PBDS-Help!!

21 posts · started Dec 2, 2006

RockinRobynRN Dec 2, 2006, 5:54 AM
I am taking an ICU position in January & the hospital uses PBDS testing. My experience is ER & Surg/Trauma ICU and I am terrified. I have heard only horror stories about this test. Has anyone taken this test & have any advice? I am going to Colorado from SC and don't want to get stuck 1500 miles from home if I can't pass for some reason. Help! :eek:
cougarnurse Dec 2, 2006, 12:37 PM
I would say do your best, and remember: the test itself uses multiple videos which are shown in short segments and the whole THING is based on the MEDICAL MODEL. Kinda strange, as this is out of our scope of practice. I am wary of the test as a true tool to test competency in Nursing employees.

'Cat'
Sylvia321 Dec 4, 2006, 2:25 PM
I have not taken it, but have heard it is used to weed out travelers. Supposedly not what it was meant for. What does your agency and contract say if you "fail" this no fail test?

Will they find you another contract? Are they going to charge you?
AmandaWIRN Dec 8, 2006, 10:40 AM
I also have to take this test in a few weeks and am scared to death- I've heard nothing but bad things about it. I did find someone to e-mail me a study guide, which I can send to you, if you like. PM me with your e-mail address and I'll send it to you. Also, keep us posted on how you do!
RockinRobynRN Jan 28, 2007, 8:18 AM
Took PBDS for ICU and passed. It was the most grueling test I have taken in my life. I took it on computer & the flashing red time warning box nearly gave me a panic attack. The information is basic nursing knowledge, but it wants you to be very specific. Feel free to PM me if you have questions. Good luck to everyone else that has to take this horrible test!
AmandaWIRN Jan 31, 2007, 10:04 AM
I took the PBDS 2 weeks ago, and passed- I had been freaking out about it because everyone on every borad I read was saying how it was this awful, horrible thing. Yes, it took a long time, but really, it wasn't all that bad. It's common, safe, medical & nursing knowledge. If you know enough to have passed boards & take good care of your patients, keeping them safe, then you should be able to pass this exam. The whole purpose of the exam for travelers is so the hospital doesn't have unsafe nurses working there. If you do not possess the basic knowledge needed to pass this exam, then you are a potential danger to patients. Really- it's NOT THAT BAD! The worst part about it was how bad i psyched myself out because of all the horrible things people told me. Just go with the confidence that you have the knowledge required to do your job well- remember your ABC's, and always err on the side of safety.
Sylvia321 Feb 1, 2007, 8:32 AM
AmandaWIRN wrote: If you know enough to have passed boards & take good care of your patients, keeping them safe, then you should be able to pass this exam. The whole purpose of the exam for travelers is so the hospital doesn't have unsafe nurses working there. If you do not possess the basic knowledge needed to pass this exam, then you are a potential danger to patients. Really- it's NOT THAT BAD!

So all those nurses who've had 10,15, 20 or more years experience that "failed" this no-fail test don't have the basic knowledge needed and are a potential danger to the patients? Is that what you are saying? And I suppose those who passed at one place and "failed" at another, are unsafe at the place they failed?

I passed boards years ago. I don't need to take a "test" of this sort. This test is being used as a tool not intended by the makers. I agree with others, I refuse to take it. There are plenty of facilities who do not use it.
AmandaWIRN Feb 1, 2007, 1:10 PM
What i am saying, is that based on the scenarios presented in the version of the exam I took, if a nurse is not able to recognize EMEGRENT conditions, such as chest pain, transfusion reactions, or CVA symptoms, and the interventions required to treat these conditions, then yes, they are a danger to their patients. I understand that the test was not meant to be a "pass/fail" type test, but in the case of travelers, unfortunately, that is how it is used. It's your choice to refuse to work for hospitals that require it, but thats not an option for some people, and it's definetly not going to stop hospitals from using it to "weed out" travelers.
tenexe Feb 9, 2007, 1:25 AM
AmandaWIRN wrote:What i am saying, is that based on the scenarios presented in the version of the exam I took, if a nurse is not able to recognize EMEGRENT conditions, such as chest pain, transfusion reactions, or CVA symptoms, and the interventions required to treat these conditions, then yes, they are a danger to their patients. I understand that the test was not meant to be a "pass/fail" type test, but in the case of travelers, unfortunately, that is how it is used. It's your choice to refuse to work for hospitals that require it, but thats not an option for some people, and it's definetly not going to stop hospitals from using it to "weed out" travelers.


