Nursing OnPoint

Snapshot: This article covers how to prepare for and succeed at interviewing for nursing jobs. It includes some of the more common nursing interview questions, and ways to answer.

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General Advice How to Prepare Interview Questions & Answers Follow-Up & Decision-Making
 

General Advice

• Prepare. There’s no substitute for preparing well an interview – especially practicing answers to possible questions, and reading up on the organizations where you’ll be interviewing. Interviewing doesn’t come naturally to most of us. It’s something we have to work at. The good news is that preparation can make even the least self confident job seekers much stronger interviewers and job candidates.

• Make a good first impression. It’s difficult to overstate the importance of this point. Many job search professionals say that hiring decisions (whether consciously or unconsciously) are often made in the first 30 seconds – or less. The job interview begins the moment you walk in the door. Be courteous, warm, and engaging – and (as the point below outlines) watch your body language too. It may not be fair, but first impressions are often difficult to change, and you want to start out on the right foot.
• Watch your body language. It’s said that up to 90% of communication is non-verbal. This means that the vast majority of the ‘signals’ you’re sending during an interview have nothing to do with what you’re saying, or not saying. Maintain good posture, smile, make eye contact, and shake hands firmly. Be engaged, and turn toward the people you’re speaking to. All of these actions, and more, will help ensure your body language helps you as an interviewer and job candidate.


• It’s all about attitude. One of the most under-appreciated aspects of the job search is that almost no one is looking to hire a person with any one, defined set of skills and experiences. Whether a hiring manager realizes it or not, he or she is probably looking to hire a personality. Consequently, the attitude you convey in your interview is a prime opportunity to demonstrate how your personality can be a fit for the organization. Do your best to be positive, friendly, and engaging – and show an interest in the people interviewing you, not simply as decision-makers, but as people. Take the challenges thrown your way during the interview in stride, and do your best not to appear upset or annoyed, even if the questions aren’t what you expected. Be actively engaged in the interview process; speak sincerely and show that you’re making a good faith effort. Regardless of the specific answers you give or information you share, that attitude will be remembered most.
• Relax – and remember you’re interviewing them too. One of the best ways to calm your nerves and aid your self-confidence is to remember that an interview is a two way street. Of course, whoever’s interviewing you wants to learn who you are, and evaluate you, but an interview is also your opportunity to learn about and evaluate a potential employer. If you think of the interview as more of a conversation than a one-sided ‘test,’ you’re more likely to actively participate in the process, relax, and interact in a natural, confident manner.

How to Prepare

• Research the organization. The first step in preparing for your interview is to learn what you can about the organization where you’ll be interviewing. The simplest initial step is to do some online searches and do some reading. If you’re going to be interviewing at a major hospital, check out the ‘search for hospitals’ function on this website and learn key information about the organization and read some online reviews. If you know anyone who currently works or has worked at the organization, it can be especially helpful to talk to that person in advance. Your goal should be to both learn some basic facts about the organization, and to get a sense of its ‘personality.’ Where is the organization located, what populations does it serve, and how large is it? What is its clinical focus, and is there anything it is particularly well known for? What is its philosophy, mission or approach to care, and could you see yourself thriving there? You can start to answer many of these questions by ‘doing your homework’ and learning about the organization in advance of your interview.
• Practice answering questions. The next step in your preparation is to anticipate some of the questions you’re likely to be asked, and to practice answering those questions (see the next section, “Interview Questions & Answers,” for more detailed information). It can be helpful to talk through such questions and answers out loud – or sometimes even in front of a mirror, so you can get a sense of your body language as you speak. If a friend or family member is willing and able to help you, ask that person to ‘play the part’ of the interviewer and pose the questions to you. Even if you’re asked different questions from the ones you prepare for, the exercise of speaking about yourself and fielding questions about your skills, experience, interests and background will help you to answer more confidently and more fluidly during the interview. Talking about ourselves isn’t something to comes naturally to most of us. Practice is the best way to gain that confidence, and that skill.


