I realized that she put wrong the medication to the female patient, quickly I checked the chart, she was allergic!! We ran with the emergency trolley to check the patient, she was right and finally and luckily she wasnt allergic, I called to the doctor. After, she told me that I was blame, I thought that it wasnt all my fault, and I decide to speak with my boss, firstly because I prefer to notify the big mistake with the main aim that never ever happend, and then, because I didnt want to have misunderstandings with the staff and my colleague. My boss congratulated me because I was sincere but Ive never felt worst in my life. It was my first job!! Since then, I have learned to check and double-check my patients charts and even ask a colleague if everything is ok.

23. How do you normally handle failure (fracaso)? First, I feel so bad because I dont like to make mistake or to have a failure, but I know that I always can learn with my failure or mistake and to find the best way to solve the problems, for me the best way is to share my afraid, my mistakes or my doubts with the rest of the staff with the main aim that never ever happen something wrong. Im human, I can have some failure but I always try to learn from this and never repeat it.

24. Tell me about at time when you were under a great deal of pressure. In my first job, when I finished my degree, once made a crucial error with a intravenous antibiotics. I was finishing my shift and I had to put a intravenous antibiotics for two patients when my colleague arrived for her afternoon shift. Firstly, we prefer to talk about what happened during my shift, finally I told her that I needed to finish with the medication before I go, she told me, you dont worry, Ill put it, I told her which antibiotic was for female patient and which was for the male patient, I felt she didnt hear me, and before I realized that she put wrong the medication to the female patient, quickly I checked the chart, she was allergic!! We ran with the emergency trolley to check the patient, she was right and finally and luckily she wasnt allergic, I called to the doctor. After, she told me that I was blame, I thought that it wasnt all my fault, and I decide to speak with my boss, firstly because I prefer to notify the big mistake with the main aim that never ever happend, and then, because I didnt want to have misunderstandings with the staff and my colleague.

25. Can you describe a stressed situation and how did you solve it? When I was working in hemodialysis unit a patient withdraw the arterial needle from her fistula, blood spill out quickly and when we realized maybe she had lost 500 ml of blood. My colleague and me worked quick in team, while she managed the hemodialysis machine and serotherapy, I covered puncture area with a lot of gauze dressing for hemostasis, took blood pressure and took a blood test to check the hematocrit. Then, we blip the doctor who ordered blood transfusion to set up at the moment. Luckily, everything was ok and we solved the stressed situation well working in team. 26. What kinds of decisions are most difficult for you? the worst part of my job could be working with children, Ive never worked with children, but Im very sad when they are sick. Another things that I dont like about my job, deliver bad news to the patients and relatives or see as a young people die.

27. How do you prioritise your workload (carga de trabajo)? What do you do when you have a number of conflicting priorities?

28. Give an example of when you have had to work as part of a team. I usually work as part f a team. When I was working in hemodialysis unit a patient withdraw the arterial needle from her fistula, blood spill out quickly and when we realized maybe she had lost 500 ml of blood. My colleague and me worked quick in team, while she managed the hemodialysis machine and serotherapy, I covered puncture area

with a lot of gauze dressing for hemostasis, took blood pressure and took a blood test to check the hematocrit. Then, we blip the doctor who ordered blood transfusion to set up at the moment. Luckily, everything was ok and we solved the stressed situation well working in team. 29. How well do you work as a part of a team and individually? Both have good advantages, but I prefer to work as a part of a team. I like working in a team because you can learn, change ideas with your colleagues and help them too. Work individually it makes you more independent because you work alone and you have to solve some situations by yourself, I can feel more confident by myself.

30. Give an example of one good decision and one bad decision you have made in the last six months and explain why they were good or bad decisions. One good decision for me was apply for this job and go for one month to England to improve my English and realize that I could live alone in a foreign country. Bad decision was that once I hadnt courageous to make an important decision in my personal life before, but It doesnt matter, now I feel very confident by myself and I know that everything will be ok.

31. What type of salary do you have in mind? I know which will be my salary in UK, and for me its enough because at the moment, the most important things is to share a new experience, to work with a new team, to improve my english and to learn a lot about the Healthcare system in UK.

