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Nurse Manager Alert: But they looked good on paper!


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by Shelley Cohen, RN, MSN, CEN

You excitedly await the arrival of your 10 a.m. nurse interviewee, knowing it is going to be a great day for your department and staff. The candidate's job application shows he or she possesses a wealth of clinical experience. You pace as you wait for the background check to clear and think about reasons this person wants to work for your organization. And in the back of your mind you are thinking, finally, we will have a mentor for best practices.

How many times has this scenario played out over the years, even with the most seasoned of nurse leaders? We get easily distracted with the clinical experiences of prospective hires, but this excitement is similar to wearing blinders. And when reality hits, it reminds you that clinical expertise in no way implies the applicant:

  • Has the ability to think critically
  • Will follow and respect policy and procedure
  • Can function effectively within a team
  • Will practice safe patient care

To temper this, nurse managers must prepare for not only the interview process, but the pre-hire practices as well. Next time around, consider the following:

1.  Although many organizations simply have policies to reveal hire and termination dates when you call to verify employment, nothing prevents you from:

  • Asking human resources about specific departments and job titles the applicant held during that time
  • Asking "Would you hire this person again?" Even if the human resources department or an old manager doesn't respond with a definite yes or no, you can learn a lot from their tone of voice, etc.
  • Calling back and speaking directly with their previous nurse manager. Those who are thrilled with the employee's performance and sad to see them go, may share comments such as, "You are so fortunate to have Sam work for you" or "Her goodbye party was the largest we ever had."

2.  Mail applicants a copy of the job description and mission statement of the organization one week prior to the interview. Include a cover letter requesting they review these documents and be prepared to discuss them during the interview. During the interview, prompt them with questions such as:

  • How does our mission statement compare with the one from your previous employer?
  • What did you think of page three of the job description?
  • What clinical elements can we help you with?

If applicants do not review these materials prior to the interview, what makes you think they will care about them if you hire them?

3.  During the interview, present an actual risk management scenario from your unit and ask them how they would respond to the scenario or handle the situation. If the answer is always to call you, be concerned about the candidate's ability to practice independently.

4.  Use the applicant's clinical expertise history from the position application to pose targeted questions. Some examples include:

  • I see you have quite an extensive career with cardiac patients. What do you think of the latest work they are doing with a-fib patients and ablation treatments?
  • I am impressed with your commitment to our geriatric patient population with all the years you have worked in this specialty. What do you see as their greatest nursing care need?

Unfortunately, no applicant comes with a guarantee that they will perform in line with the details provided in the pre-hire process. This is why all managers need to take advantage of the 90-day probation period. Don't let practice behavior issues linger. If they are there in the first 90 days and not corrected with feedback, they are most likely going to stick for the duration of their employment.

Take off your blinders, go in with both eyes and ears unobstructed, and prepare for the interview with specifics related to the individual. You will find and hire that special nurse whose paperwork and performance match. It just won't happen every time.