• Prepare questions to ask. The flip-side of preparing answers to possible interview questions is to prepare questions of your own for the interviewer. (This is also covered in more detail in the following section, “Interview Questions & Answers”). Most individuals, usually at the conclusion of the interview, will ask you if you “have any questions,” and it’s important to be prepared with a few. One of the things you want to avoid doing is asking obvious questions that could be answered with a little background research. For example, it would be appropriate to ask, “what opportunities are available for continuing education and professional advancement?” but less appropriate to ask, “where will I be working if I get this job?” or “do I need a bachelor’s degree for this position?” Such questions show that you haven’t read or understood the requirements for the position, or that you’re very unfamiliar with even basic facts about the department or unit you’d be working in.
• Locate and prepare your references. Part of interviewing means communicating with and preparing your personal references appropriately, because most organizations won’t contact your references until after your interview. First and most importantly, ask permission from your references, and notify them in advance of the jobs you are applying for. It’s helpful and courteous to send your references an up to date resume, and to let them know the most important characteristics of the positions you’re applying to, so they can highlight your most relevant skills. Whatever you can do to help your references help you is in your interest; try to lessen the time and burden on those you are asking to vouch for you.


• Bring the correct documents. Even if you’ve already submitted your resume, cover letter and job application online, when you go to your interview you should nonetheless bring two to three hard copies of your resume (one copy for every interviewer and one for the HR department). Other documents it would be wise to bring with you include a list of your references (with their full name, job title, and current email address and phone number), a copy of your nursing license (or of your passing board scores if you haven’t yet received your license), a copy of your CPR certification (most nursing jobs require this), and any letters of recommendation in sealed envelopes, if you haven’t already submitted these documents. Keep in mind that if the employer requires a criminal background check (often done if the organization is actively considering hiring you), you will also need a list of all of your previous addresses for the past five to seven years. Finally, you may find it helpful to bring a note pad and a pen or pencil so you can jot down information or questions during the interview.
• Dress professionally. Part of making the right impression during an interview is dressing appropriately. Both men and women should stick with a professional, conservative look; this isn’t the time or place to make a bold fashion statement. Women should wear a business suit or pantsuit, with low-heeled, close-toed shoes, and keep jewelry and accessories simple. Men should wear a business suit. Both men and women should minimize or eliminate scents; perfume or cologne can be distracting, and some individuals may be allergic to certain scents. Good grooming is important, and be sure your clothes are clean and well-pressed. Like it or not, these details form part of your non-verbal communication, and make a difference in the interview.


• Know the route. Part of preparing for your interview is knowing how to get there. You should familiarize yourself with the route and where to park in advance, or if you’re taking public transit, know the schedule and travel time. Especially if you haven’t been to the location before, allow plenty of extra time. Consider direct travel time, plus parking (don’t forget to bring money), and time to find the interview location too, which can be a challenge in a larger facility. If possible, travel to the interview location in advance to minimize guesswork. Ideally, you should plan on arriving 15 to 20 minutes early. You may need to spend some time checking or signing in to the facility, and you want to walk into the interview calm and composed.
• Treat telephone interviews like in person interviews. While these tips are primarily intended for traditional “in person” interviews, many if not most of the same general guidelines apply if you interview by phone. Phone interviews are often a type of ‘gateway’ interview employers use to decide if it is worth their time to extend you an in-person interview opportunity, and it’s in your interest to prepare for and execute the interview with that in mind. When you interview by phone, make sure you find a quiet place to speak; minimize distracting background noises like talking kids or ringing phones. Keep some notes to glance at, and smile while you speak. It may sound silly, but research shows that smiling while you talk makes your voice more upbeat and pleasant. Some individuals find it helpful to ‘dress up’ for a phone interview. While your interviewer obviously won’t be able to see you, doing this may help you get in a more professional frame of mind. In short, treat a phone interview like the ‘real thing’ – because it is.

Interview Questions & Answers

• Interview questions for nursing jobs fall into three broad categories.
  • The first category is the standard “behavioral” style of interview question, which is meant to probe your skills, priorities, values and experiences.
  • The second category is the “scenario-driven” or “case study” style of question, which is meant to test your nursing knowledge and critical thinking ability.
  • The third category encompasses questions you’d like to ask the interviewer, which is meant to rest your interest in the position and your knowledge of the employer.
• To help yourself relax, remember that your interviewer is usually more interested in how you answer – and in particular, how you think through your answer – than in specifically what you say. This is true even for “scenario” clinical questions, in which there may appear to be a “correct” or “incorrect” answer, when in fact there usually isn’t. If you approach interview questions not as a “test,” but rather as an opportunity to share your experiences and approach to doing work, you will be more confident and more successful.