32. What do you find difficult about being a nurse? In my opinion the most difficult part of being a nurse is when I have a discomfortable, restless (inquieto) patient with a lot of pain or the patient is conscious that he is going to die and he/she and their relatives are so sad . It is a hard situation. Experience in those cases, should help to became stronger in any situation. 33. What do you find the most rewarding about being a nurse? I feel enormous satisfaction when I see the improvement in my patients evolution, when they are admitted and they tell me they have been comfortable and thankful with my care or when they tell me that Im an angel. Thats the best perk in my job.

34. How would you cope with a colleague who turned up for work with alcohol breath? I would talk to him and I would tell him that he should go home because he couldnt work effectively because it supposes a risk for the patient. 35. How would you deal with an aggressive patient / relative? If the patient is aggressive or insult me I would try to calm him/her down, I would talk slow. If he or she talk to me very shout I would reduce my tone voice. I would do and effective communication, empathizes attitude and dont dramatize the situation, dont be critical and promote a quite environment. 36. What do you understand by CPD? Counting professional development? From my point of view, CPD is really important to all the employers. We have to update our skills and widen (expandir) our knowledge in order to promote high quality of care. We have to stay informed of all our latest news. 37. What does professionalism mean to you? Professionalism mean to me, to do the best, respect myself and others. Respect the patient and their privacy, in this way, protect confidential information. Maintain my professional knowledge. Definitly, be trustworthy.

38. How would you deal with a doctor who was rude? If the conflict happens once I wouldnt mind enough but if the doctor is always rude with me I would talk to him. It should be clarified. If I did something wrong. If the doctor continue with a rude behavior I will notify my supervisor, sister

39. How do you handle a patient who complains constantly of pain? I would see the chart and I would talk to the doctor and confirm that the patients pain is being managed in the most effective way. If the pain continues in spite of the painkillers I would listen to his complaints and reassure (tranquilizar) his concerns. 40. How would you handle a patient who complains about everything? I just be patient and I would reassure him/her that everything possible is being done to make him/her comfortable. 41. How would you handle the family of a patient in your care who is displeased with your care of the patient? I would listen to his/her concerns and I would try to reassure him/her that the patient is getting the best quality of care.

42. What do you feel you contribute to your patients? I offer my patients the best care because I chose nursing as a vocation. I am wellprepared and I love to take care them. 43. Can you please tell me what you understand by Evidence Based Practice? And how important it is in your nursing career? The practice of nursing in which the nurse makes clinical decisions on the basis of the best available current research evidence, his or her own clinical expertise, and the needs and preferences of the patient. Its important that nursing is continuing develop and investigation to offer the best care to the patients. 44. Do you read Journals / articles and research papers, and websites to keep your knowledge up to date? Can you tell me the names of what you read? Yes, normally I read articles SEDEN, nursingtimes, enfermundi, nursing magazing. I take free online course with Fuden and Satse (trade union).

45. What would you do if a patient had been prescribed a treatment that went against your own knowledge and experience? Has this ever happened to you? If Im not sure or I disagree with a treatment that I have to manage, I prefer to discuss with the doctor or with the rest of the staff, and try that they explain to me why they have prescribed that treatment.

46. How do you ensure that you comply with the Hospital policies and procedures at work for the following: Care planning: Carrying out the nursing process: ADPIE Assessing (collecting and organizing data, obtained by report, observation, interview). Diagnosing ( nursing diagnosis of an actual or potential health problem) Planning (formulating goal/expected outcome, setting priorities, identifying nursing interventions)

