by Josh Tipple
In this third article from the Physio interview preparation series, we thought we'd do what we did last time and look at a specific question from a recent band 5 interview and suggest a possible answer. This time we'll go through a respiratory / acute question on prioritisation.
Be aware that this is only a single example of a question and its suggested answer, and depending on the type of job, the place of work, or even the interview panel members, you might need to adapt and/or provide other elements in your answer to get all the points.
If you'd like to know more, discuss other questions and answers, and even have a go at practising them, our interview preparation seminars are here for you! (You can also grab our interview preparation packs if you're too far away to attend our seminars.)
Respiratory and acute specific questions in junior interviews tend to focus on:
- Condition specific questions
- Respiratory assessment and treatment techniques questions
- Prioritisation questions
- On-call and ICU / ITU questions
- Interpretation, normal values, chest X-ray and auscultations questions
- Contraindications, flags, difficult situations
- Acute & post-op questions
Let's have a look at one example and remember to look out for buzzwords. (B)
Here's our question:
Prioritise these patients: a day 1 post-op laparotomy, a respiratory patient, a new mobility referral, a discharge patient and a patient known to you who needs increasing assistance to mobilise?
Nice classic prioritisation question that one. You're very likely to get one of these in your interview, especially when going for rotational posts that include acute and respiratory wards. First of, just take the time to write the 5 types of patients down on paper. Trust me, it's easy to forget half-way through your answer and suddenly replace a "discharge patient" with a "day 1 patient" for instance. Just write them down - you'll avoid any confusion and it will give you time to gather your thoughts before answering.
Do not assume the interviewer knows your thought process, explain everything (even though you think it's too obvious to even mention)..!
This question will require you to clinically reason why you would chose a specific order – most interviewers will accept a number of combinations as long as they are well reasoned.
So, how could we prioritise this lot? Here's how we'd do it:
- Respiratory patient: Respiratory patients are generally the most dependent patients; they would/should have been seen previous by physiotherapists on the ward and a plan in place for the management. These patients are likely to deteriorate if not seen and this could lead to serious health issues (including pneumonia and septicaemia) (B). Therefore it is imperative that they are seen early to ensure their condition remains stable and the management plan continues to benefit patient.
- Discharge patient: These patients will require review before they are discharged for safety reasons (such as stair assessment). If they are not reviewed this may lead to bed blocking (B) (show your awareness of pressure on the wider hospital), increased workload (B) for the next day therapist (awareness of others in team), and readmission/injury to patient if patient discharged but not being safe at home. The earlier they get seen the more time wards have to ensure same day discharge (B).
- Day 1 post laparotomy: These patients are likely to deteriorate should they not be seen early after surgery to assess their chest and function. Most trusts have a policy to see all post op patients on Day 0/1. During surgery the lungs are mechanically ventilated and the effect of the anaesthetic can impair respiratory performance, therefore teaching the patient ACBT and incentive spirometry (or IPPB) early is essential.
- Patient who is known to you and needs increasing assistance to mobilise: These patients are deteriorating therefore needs to be seen but at present are not presenting with any symptoms that would suggest they are very unwell. Therefore, they can be seen as a lesser priority to those that are already clinically unwell or require urgent intervention to complete their management plans.
- New mobility referral: Nurses will carry out mobility assessments as part of their initial contacts (B), therefore these patients would have a way of mobilising. There is no indication of any plans to discharge or that the patient is unwell, therefore they can be prioritised down to accommodate more dependent patients/situations.
So that's this one answered. Remember, prioritisation questions are all about given reasons why you prioritise your caseload a certain way, and if you can bring in extra stuff such as your awareness of wider issues (discharge pressures, increased workload, delegation, trust financial pressures...) you'll definitely impress. Onto the next one!
We hope this has helped you gain some insight into what kind of answer interviewers can look for. Remember, this is only one specific example and questions can vary greatly, as well as the type of answers expected from you.
Interview buzzwords (B)
In every blog post from the Physio interview series, you'll see (B) next to some words. These are buzzwords and buzzphrases - stuff that interviewers are waiting for you to say in your interview, as they help demonstrate your understanding of the topic.
Here's the list of buzzwords and buzzphrases in this article:
- Respiratory patients can deteriorate if not seen and this could lead to serious health issues (including pneumonia and septicaemia)
- Bed blocking
- Increased workload
- Ensure same day discharge
- Nurses will carry out mobility assessments as part of their initial contacts
About the author
Josh is a senior Physiotherapist currently working for ACERS, an award winning MDT based in City and Hackney, supporting people with respiratory disease. Throughout his NHS experience, he has worked with a wide range of patients with lung conditions, from acute wards to the community, offering his expertise to optimise physical activity and reduce admissions within this patient population. Josh also runs our Respiratory / Acute seminar and has contributed to the writing of our Respiratory / Acute interview pack.
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