• Here are some common “behavioral” interview questions and strategies for answering:
  • Tell me about yourself. This is a broad question that can lead some interviewers astray; it’s not an invitation to tell your life story – where you’re from, where you’ve lived, or old and irrelevant work history. Instead focus on what most interests the interviewer: that is, on your most important, recent accomplishments and what you can do or bring to the organization. (Whatever you do, don’t say “what do you want to know about me?”) Use an example or tell a story to demonstrate that you’re a fit for the job. You could highlight work, clinical and/or volunteer experience to demonstrate how your skills and values are aligned with those of the organization. Be succinct. You shouldn’t take more than about a minute to answer this question.
  • Why do you want to be a nurse? This is a question with some obvious answers. Your goal isn’t to necessarily avoid voicing them – the most common theme being “because I want to help people” – but it is your job to show some imagination and personalize your response. Be honest and be specific in your answer. One strategy is to tell a brief story or describe a seminal experience that brought you to nursing – such as volunteering, caring for a sick relative, or working in healthcare in some way. See if you can emphasize the challenge and the skill that nursing requires; these attributes of the profession are sometimes overlooked, and especially if your interviewer is a nurse, he or she will probably appreciate your recognition of them. Even if the pay or job security of nursing are attractive to you, it’s probably best to de-emphasize these more extrinsic motivations.
  • Why are you the right person for this job? Another variation on this question is, “why should we hire you?” To answer this question well, you need to avoid giving vague answers with no supporting evidence. Stating “because I’m a hard worker” is hardly informative, nor does it set you apart. Instead, pay close attention to the skills and experience required for the position, and demonstrate how and why you’re a fit for them. In particular, try to use a specific example or story from your work experience or education that demonstrates your problem-solving ability, a key attribute that organizations of all kinds require and appreciate.
  • Why do you want to work here? It’s important not to confuse this question with “why are you leaving your current job?” Focus on the positive, be specific, and demonstrate that you’ve researched and understand the position and the organization. In particular, provide an example from your work history, volunteer commitments or academic experience that demonstrates how your values match those of your prospective employer. Don’t kiss up and lavish praise on the organization, but do show how you’d “fit in” with the broader culture and mission.
  
  
  
  • What is your greatest strength? Another variation on this question is “tell me your three greatest strengths” or “tell me what you’re best at.” The key here is to answer in a concise, sincere and specific way that demonstrates your actual skills and accomplishments without sounding generic, or boastful. Try to answer in a way that is personal and thoughtful, and that demonstrates how your skills meet a key need for the organization. For example, saying “I’m a people person” is lot less meaningful than saying, “I’m an effective communicator,” and then providing an example to back up your claim. Be careful not to give an underwhelming answer, like “I’m organized,” or “I’m dependable.” Knowing how to do your work and showing up on time are expected qualities, not exceptional ones.
  • What is your greatest weakness? This is a potentially tricky interview question. The key is to be honest, while not admitting to a weakness that you can’t explain, or better yet, turn into a strength. Focus on using an example or telling a story that reflects how you overcame a weakness, or grew or matured in some way. Your interviewer doesn’t expect you to be perfect. Rather, he or she wants to know that you can be honest about your shortcomings, and demonstrate ways to improve upon or work around them.
  • Please explain your work history, and any gaps in your resume. The key to this question is to be very familiar with your resume, so that you can speak confidently and accurately about your experience; it’s surprising how many job applicants can’t do this well. Know the names and dates of where you worked, your job title, and the core responsibilities you held in each position. Keep it brief: speak to your past two to three jobs at most, and mention one key attribute, responsibility or accomplishment from each. Try to demonstrate how those accomplishments bolster your readiness for the position you’re interviewing for now. If you have gaps in your work history, be upfront about this, and provide any relevant context. For instance, if you stopped work for child or family care or to pursue educational goals, provide that information. Explain the gap to the best of your ability, and then move on.
  • Tell me about a challenge and how you overcame it. This question is meant to test your critical thinking ability, and usually, your capacity for teamwork. Choose an example that demonstrates not only what you did, but the process you used to arrive at the solution. You should put your ability to collaborate and communicate front and center.
  