Implementing / intervention ( put in action Nursing care plan) Evaluating ( reassess and analyze) The nursing care plan consists of a nursing diagnosis with defining characteristics (subjective and objective data that support the diagnosis), related factors or risk factors, expected outcomes/goals, and nursing interventions. Drug administration A nurse need a good training in drug administration to keep safety and check the side effects, we need to know about all the routes administration. We must consider: Right patient Check the name on the order and the patient. Ask patient to identify himself/herself. Right medication Check the medication label. Check the order. Right dose. If necessary, calculate the dose and have another nurse calculate the dose as well. Right route Confirm that the patient can take or receive the medication by the ordered route. Right time Check the frequency of the ordered medication. Double-check that you are giving the ordered dose at the correct time. Confirm when the last dose was given. Right documentation Document administration AFTER giving the ordered medication. Chart the time, route, and any other specific information as necessary. For example, the site of an injection or any laboratory value or vital sign that needed to be checked before giving the drug. Right reason Confirm the rationale for the ordered medication. What is the patients history? Why is he/she taking this medication? Revisit the reasons for long-term medication use. Right response Make sure that the drug led to the desired effect. If an antihypertensive was given, has his/her blood pressure improved?

Does the patient verbalize improvement in depression while on an antidepressant? Be sure to document your monitoring of the patient and any other nursing interventions that are applicable.

Police and protocols Police and protocols are important to do a good job and give the best caring to the patients. They allow continuing caring whether you are a senior nurse or a junior nurse who works for the first time. Protocols guide you to give the best holistic care and decrease mistakes happen.

47. What is Risk Management? Risk management in healthcare includes a huge spectrum of things that could and can go wrong. It includes: Slips, trips and falls involving staff, patients and the public. Administrative errors that impact on patient care. Clinical incidents that have a direct effect on the outcome of patient care. For a god management of risk we must: Communicate and consult/ establish the context/ identify risks/ analyse risks/ evaluate risks/ treat risks/ monitor and review

48. How would you discribe your attitude toward risk? 49. Do you consider yourself a risk taker? I consider myself as a organized person who have responsible attitude toward risk. For a god management of risk we must: Communicate and consult/ establish the context/ identify risks/ analyse risks/ evaluate risks/ treat risks/ monitor and review

50. Should patients requiring vital signs monitoring every four hours be woken at 2am to have their observations recorded? What do you think? Recording (registrar) patient observations is an important part of nursing routine and an essential skill to be able to detect changes in the patients condition. A one-off or isolated (aislado) observation is of little use unless compared to recent trends in clinical status. If a nurse is concerned about a patient enough to be motivated to carry out (llevar a cabo) four hourly observations then that patient should be woken to have those observations recorded. However (sin embargo), nurses should feel empowered and confident enough to be able to adapt their routine to reflect (reflexionar) a patients progression towards (hacia) recovery (recuperacin). Nurses should also trust their instinct and if they feel the patient is deteriorating, the question they should ask themselves should be whether four hourly observation is enough or should the patient be monitored more regularly or even continuously.

Sleep is an important component of patient recovery and one of the most essential activities of daily living. This leads (conduce) to increased length (longitud) of stay in hospital, which corresponds with increased cost and, most importantly, is unpleasant for the patient. Nurses should be able to carry out an end of bed observation without waking a sleeping patient. That is, be able to assess whether the patient has a patent airway (va aerea permeable), observe respiratory pattern (patrn respiratorio) and count the respiratory rate and be able to detect whether the patient is well perfused and, therefore (por lo tantp), whether the patient has a adequate cardiac output (rendimiento).

51. What are the skills and qualities that you feel are required to be a good staff nurse? I think that a nurse must give compassionate, safe, high quality care to all patients and their relatives. Must be a good Problem solver: Small signs can give you early warning that a patients health is changing. Polite, responsible, pro-active A good nurse needs to be up to date always about nursing process. To be able to use what you learn to improve patient care. To have emotional stability A skilled nurse can help anyone, whatever their situation, feel at ease (sentirse a gusto). The people you deal with may feel anxious, afraid, embarrassed or distressed either about their own health or the health of someone they love. Respect, sensitivity and empathy are important. You need to like people! To listen carefully and be able to answer questions, discuss options and give advice on healthier living. Clear communication is also at the heart of good teamwork. Organised: Deciding who or what needs your attention the most, and doing things efficiently, will help you give patients the best possible care. Taking responsibility means having a certain confidence in your own judgement and abilities. 52. What would you do if your patient was unresponsive (no responda)? If I see a patient on the floor, first, I put her/him in safety environment and position. Then, I would assess him/her vital signs, look for any obvious injuries, I would do neurology checks. Finally, I would ask for help and bleep the doctor but Ill never leave him/her alone.

