Transcript: Clinical Interview Questions for New Nurse Practitioners

​Liz Rohr:
Well, hey there. It's Liz Rohr from Real World NP. You are watching NP Practice Made Simple, the weekly videos to help save you time, frustration, and help you learn faster so you can take the best care of your patients. In this week's episode, I'm going to be talking about clinical interview questions. So a lot of graduating nurse practitioners and even nurse practitioners who have some experience working already may face this type of clinical interview question when they're interviewing for a new job. So I want to start by saying that I am not a career interview job finding expert. If you would like more support in that area, definitely check out theresumerx.com. Amanda Guarniere is a specialist when it comes to nurses and nurse practitioners connecting them with their dream jobs. So definitely check that out in the link below. However, I do have my own perspective as an experienced nurse practitioner who helps with hiring new nurse practitioners and other clinical staff.

So in this video, I want to talk about the general context of interviews and the way to approach it and the way to think about it, and then also the way to approach clinical interview questions. So just for some context, when it comes to finding a job as a nurse practitioner, let's just say you're a new grad, you've just graduated from school and you're looking for your first NP job. It's really hard to imagine what working as an NP is like, because you've never done it before. The only experience you have is in clinical, like the clinical practice you've done in your training. So it's hard to extrapolate what the employer is looking for. So I'll just kind of share my perspective. So when it comes to hiring clinical staff, it's really hard to think about ourself in this way because the things that we know are obvious to us.

But when there's a candidate that I'm interviewing, for example, I know basically nothing about them and their clinical background of what clinical sites they went to, their air areas of passion and expertise, like that's unclear. And so I'm trying to figure out from their resume and their cover letter where they land in that place and how it matches with the current clinical practice that my clinic is doing. So for example, if I have a family medicine practice, what I'm looking for is someone that is an excellent fit for my clinical practice, my family practice. So do they have family practice experience? Are they interested in those topics? Do they understand what my clinic is doing? And is that something that they're interested in doing? And then also continuing on with, right? So if they're interested in dermatology, but then they're coming to a family practice, do you know what I mean?

It needs to fit. And then the other thing I'm thinking about is how good of a fit they are with the company culture, with the clinic culture. Do they have similar values? Are they committed to mission driven work, et cetera, et cetera. And are they people that we want to spend time with? Is it a cohesive bunch of people that are going to be a great solid team? Are they going to be a solid team member contributing? Right. So when it comes to the interview part, there are many aspects of the interview and definitely check out Amanda's stuff if you haven't already, again, linked down below to help with that whole process. But when it comes to the clinical interview part, there's a couple things that I as a prospective employer and other employers are trying to understand. So the expectation is not that you know everything. Right. That is part of medicine, and that's part of what makes it so fun is that it never stops.

So that learning is forever and you see new things every single day. Like walking textbook isn't a status I aspire to but is not necessarily achievable. It's just I'm always aspiring to that place. So the goal is not the expectation and the goal is not to see that you are a walking textbook. The general gist of what they're going for is that they're trying to understand your critical thinking process. We do kind of want to see what your foundation of knowledge is. Have you had enough time in a, for example, a family practice? Have you had enough clinical time in a family practice such that you have some foundation that you're bringing with you versus did you do all of your clinical rotations in dermatology, for example. I'm just making that up. Right. But what is the general foundation of what you have? What is your critical thinking process?

And when it comes to being a new grad, it's just so, like you're new. Right. So we know that you will have a ton of questions, endless questions, but what is it going to be like when you're in clinical practice? You're seeing patients. Are you going to freak out and then just ask everybody's opinion, like a million different questions? Or are you going to utilize your resources, use your critical thinking skills, take the next steps, the first steps to get to the first level of knowledge and then ask your questions and present your case. Right. So two videos actually, so I have a couple other things I want to say, but two videos that would be really helpful for you if you're in this situation is Five Steps to Making a Plan of Care. And then also how to ask questions the right way.

There's a right way and a wrong way, definitely check out that video. And I did all of the wrong things, so please don't do what I did. But watching those two videos will help you kind of talk about how you came to your clinical questions. So what I'd recommend doing, for example, let's just do this as an example. So I actually don't have a list of clinical questions that they might ask, but if you have this general approach that you take, you'll be fine. Right. So what I recommend is coming up with some kind of like practice scenarios just for fun, right, for yourself.

