بِسْمِ اللهِ الرَّحْمنِ الرَّحِيمِ
Assalamu`alaikum and greetings to all…
Today was my second interview for a staff nurse position. I arrived early and waited for about an hour before I can meet the Medical Director. The interview was done in a Wellness Clinic and I sat on the patient’s chair. I felt really awkward as the atmosphere was so tension and the doctor was the only interviewer. He did not ask about basic question like introduce yourself but he directly asked about clinical practices.
The first question he asked was what is the normal range of body temperature? I answered 36.5 to 37.2 degree Celsius. Whew..I was safe because it was so easy. Secondly, he asked about the value of hypoglycemia and hyperkalemia. Oh my goodness! I did not prepare for these questions and the information was not stored in my long term memory. I randomly said that for hypoglycemia it was below 3 mmol/L. Alhamdulillah, my answer was almost correct because normal random glucose level according to Sarawak General Hospital is 3.5 to 7.8 mmol/L while 3.0 to 5.6 mmol/L is the normal range for fasting glucose level. About the potassium level, the normal range is 3.3 to 5.1 mmol/L. Therefore, hyperkalemia should be more than 5.1 mmol/L. Keep that in mind!
After that, the questions were getting tougher and tougher as it were about drugs and dilution of medication. Name any 3 common antihypertensive drugs? I can only recalled Atenolol and Nifedipine. Deep in my heart I am totally screwed up. Alright readers! Other antihypertensive drugs are Amlodipine, Captopril, Labetalol, Methyldopa, et cetera.
Name 3 common gastrointestinal drugs from Proton Pump Inhibitors (PPIs), Histamine-2 receptor blockers and antacid classes? I answered Pantroprazole, Cimetidine and Trisilox respectively. Err..now revision time. According to MedicineNet.com, some of the example of PPIs are Omeprazole, Esomeprazole and precisely Pantroprazole. Ranitide is a very common drug of Histamine-2 receptor blockers and an example of antacid is Mist Magnesium Trisilicate (MMT).
Honestly, I did not have any idea about anticholesterol drug during the interview. According to MedicineNet.com some of the examples of statins are Lovastation and Simvastatin. I knew about this drugs and it’s so common. I felt so disappointed with myself.
Then, the doctor asked about pain killers and I mentioned Paracetamol, Diclofenac and Morphine. I was saved by this question but it was for a few seconds only.
Another tough question was about the frequency of giving Acyclovir. For our information, Acyclovir is an antiviral drug. Based on McKenry, Tessier and Hogan (2006) point of view, oral Acyclovir is used in the prophylaxis and treatment of genital herpes infection in both immunocompromised and immunocompetent clients. It is also used to treat varicella (chickenpox) infections in immunocompetent children if used within 24 hours of the appearance of the rash. In their book, Mosby’s Pharmacy in Nursing (22nd ed.) the usual initial oral dosage for a herpes genital infection is 400 mg TDS up to 10 days.
The hardest part was when the doctors asked about drug calculations on how to prepare Dopamine 10 mcg/kg/min. Dear Syahirah, the formula is 3 x Body Weight = 50 mls.
If the body weight is 60 kg.
3 x 60 kg = 180 mg Dopamine
Dose = (180/200) x 5 mls = 4.5 mls
Preparation: Dilute 4.5 mls of Dopamine to 45.5 mls of N/Saline to make up 50 mls total volume and give concentration of dose 1 mls/h equivalent to 1 mcg/kg/min.
Dose of Dopamine per vial is 200 mg in 5 mls.
50 mls = 200 mg
50 mls = 200000 mcg
1 mls = 4000 mcg
4000 mcg/60 kg = 66.67 mcg/kg
66.67/60 min = 1.1 mcg/kg/min
1 mls/h = 1 mcg/kg/min
Furthermore, we came to investigation procedures. The doctor showed to me 4 type of tubes and he asked me to choose which one is for LFT, FBC, PT APTT, BUSE, Kidney Function Test, Cholesterol. Sigh..I felt so pathetic. The tubes were different if compared with tubes used in government hospital. However, the contents still the same like EDTA, plain tube, etc. PT and APTT needs Citrate (anticoagulant) tubes and it may come with light blue stopper. Immediately after draw, gently invert tube 3 to 4 times. Do not shake.
Being a nurse is not easy but once we know everything, it would be more fascinating.
Until we meet again.
May peace be upon you.