  
  
  • Tell me about a time you had to cut corners. Another variation on this question is, “tell me about a time you faced an ethical dilemma.” The truth is, with this question your interviewer is really looking to test your honesty and ethical standards. The key is to use an example or tell a story in which the standards you let slip were relatively inconsequential, or in which you had to bend the rules to do the right thing or ensure patient safety in some way. Whatever you do, don’t say, “I’ve never cut corners,” or “I’ve never really felt challenged by that kind of problem,” since this is almost certainly not true.
  • Tell me about a time you disagreed with someone. With this question, your interviewer is testing your integrity and interpersonal skills. Show how your defused an otherwise tense situation, and emphasize what you did to solve the problem at hand, not what you did to “prove” that you were right. You might also touch upon what you learned or took away from the situation, and how it has made you a better, safer nurse.
  • Why are you leaving your current job? This is a potentially tricky question. The most important thing is to not criticize your current employer. However justified your grievances may be, doing so will make you look petty and confrontational. It will also raise a red flag for your interviewer that you may walk away from this position too if it doesn’t meet your standards. Instead, focus on the positive. Find a way to explain that while you’ve grown in your current position, you’re looking for new challenges and opportunities, and then highlight how the job you’re interviewing for is a good ‘fit’ for your next steps.
  • What are your career goals? A variation on this question is, “where do you see yourself in a few years?” The key to answering this sort of question is to strike a balance between being ambitious and being realistic. On the one hand, you don’t want to come across as not having any goals. On the other hand, you want whatever goals you communicate to be achievable, and to fit within the scope and mission of the organization where you’re interviewing. Try to think of leadership roles within the organization that are a rung or two up from the position you’re interviewing for. And if you’re not certain, it’s alright to highlight your skills and interests but not name a specific role or position you’re aiming for.


• Below are some common “scenario-driven” interview questions and possible ways to answer; some are meant to test foundational nursing prioritization and knowledge, and others are more a test of your interpersonal skills. Remember to start with basic assessment, and then prioritize your actions. Also, it’s OK to ask clarifying questions if you feel you need some more information to answer. Note: you should take into consideration the specific clinical environment you’re interviewing to work in, and practice questions in that clinical domain. The questions below cover some of the more common clinical nursing scenarios.
  • A patient presents with chest pains. What do you do? As with all scenario-based questions, prioritize ABC’s (airway, breathing, circulation) and perform an assessment. Is the patient still breathing? Conscious? If not, immediately call a rapid response. Assuming the patient is still breathing, help him or her to sit upright to ease the work of breathing, administer oxygen, check vital signs including pulse oximetry, call for help, and assess the patient’s pain (0 to 10 scale, its characteristics, when it began, what makes it better and worse, etc). When help arrives administer sublingual nitroglycerin, get a state EKG, call the doctor to get stat labwork (troponins, CKMB, BPH, etc.) If the patient goes into cardiac arrest, begin CPR.
  • A patient has a change in mental status. What do you do? Again, begin by assessing the patient. If he or she is not breathing/conscious, call a rapid response immediately. Check vital signs, and use the Glasgow Coma Scale to assess mental status. Observe for seizure activity and check pupils to see if they are equal and reactive. Then, begin to look for possible causes. Keep in mind that altered mental status is a symptom, not a disease; some causes are easier to reverse (such as hypoglycemia), and some are more permanent (CVA/stroke). Begin by checking blood glucose – a reversible cause and one of the most common reasons for change in mental status. If this is normal, consider the patient’s recent medical history, including drug or alcohol use and seizure history. Check for signs of meningitis and encephalitis, which can be life-threatening; for meningitis signs include sudden fever, severe headache, and stiff neck; for encephalitis, signs include seizures, stupor and coma. Get stat labs on blood, urine and any bodily secretions. Gently re-orient the patient as you are able and provide supportive nursing care.
  • A patient has a critical lab value of Potassium 2.5. What do you do? Again, begin with ABC’s (airway, breathing circulation), and assessment; call a rapid response if indicated. Recognize that normal potassium levels are between 3.5 to 5.0 mEq/L. Re-draw stat labs to verify the potassium level; individual lab results are sometimes inaccurate. Follow the organization’s procedure for prompt reporting of a critical lab value; this probably means paging a physician and documenting your communication. Pay particular attention to respiratory depression, a symptom of low potassium, and also look for muscular weakness, myalgia, and muscle cramps (due to impaired skeletal muscle function). Get an EKG; this may reveal a flattened or inverted T wave, ST depression and wide PR interval. Once you have the order, administer either oral or IV potassium depending on the protocol. If you administer IV potassium, do so preferably via a central line at the appropriate rate (usually no more than 10-20 mEq/hour). If given too quickly, IV potassium could precipitate a lethal ventricular tachycardia. Consider discontinuing or replacing potassium wasting medications (e.g. lasix), and substituting potassium-sparing medications (e.g. spironolactone).
  