Your correct about that. A nurse that isn't able to identify those things as they are occurring is a risk to their patients.

Unfortunately this is not a measurement of how a nurse would react under those circumstances. This is a test designed to weed people out. Even the most confident nurse would be anxious approaching a test like this, as every single person has said they were. Some people may have difficulty in doing well on written tests. Especially when your job and reputation are on the line.

I know plenty of people that would probably do great on that test that I wouldn't trust with my Dog. I also know plenty of people that might not do so well on tests that I would trust with my life.

Your last statement is also troubling because nobody is forced to work for anyone in this country, especially as travelers and second: If all travelers stopped utilizing those hospitals that weed nurses out with this ridiculous tool they would stop using it if they wanted to fill their slots. Its clear supply and demand.
AmandaWIRN Feb 9, 2007, 1:14 PM
tenexe wrote:Your last statement is also troubling because nobody is forced to work for anyone in this country, especially as travelers and second: If all travelers stopped utilizing those hospitals that weed nurses out with this ridiculous tool they would stop using it if they wanted to fill their slots. Its clear supply and demand.

Not everyone has the luxury of picking & choosing from multiple job offers- while this usually isn't the case for travelers, people who are taking a permanent position may not have different hospitals to choose from if there is only one in their area, or there may not be positions open in more than one facility, so some people, not necessisarily travelers, really don't have many choices when it comes to job opportunities.

After taking this test, it is my opinion that if you can't look at a video of a patient, assess their symptoms (which in most of the videos are extremely obvious), and then state what interventions are needed for the patient, then that is a problem. Nerves should not be a factor- working under pressure & thinking quickly in life-or-death situations is part of our job. If that requires putting your anxiety aside to get the job done, then that's what it takes. If a patient is crashing, "I got nervous" isn't an acceptable excuse for a nurse not responding appropriately. There have been plenty of situations working in the ER where I have found myself with a patient whose grave condition has made me nervous, but you have to suck it up, push the nerves aside, & do what you need to do to help the patient.

Anyways, that's just my two cents (well, ok, maybe my 10 cents...). I think we'll just have to agree to disagree on this one.

I do still have a study guide for the exam, if anyone needs it, PM me.

And, as Forrest Gump said- "That's all I got to say about that." :)
Sylvia321 Feb 10, 2007, 6:31 PM
AmandaWIRN wrote:After taking this test, it is my opinion that if you can't look at a video of a patient, assess their symptoms (which in most of the videos are extremely obvious), and then state what interventions are needed for the patient, then that is a problem. Nerves should not be a factor- :)

I haven't taken the test, only heard about it. I understand that the video lasts less than 60 seconds and you have around 5 minutes to write or type your answers. I happen to write faster than I type. Many nurses are not fast typers and many are not fast on computers. True a lot can happen in one minute, yet if you blink your eyes then you can also miss a lot. I have heard that many did not see the unit of blood hanging for the brief few seconds that it was shown in the video and so they made a wrong "diagnoses". I heard they require you to "diagnose" the patient, I do not have MD after my name so that would be illegal for me to do. I can give a "nursing" diagnoses,not a medical diagnoses. Different facilities have different "routine" tests and medications. Also diferent physicians order some things specific to them. I have heard of OR nurses having to take the med/surg test and Peds nurses taking adult med/surg tests. I agree, nerves shouldn't be a factor, yet some have severe test anxiety and are terrific nurses. I also heard it is very subjective by those who score the test. Not all facilities send it to the makers to grade, I believe I read it costs the facility about $100 for each test to grade by the makers. That can run up to big $$$. Also, why should I have to take this test if I had already taken it once and passed? In a real-life situation you have more than 60 seconds to assess and reassess, you are severely limited whith this testing. And as I stated before, So all those nurses who've had 10,15, 20 or more years experience that "failed" this no-fail test don't have the basic knowledge needed and are a potential danger to the patients? Is that what you are saying? And I suppose those who passed at one place and "failed" at another, are unsafe at the place they failed?