53. A 48y-o male is admitted with S.O.B. He has a history of COPD. What are your initial nursing actions? / A patient with a history of COPD is admitted to your unit. He has breathing difficulties. What are your initial nursing actions? First of all, I would make him feel calm and that the situation is under control, something that reduces the anxiety which aggravates the dyspnea (dispnia) episode. Ill make sure he or she is comfortable and not restricted by clothing. Then, I would take the vital signs for the patient, (BP, Sat) especially to check the ones about his respiration. Be sure not to alarm if he has Sat of 89-92% because is the normal range for a patient with COPD. Would be interested to check the peak flow rate to know if it has decreased. In other way, I would show him to a ventilated and quiet room, in that way his breathlessness (falta de aliento) would be diminished If he has low Sat, bleep the Dr, and ask him if he want us to put some oxigenotherapy or aerosol therapy to the patient, but I won't leave him alone. Finally, I would reevaluate his situation. 54. How do you ensure safe use and storage of medications? First, when I start my journey, I check the medications that Im going to need, in this way to ensure safe use I prefer to work with other colleagues staff for double check. Ill asked about the protocols to storage of medications when I arrive to a new ward, to check daily, weekly or monthly sell-by-date (fecha de caducidad), the way f conditions of storage, to place a order if some medications is finished... 55. You have a bedridden patient (paciente encamado), who also has diabetes. What observations will you need to make? What special care will she need? Prevention is better than the cure. Control of the factor(Pressure, Shearing force (zigzallamiento), Friction, Moistur) Monitor general health, check her/him blood glucose levels and well being. Encourage to mobilize Positional changes Protecting bony prominences Appropriate equipment Appropriate nutrition, increase proteins in their meal and fluids Skin care

56. How do you ensure effective communication with patients? First of all, I won't give any important information to any patient not having ensured previously that he/she can hear me well and that he/she is able to understand my words. The most important action would be adapting us to the patient situation, speak to him/her with the same words that he/she uses to communicate in his/her daily life, ask them simple questions, use the body language and keep eyes contact too. Then, Ill make sure that they have understood of what I said. After that I would explain to him/her the situation and then I would ask some questions about what I said.

57. What have you achieved as a nurse? The most important thing I've achieved during my experience as a nurse is to understand the true importance of having a nice relationship with the patients, relatives and colleague. I think it's very necessary trying to understand the patients, respecting them and their decisions and helping them to feell more comfortable. When they feel that you really want to care for them, they appreciate your help and nursing becomes a rewarding profession that brings self-satisfaction and the respect of both patients and medical staff by doing your job well. 58. Can you describe a typical day at work? Depend on the ward and the shift. E.g. renal ward. I get the report from my colleague, then I check every medication, and I start to give the breakfast medication, review the pressure sore, heal wounds, take the vital signs, blood test and with the care assistant I'll help people with their hygine and dress. Then I report to the doctor if there is any significant changes, and sometimes I have to do some nursing procedure such as venipuncture, urinary catheterization. About 12h, I give the medication, and if there are any diabetic patient, I do the glycemic control, and I administer insulin. And the last, I evaluate bowel and bladder control and I write my interventions down . 59. What is a costume care? Customer Care is the provision of service to customers before, during and after caring. It is a series of activities designed to enhance (enjans/mejorar) the level of patient satisfaction.