  
  
  • A patient’s family member approaches you and says she’s upset with the care her sister is receiving. What do you do? This is a scenario-based question that is more a test of your interpersonal skills and ability to resolve conflict than your nursing knowledge per se. You could start by apologizing for whatever poor experience or care the family member may have received, and then ask that individual to provide you some more information so that you can understand the nature of the problem. If the family member is upset and you’re in a highly trafficked area or a patient care area, you might ask her if she wouldn’t mind stepping away/down the hall, etc. so that she can share her concerns in greater privacy (and to protect other nurses and patients from a potential conflict). Emphasize how you would calmly gather information and move toward solving the problem. Your goal should be to accept, not deny, the feelings of the family member, and stay away from assigning blame, or judging her criticism invalid, even if you disagree with it. Show how you would communicate with others, if needed, to resolve the issue.
  • A nurse criticizes you in front of several other nurses and tells you the report you’ve given her on a patient is poor, and that you haven’t done your job. What do you do? This is another scenario-based question that is a test of your interpersonal skills and ability to resolve conflict. As with the previous scenario, you could begin by asking her for more information; that is, what is it she specifically believes is lacking? Move toward solving the problem, not criticizing her in return, which may only escalate the conflict. If she’s speaking in a way that is personal or unprofessional, you could calmly say something like, “I don’t believe this kind of criticism is appropriate or justified, and I’m uncomfortable speaking about this in front of our colleagues. Why don’t we step aside so that I can give you the information you need to safely care for this patient.” Keep your focus on fixing the problem.
  • You suspect a nurse on your unit is stealing medication. What do you do? This is a scenario-based question meant to test your ethical judgment and your ability to protect your patients and the organization from potential harm. You might start with asking for more information about the situation: what kind of medication, how much, and how often? Regardless of your specific response, you need to show that you will comply with legal and safety requirements, and report the nurse to your supervisor or nursing manager. Avoid using judgmental language such as “stealing” in your report. For example, you could relate that this nurse’s patient states he received no pain medication, although the Pyxis and/or medication record reflects that this medication was dispensed and given to the patient. Or, you could state that you observed the nurse removing the medication from the Pyxis, and that the patient reports he never received it. Stick to the facts, and avoid inflammatory language. Be prepared to write an incident report and understand that if the allegation is substantiated your colleague may be eligible for a rehabilitation program offered by your employer and/or state board of nursing.


• Here are some questions you can ask an employer. The idea here to ask informed, competent questions that demonstrate your intelligence and interest in the employer.
  • What is most important to succeeding in this position? This question shows you’re interested in performing well, and want to know some specific qualities that are important for the job.
  • What are your greatest needs as a unit or as an organization right now? This question shows you’re capable of taking a broader view of the organization’s priorities and challenges, and are interested to help meet those goals.
  • What are the primary challenges in this position? This question shows that you acknowledge the inevitable set-backs and difficulties of the job, and are interested in overcoming them.
  • What sort of training, continuing education or professional development is available? This question shows you understand the importance of keeping your skills and knowledge up to date, and are interested in advancing within the organization over time.
  • How is job performance measured? This question shows you care about doing well in your position, and understand that specific benchmarks will be used to assess your performance.