I see this test pushing more away from the profession.
AmandaWIRN Feb 10, 2007, 8:17 PM
Like I said in my previous post- that's my opinion, end of story- I would hope that we can agree to disagree, because I'm not going to change my opinion. And once again... That's all I have to say about that. :)
Sylvia321 Feb 11, 2007, 5:22 AM
AmandaWIRN wrote:Like I said in my previous post- that's my opinion, end of story- I would hope that we can agree to disagree, because I'm not going to change my opinion. And once again... That's all I have to say about that. :)

Wow, I would never expect others to change thier minds/opinions because they do not view as I do. My mistake, I had thought we all were having a debate/conversation/discussion (whatever you wish to call it) regarding this test.
Ciao
mmc1114 Feb 11, 2007, 3:28 PM
I too have taken a job in Colorado to start in March, 1500 miles away from home and freaking out about the PBDS test. I understand there is a specific one for the OR. Has anyone taken it? how was it? any input would be helpful...Thanks
tenexe Feb 20, 2007, 5:19 AM
AmandaWIRN wrote:Not everyone has the luxury of picking & choosing from multiple job offers- while this usually isn't the case for travelers, people who are taking a permanent position may not have different hospitals to choose from if there is only one in their area, or there may not be positions open in more than one facility, so some people, not necessisarily travelers, really don't have many choices when it comes to job opportunities.

After taking this test, it is my opinion that if you can't look at a video of a patient, assess their symptoms (which in most of the videos are extremely obvious), and then state what interventions are needed for the patient, then that is a problem. Nerves should not be a factor- working under pressure & thinking quickly in life-or-death situations is part of our job. If that requires putting your anxiety aside to get the job done, then that's what it takes. If a patient is crashing, "I got nervous" isn't an acceptable excuse for a nurse not responding appropriately. There have been plenty of situations working in the ER where I have found myself with a patient whose grave condition has made me nervous, but you have to suck it up, push the nerves aside, & do what you need to do to help the patient.

Anyways, that's just my two cents (well, ok, maybe my 10 cents...). I think we'll just have to agree to disagree on this one.

I do still have a study guide for the exam, if anyone needs it, my e-mail is listed above.

And, as Forrest Gump said- "That's all I got to say about that." :)


I can only surmise from your response that you did not even read my post. There is NO, ABSOLUTELY NO life or death situation at hand in video, Any educator can tell you that people may have "nerves" regarding tested material that they may not have when demonstrating the same skills in a real scenario. That is why they have "special accomodations" for people that don't test well. They have them in every formal testing arena including the nursing boards. In reality if you could validate that you have actual testing anxiety and could get a formal evaluation to back that up you could probably litagate against someone who terminated you for failing a test without offerring you proper accomodations. I don't mean to be rude but it really doesn't matter if you change your mind. Your entitled to your opinion however rigid and unyielding it may be. However it should be pointed out that you can not believe in gravity but if you jump off a building your still going to fall to the ground. point: your belief doesn't change reality, just how you want to perceive it, and any professional education will should be able to provide you with more empirical evidence to prove this point.
TravelerDMRN Feb 20, 2007, 12:43 PM
PBDS is like the new "friendlier" ACLS in most places. Yes, it is a test. But, if it is treated like the assessment tool it should be, then you will be fine.

It is a series of videos that are specific to your experience (ED nurses take a different series than critical care nurses or an L&D nurse, etc).