60. What do you understand by "Person Centered Care"? The essence of person-centred care is to put the person at the centre of care planning: this means finding out (averiguar) exactly who they are. To manage protocols and nursing process is really important, but a good nurse will need to adapt all the resources and knowledge in every patient, not only in the way of the health care, also in their beliefs, social environments, people lifes choices... E.g.: I look after a diabetic patient with a diabetic foot ulcer and she or he needs to feed with proteins, but is vegetarian, Ill need t adapt her or his dietetic preferences when Ill be planning the meal. 61. What do you understanding by Quality and Clinical Governance? C.G. is a systematic approach (enfoque) that covers activities that help sustain (sostener) and improve high standards of patient care. It is composed for: education and training, clinical audit, clinical effectiveness (eficacia), openness (franqueza), risk management and information management. 62. Why is confidentiality important? Confidentiality is an important issue (tema) because without it, professionals would find it difficult to build relationships with their patiens. Trust in a carer relationship is important, as a patient would not want to share personal information with someone if they felt it was not confidential. The aim of a confidential care service should be to protect the patients information and restrict who has access to it. The patient should be informed what his or her information is being used for and who has access to it, and they should give consent for it to be used in this way.

63. A wound swab (torunda) is returned positive to MRSA, what are you going to do? First, Id inform the patients and reassure him. Then, commence treatment and monitoring (controlar). The most important things is the infection control procedures to avoid cross infections as a thoroughly hand hygiene before and after any interventions. 64. Risk factors may lead to chronic wound such as... Malnutrition, dont have a balanced diet, dont do exercise, blood flow p roblems, infection, aging, diabetes, smoking, weight, swelling, medication..

65. Patient safety: Improving patient safety involves assessing how patients could be harmed (perjudicado), preventing or managing risks, reporting and analyzing incident, learning from such incidents and implementing solutions to minimize the likelihood (probabilidad) of them reoccurring We can ensure the patient safety in the following: We have to use standard precautions, patient privacy maintained, prevent infection, lock the wheelchair, practice good hygiene, promoting patient satisfaction, good communication is vital, and hand washing saves lives. 66. Empathy: Its about putting yourself in the patients shoes and being treated like you would wish to be treated. The best way to treat anyone with dignity is to imagine yourself in their position. 67. Acute care: (cuidados intensivos) Acute care is where people receive specialized support in an emergency or following referral (remisin) for surgery, complex tests and care or other things that cannot be done in the community. 68. Shared decision making: Its a process where clinicians and patients work together to select the best options for the patient, based on clinical evidence and the patient's informed preferences. It occupies the middle ground between more traditional clinician-centred practice, where patients rely on (confiar) their doctor or other healthcare professional to make. 69. Self management: It support aims to enable people with long term conditions to taken an active role in managing their health. It commonly involves patients developing an understanding of and following complex medical regimens as well as making challenging changes in their lifestyle to help manage their condition. Decisions about their care, and informed patient choice, where patients are given information and then left to make their own choices. 70. The Glasgow Coma Scale or GCS: Its a neurological scale that aims to give a reliable, objective way of recording the conscious state of a person; provides a score in the range 3-15. Motor Response, verbal response, eye opening response.

71. Norton Scale: Its widely used to assess the risk for pressure ulcer in adult patients. Use a 1 to 4 scoring system for 5 indicators. Physical Condition Mental Condition Activity Mobility Incontinence The five subscale scores of the Norton Scale are added together for a total score that ranges from 5-20. A lower Norton score indicates higher levels of risk for pressure ulcer development. 72. Commissioning: (puesta en marcha) Commissioning involves planning and buying services by assessing the needs of the population; prioritising outcomes; purchasing medicines, equipment and services; managing service providers; measuring impacts and planning next steps. 73. Quality improvement: Its an important element of the quality agenda. It aims (aspirar) to improve patient experience and outcomes by taking a systematic approach (enfoque) that uses specific techniques to improve quality. These approaches are often known as organisational and industrial methods, as their origins are in the manufacturing industries

74. Accountability (responsabilidad) Its about more than responsibility. To be accountable you need to have the ability, responsibility and authority for your actions. In order for anyone to be accountable they must: have the ability to perform (realizar) the task accept the responsibility for doing the task have the authority to perform the task within their job description, and the policies and protocols of the organisation. This means that: the task is necessary and delegation is in the patients best interest the support worker understands the task and how it is to be performed the support worker has the skills and abilities to perform the task competently the support worker accepts the responsibility to perform the task competen tly.