Follow-Up & Decision-Making

• Know the time frame. It’s perfectly acceptable, and often helpful and desirable, to know your interviewer’s time frame for making a hiring decision. Before you leave the interview you can simply ask your interviewer, “do you know approximately when you might be making a decision?” or “when might I next expect to hear from you?” Hopefully you’ll get a time frame such as “within the next two weeks.” If your interviewer dodges the question or isn’t sure, you might say, “does one to two weeks sound about right?” Your interviewer can then respond to this by confirming the time frame, or may provide you additional information such as, “actually, we plan to continue interviewing candidates for the next three to four weeks.” You’re well within your rights to ask this question, and it also helps alert your interviewer that you’re serious about and interested in the position.
• Know how and when to follow up. If you haven’t heard from your interviewer within the designated time frame, you can briefly remind your interviewer who you are and when you interviewed, and then ask if a decision has been made. If you sense a reservation of some kind, you can then ask “do you have any questions or reservations about me as a candidate that I can clear up on the phone?” This may sound aggressive, but phrased the right way it can be helpful, and may give your interviewer the opportunity to ask a difficult question that he or she was reluctant to broach. The worst you can hear is, “no, we have no further questions.” But, if there’s something that’s stopped you from getting a job offer, this is an ideal way to help your interviewer remove that roadblock.
• Know how and when to discuss salary expectations. If during or soon after your interview you are asked “what salary are you looking for?” or “how much do you think you should earn?”, do your best to defer the question; it’s advisable to avoid discussing salary expectations during an initial interview. A better time to discuss and negotiate salary is when you’re offered a job, not before, because this gives you more bargaining leverage, and because a potential employer’s focus on salary can be a distraction from evaluating you as a job seeker. If you do get asked this question prematurely, try to defer it by saying something like “I believe my education and skills make me a competitive applicant for this position, but I’d rather not discuss specific salary expectations at this time.”


• Always send a thank you note. Interviewers often overlook this step, but it’s important, both as a courtesy and as a way to distinguish you from other job candidates. You should send a thank you note promptly, preferably within one day after completing your interview. Before you leave your interview, make sure you have that individual’s or individuals’ contact information: name, job title, email address, and phone number. These days sending a thank you via email is appropriate; just make sure you treat this as ‘official’ correspondence, because it is. Check spelling and grammar, and send the note from a professional-looking email address ([email protected] may be OK for planning a vacation with your friends, but not for your job search). If you’re able to send a thank you on good stationary, that’s even better. Regardless, send a thank you to each person who interviewed you; re-state your interest in the position, and thank your interviewer or interviewers for their time.
• Ask for feedback, and keep your options open. An important part of your interview follow up, and the job search process, is not only discovering your strengths, but also areas where you could improve. If in the course of your follow up you learn you weren’t offered the position, it’s OK to say something like, “I understand, and I’m looking for feedback to improve next time. Could you offer me any tips or advice? Is there a particular type of experience or set of skills you’re looking for?” Your interviewer will probably be able to offer you some advice, and may be impressed that you asked. Plus, you never know, there may be a position that hasn’t even been posted yet that’s a better fit for your skills and experience. You want to show you’re open to feedback, and keep your options open. Regardless of what you hear, thank the individual for his or her input, and for their time. You may be surprised by the new leads or ideas that come from the information you gather.
• If you turn down the job, communicate respectfully. What happens if you interview simultaneously for several positions, and end up with multiple job offers? This is a “good problem” to have, and if you’re conducting your job search effectively it’s one you may well face. Don’t be so quick to ignore the organizations where you ultimately turn down job offers. You should decline whatever offers you don’t choose to accept as promptly as you’re able, and sincerely thank your interviewer or interviewers for their time. It’s appropriate to send at least a thank you email, and to close the loop. Why? Not only is this courteous, it’s also hard to predict if or when you may encounter those people or that organization in the future. It’s always in your interest to be professional. The job offer you decline today may be the one you’re interested in a few years down the road. Don’t ‘burn your bridges;’ communicate effectively, and always keep your options open.
• Communicate with and respect your references. As you follow up on your interviews, and hopefully receive a job offer or job offers, it’s important to let your references know the outcome of your search. Your references have done you a personal and professional favor by vouching for you; the least you can do is let them know how your job search went, and the position you ultimately accept. Be sure to send your references a thank you email or letter too. Ideally, you will begin to build a professional network you can rely upon – and in turn give back to – throughout your career. Your references are an important part of that network, and your future career.