So common presentations in primary care, back pain, UTI, vaginitis, chest pain. Right. So thinking about that as a chief complaint for a patient, think about your own critical thinking process. How would you approach that patient? And so I talk about this in how to make a plan of care, but basically I want to hear, I don't expect you to have the answers, but I want to hear what you're thinking about, how you're thinking about it, when you're consulting your resources, where that leads you and when you would ask questions. Right.

And so I'm trying to come off with examples for this video and I get nervous thinking about because interviews are nerve-wracking, right? But if we're thinking about for example, chest pain, right, I would probably get flustered with a clinical question in an interview just because I get nervous with interviews in general. But for example, chest pain. Right. So say you have a patient that comes in with chest pain and that's the only scenario you get, what do you do? Right. That's not a lot of information. Right. And that's fine, you just say out loud what you're thinking about. Right. So information that I'd want to know about a patient who had chest pain, I'd want to know if they didn't give you a case, if they give you details of a patient, how old are they? Do they have any medical comorbidities? Do we have any other information? Are we just walking in the room? Right.

And then I'm talking about my step by step approach. Okay. So I take a triage based approach to all of my patients. I also have a systematic approach that I take for all of my patients. So I'm asking the history questions in a very sequential way, physical exam in a sequential way. And then when I'm coming up with my differential diagnosis and my next steps of action, I'm doing it in a triage based approach with the worst case scenarios first, and then I'm working through the next steps. Right. So it's not necessarily that you're rattling off the differential diagnosis for chest pain, but you've shown them that you are thinking about it critically and that you're a safe clinician.

Honestly, the three things that they're looking for is what is your general foundation of knowledge? What is your critical thinking process? And are you a safe provider? Because it actually doesn't really matter how much of a foundation of knowledge you have in some ways because if you are a safe clinician, you know what's safe and what's not safe. Right. And so can you explain yourself and explain your thought process enough to demonstrate to me that the utmost concern for you is safe patient care and you're not going to miss things because you're being careless or you're not going to be nonchalant about it. Right. And most NPs are more concerned than they are not. Right. They're kind of overly concerned, which is fine because it's important to be a safe clinician. Right. But in terms of the hiring issues that I've had in terms of candidates that are not a good fit is either they don't have strong critical thinking skills, they are not safe providers, they haven't demonstrated enough to me that they are a safe provider.

And then the other piece is, again, just general hiring stuff is like are you a good fit for the team in terms of the clientele that the clinic serves in comparison to the other providers that work there, the other staff that work there, values alignment, stuff like that. And I also talked about, I was chatting on Instagram and direct message with a new nurse practitioner who was in this situation of trying to figure out how to handle these clinical interview questions. And I asked her if she had any feedback to share with other NPs and she wanted to stress, so I gave her this feedback. She did her interview and it went really well. So it was wonderful to hear. And she even said that the physician that was interviewing her, they don't expect her to know everything and that they really just want to see that they understand her beginning steps of gathering information. Right.

So even at the get-go in that interview, they said that to her, which is what I kind of just said to you. And then two things to keep in mind is that there's no right answer. There's not one right answer. And I say this, I feel like I say this a lot, but there definitely are wrong ways to do things. Right. There's a wrong way, there's an unsafe way to take care of a patient, but there are many right ways as long as it's safe. Right. And then the other part is just they're really looking at, again, personality and are you a fit with everybody on that team and do you take initiative and do you have strong critical thinking skills. So hopefully this will help prepare you just with those kind of perspectives on the actual interview. Definitely check out those two other videos that I mentioned though, the five steps to make a plan of care and the right and wrong way to ask questions. And I'll link to both of those down below.

And also, again, I've mentioned Amanda a couple different times, but theresumerx.com, she actually has a new training coming up called No More Job Boards. And it's a way of finding a job that's not just looking on a website that has job postings. So definitely check that out. Again, links down below this video and hopefully that will help you in your job searching process. And also she can support you in those other facets of job finding stuff. So if you haven't grabbed the ultimate resource guide for the new NP, head over to realworldnp.com/guide. You'll get these videos sent straight to your inbox every week with notes from me, patient stories and bonuses that I really just don't share anywhere else. Thank you so much for watching. Hang in there and I'll see you soon.