It is clinical based and is a tool to measure critical thinking. There are no multiple choice questions; it is all essay form. It asks you to describe your interventions in a certain situation shown on the video tape. Imagine if you were in the clinical setting and saw the same thing....what would you do?

If you are at a loss, start simple---ABC's Airway, Breathing, Circulation (I guess if I needed to spell that out for you, you might have a slight problem with PBDS).

Then just think about what things you would do to trouble shoot the problem. Is it severe enough that you will call the doc? Then say so. Don't most assessments past the ABC's include vitals? Then say so. And write down each vital sign....say, I would check pulse, BP, resp. rate, temp, and a pulse ox.

If you anticipate orders, you can also mention that. If pt. is bleeding out his eye sockets, then say that you would have blood bank come up and draw a clot so that you could type and cross him for anticipated blood transfusion.

If the lady in the video looks as if she has had a stroke (one of the critical care videos I was given) then list anything you can think of: I would get a set of vital signs including pulse, BP, resp. rate, temp, and ox. sat. I would do a neuro assessment checking pupil sizes and reactivity. I would also check motor function noting the strength of each extremity and noting any one side being weaker. I would assess verbalization and facial symmetry and note any slurring of speech.

I would apply a nasal cannula and give O2 in an attempt to increase cerebral oxygenation. If she was in the ICU, she would be connected to the HP monitor where I could cycle automatic blood pressure readings, and have continuous O2 and heart monitoring. I would have someone notify the MD while I placed a 20 gauge angiocath if the patient needs to receive contrast in the CT scan where I am sure she is headed. I would also ask that family be notified, if they were not already available, for any advanced directive decisions or further history if thrombolytics will be considered.

If labs have not recently been drawn, CT scan would need a curent BUN/creat if they are going to use contrast. If thrombolytics become an issue, coags would need to be sent. Best to just send a rainbow of tubes for anything the MD's end up wanting.

It may seem like most of what you write would fall into the "duh" category, but if you would do it, right it down. They just want to see that you would do something. All of your interventions may not be required, but any time you can write down one more thing in addition to your "uh, I guess I'd call the doc" response, the better.

The facility where I am currently working went out of their way to make it a non stressful environment. They said it was not something that was passed or failed, but something to guage where a specific individual might need some assistance or extra training. They had only ever let one person go because of their performance on it and that was after they spoke with her afterward (turned out she had a pretty bad attitude and the facility didn't feel they should keep her after they were giving her every chance to work with them).

Most travel companies also will include a study packet for you if they know the facility will do the PBDS testing (they want you to succeed too).

Bottom line...don't stress out. Even if you totally blow it, most places will sit down with you afterward. If you can't take tests, then most places will even give you a chance to go through it with them verbally.

Don't stress and most everyone will do fine.
AmandaWIRN Feb 20, 2007, 1:22 PM
tenexe wrote: I don't mean to be rude but it really doesn't matter if you change your mind. Your entitled to your opinion however rigid and unyielding it may be. However it should be pointed out that you can not believe in gravity but if you jump off a building your still going to fall to the ground. point: your belief doesn't change reality, just how you want to perceive it, and any professional education will should be able to provide you with more empirical evidence to prove this point.

WOW... Thank you... I have now learned my lesson: Never again will I bother to share my opinion in this forum if I even suspect that anyone might disagree with me. In stating my opinions, I have not once made any negative statements specifically directed at any one person in this forum, however, in this short post, you have managed to call me "rigid & unyeilding" simply because I choose to have an opinion & stick to it. You have also managed to imply that my opinion is not in touch with reality, and that I do not have enough "professional education" to provide me with "empirical evidence" to prove YOUR point. I thought it was possible for people to agree to disagree, but apparently not for some people...
I am SO done with this thread...
cougarnurse Feb 20, 2007, 1:36 PM
cougarnurse wrote:It's great that we have differences of opinion....let's keep it that way, too. We all can learn from each other, eh? :)

'Cat'
:endof:
OK......once again. We ALL have differences of opinion. Things have been fairly decent on this thread. I do believe we need a cool off period with it.

'Cat' :)