75. Information security: The objectives of East Cheshire NHS Trusts information security policy are to preserve: Confidentiality Access to Data shall be confined to those with appropriate authority Integrity Information shall be complete and accurate. All systems, assets and networks shall operate correctly, according to specification Availability Information shall be available and delivered to the right person, at the time when it is needed *communicate effectively with patients to ensure they understan.

The general principles of infection prevention and control 1. Achieving optimum hand hygiene (jaiyin). 2. Using personal protective equipment. 3. Safe handling (manejo seguro) and disposal (manejo) of sharps (punzantes). 4. Safe handling disposal of clinical waste (residuos). 5. Managing blood and bodily fluids. 6. Decontaminating equipment. 7. Achieving and maintaining a clean clinical environment. 8. Appropriate use of indwelling devices (dispositivos permanentes). 9. Managing accidents. 10. Good communication - with other health care workers, patients and visitors. 11. Training/education.

Hand hygiene (jaiyin). Its the most important activity for reducing the spread of disease. Hands should be decontaminated before direct contact with patients and after any activity or contact that contaminates the hands, including following the removal of gloves. The correct hand hygiene procedure should be followed when washing with soap and water or using an alcohol hand gel or rub. Alcohol hand gels and rubs are a practical alternative to soap and water, alcohol is not a cleaning agent. Hands that are visibly dirty or potentially grossly contaminated must be washed with soap and water and dried thoroughly (a fondo). For the correct hand hygiene you should: Keep nails short, clean and polish free Avoid wearing wrist watches and jewellery, especially rings with ridges (cresta) or stones Artificial nails must not be worn (usado) Any cuts and abrasions should be covered with a waterproof dressing Remove your wristwatch and any bracelets and roll up long sleeves before washing your hands (and wrists).

Adequate hand washing facilities must be available and easily accessible in all patient areas, treatment rooms.

Hand Drying Improper drying can recontaminate hands that have been washed. Wet surfaces transfer organisms more effectively than dry ones and inadequately dried hands are prone (propensa) to skin damage. Personal Protective Equipment. Personal protective equipment (PPE) is used to protect both yourself and your patient from the risks of cross-infection. It may also be required for contact with hazardous chemicals (productos qumicos peligrosos) and some pharmaceuticals. PPE includes items like gloves, aprons (delantal), masks, goggles (gafas de proteccin) or visors. In certain situations such as theatre, it may also include hats and footwear.

Safe handling (manejo seguro) and disposal (manejo) of sharps (punzantes). Sharps include needles, scalpels, stitch cutters (puntos de sutura), glass ampoules and any sharp instrument. The main hazards of a sharps injury are hepatitis B, hepatitis C and HIV.

To reduce the risk of injury and exposure to blood-borne (transmisin hemtica) viruses, it is vital that sharps are used safely and disposed of carefully, following your workplaces agreed policies on safe working procedures. Some procedures have a higher than average risk of causing injury. These include intra-vascular cannulation, venepuncture and injection. You should ensure that: Sharps are not passed directly from hand to hand. Handling is kept to a minimum (reducir la manipulacin). Needles are never re-sheathed (shiid). Staff take personal responsibility for any sharps they use and dispose of them in a designated container at the point of use.

HOW ARE PRESSURE ULCERS PREVENTED

Pressure sores, also called decubitus ulcers or bed sores, are a big problem in hospitals. Pressure ulcers can cause pain and very serious infections that can lead to death. Pressure ulcers make a hospital stay longer than it should be. They raise the costs of patient care. Most pressure ulcers result from the lack of mobility (falta de). Nursing assistants and other healthcare workers can prevent them. We must prevent pressure ulcers with proper skin care, by looking at the patient and their skin, by giving our patients a good diet and a lot of fluids, by helping them walk, and by turning and positioning them often. Ways that a nursing assistant can prevent pressure ulcers:

Provide good skin care. Use mild soap. Rinse (enjuagar) the skin well and then pat it dry (secar con palmaditas) with a soft towel. Use a bland lotion to lubricate dry skin. No NOT use alcohol or alcohol base lotions on skin. Look at areas where skin touches skin, such as under the breasts. Keep the skin clean and dry. Immediately remove all wet or dirty linens, briefs (brifs/underwear) and clothing. Do not let the patient remain wet or dirty with urine, feces or other fluids. Turn and position patients at least every 2 hours. Observe and report the condition of the skin. Look at and observe the patient's skin for signs of whiteness (blanching/ampollas), redness, heat, tearing or breaks. Encourage mobility. Encourage your patients to ambulate and move if it okay with their doctor. Provide for toileting needs. Anticipate the patient's need to use the commode or bathroom. Follow the patient's bowel and bladder (vejiga) training program if it is ordered. Patients that are wet with urine or soiled with feces are at risk of getting a pressure ulcer. Encourage and provide nutrition and fluids. Make meal times happy and pleasant. If they are not eating, offer them another choice of food. Report and record all food and fluid intake. Use pressure reducing cushions (cojines), mattresses (colchones), beds, booties, elbow pads (almohadilla), etc. These items lower pressure when patients stay in the bed or chair for long periods of time.

Do NOT elevate the head of the bed more than 30 degrees, unless ordered . If the bed is higher than this, it will cause friction, shearing (zigzallamiento) Do NOT allow a patient to remain on a bedpan (orinal) for a long period of time. Remaining on a bedpan also creates pressure, a force that leads to pressure ulcers. Use a lifting device (elevador) or a lifting sheet to move or lift a patient. Do NOT drag (arrastrar) a person's body along bed sheets. Lifting devices and lifting sheets lower friction and shear. Document and report all your patient observations and care . Nursing assistants must report if the patient is not eating or drinking, if they are not getting out of bed and if you see a red area on the patient's skin.

Summary Most pressure ulcers can be predicted and prevented. Nursing assistants play a very important role in their prevention. If a patient is at risk for getting a pressure ulcer, all preventive measures must be done and documented. Preventing and treating pressure ulcers needs the entire team to work together!

PULMONARY EMBOLISM The most common sources (fuente) of embolism are proximal leg deep venous thrombosis (DVTs) or pelvic vein thromboses. Symptoms of pulmonary embolism include: Difficulty breathing, Chest pain on inspiration. Palpitations. Clinical signs include: Low blood oxygen saturation and cyanosis. Rapid breathing and a rapid heart rate. Severe cases of PE can lead to collapse, abnormally low blood pressure, and sudden death (muerte repentina) Hospital care often involves (implica) prevention of DVT. There are also precautions you can take yourself. Prevent steps in the hospital. Clot prevention strategies in the hospital may include: Anticoagulant therapy. An anticoagulant, such as a heparin injection, is given to anyone at risk of clots before and after an operation as well as to people admitted to the hospital with a heart attack, stroke, complications of cancer or burns. You might take oral warfarin for a few days before major elective surgery to reduce your risk of clots.

Graduated compression stockings (medias de compresin). Compression stockings steadily squeeze (aprietan firmemente) your legs, helping your veins and leg muscles move blood more efficiently. They offer a safe, simple and inexpensive way to keep blood from stagnating (estancamiento) after general surgery. Use of pneumatic compression. (pressotherapy) Physical activity. Moving as soon as possible after surgery can help prevent pulmonary embolism and speed your overall recovery. This is one of the main reasons we may push patient to get up and walk as soon as one day after surgery. Exercising your lower leg muscles to improve circulation in your legs. Point your toes up toward your head so that the calves (scalf/pantorrilla) of your legs are stretched (estiradas), then relax. Repeat. This exercise is especially important to do when you are sitting for long periods of time.

Have a few questions to ask them also, to show your interest for working with the company e.g. question about the unit, professional development etc

If I get this job, how can I be promoted, e.g. band 6 or another ward? When we would start to work? Could I have any training course to improve my knowledge? Do you know any academy or resources to improve my english in my free time? What about the acomodation, could I live alone or with another colleague? How much it costs to rent a flat or room? Checking your website, I saw that the hospital has a renal unit, and kidney transplant are carried out in Manchester Royal Infirmary, but Im not sure I haemodialysis is carried out in Royal Preston Hospital or in Manchester Royal Infirmary, if the hospital have got a heamdialysis unit, could I ever work in this unit?