Nursing and midwifery

What interviewers look for

• You assess before you act: you take vital signs correctly, you know when a result is abnormal, and you call for help early instead of waiting for the doctor's round.
• Medication safety as a habit: you check the rights of administration for every dose, ask about allergies, and question an order that looks wrong.
• Infection prevention you really practise: hand hygiene at the right moments, PPE put on and taken off in the right order, and used needles straight into the safety box.
• For midwives, safe maternal care: you know the danger signs in pregnancy and labour, you can explain how the partograph guides decisions, and you refer on time.
• Clear records and handover: notes written at the time with the hour and your signature, and a handover the next nurse can act on without guessing.
• Respect and confidentiality: you speak kindly to patients and families, you ask consent, and you keep each patient's information private.

Questions they ask

1. 1“Walk us through how you take and record vital signs for a new admission.”

   Why they ask: The panel checks basic clinical skill and whether you act on what you find. Many candidates list the signs but never say what they do with an abnormal result.

   How to answer

   • Name each sign in order: temperature, pulse, breathing rate, blood pressure, oxygen saturation if there is a pulse oximeter, and level of consciousness.
   • Show good technique: the patient at rest, the right cuff size, and breathing counted for a full minute in a child.
   • Say what you do with an abnormal value: recheck it, tell the nurse in charge or the doctor, and record the time you reported.
   • Finish with the record: each value, the time and your signature on the observation chart.

   When a patient is admitted, I let them rest for a few minutes, then take temperature, pulse, breathing rate and blood pressure, and oxygen saturation when we have a working oximeter. I count breathing for a full minute, especially in children. I write each value with the time and sign the chart. Last month an elderly man came in with a low blood pressure and a fast pulse. I rechecked on the other arm, called the doctor on duty straight away and wrote down the time I called. He was started on treatment within minutes.

2. 2“How do you make sure you give the right medicine to the right patient?”

   Why they ask: Medication errors are a leading cause of avoidable harm in health care. The panel wants a routine you follow every time, not a promise to be careful.

   How to answer

   • Name the rights: right patient, right drug, right dose, right route, right time and right documentation. Some hospitals add right reason and right response.
   • Check identity with two identifiers, such as name and file number, and ask about allergies before the first dose.
   • Say you read the label and expiry date more than once, and that you question any order that is unclear or looks wrong.
   • Add that high-alert medicines, such as insulin or oxytocin, are checked a second time with another nurse.

   I follow the rights of medication administration on every round: right patient, drug, dose, route, time and documentation. I check the patient's name and file number against the drug chart, and I ask about allergies before a first dose. I read the label when I take the medicine from the shelf, when I prepare it and again at the bedside. If a prescription is unclear, I call the prescriber before giving anything. Once I saw an antibiotic prescribed for a woman whose file said she was allergic to penicillin. I held the dose and called the doctor, and the order was changed.

3. 3“You realise you have made a medication error. What do you do?”

   Why they ask: The panel is checking honesty and a patient safety attitude. A hidden error is far more dangerous than the error itself, and they want to hear that you would report it at once.

   How to answer

   • Check the patient first: vital signs, any reaction, and stay with them.
   • Tell the nurse in charge and the doctor straight away, and follow their instructions.
   • Write what happened factually in the notes, and fill in the incident report if the facility has one.
   • Say what you learned and what you now do differently, without blaming others.

4. 4“A pregnant woman at 34 weeks comes to ANC with a severe headache and blurred vision. What do you do?”

   Why they ask: These are danger signs of severe pre-eclampsia, which can lead to eclampsia (fits). The panel checks that you recognise the signs, measure the right things and escalate without delay.

   How to answer

   • Name the problem: severe headache and blurred vision in late pregnancy are danger signs of pre-eclampsia.
   • Say what you check: blood pressure, urine for protein, swelling of the face and hands, and the baby's heartbeat.
   • Escalate at once to the doctor or senior midwife and prepare for referral. The protocol medicine is given only by trained staff following the facility protocol.
   • Keep her calm, never leave her alone, explain to her and her family, and record every reading with the time.

   Severe headache and blurred vision at 34 weeks are danger signs of pre-eclampsia, so I would treat this as an emergency. I would take her blood pressure straight away, test her urine for protein, check for swelling and listen to the baby's heartbeat. While I do this, I would ask a colleague to call the doctor or senior midwife. If her blood pressure is high, we follow our severe pre-eclampsia protocol and arrange referral to the hospital, with a midwife travelling with her. I would stay with her, explain calmly to her and her husband what is happening, and write every reading with the time.

5. 5“How do you use a partograph, and when does it tell you to act?”

   Why they ask: The partograph is the main tool for spotting slow or obstructed labour early. The panel checks that you use it to make decisions, not as a form you fill in after the birth.

   How to answer

   • Start it when active labour begins and fill it in as you go, never afterwards from memory.
   • List what it records: cervical dilatation, descent of the head, contractions, the baby's heart rate, the liquor, and the mother's pulse, blood pressure and temperature.
   • Explain the lines: crossing the alert line means labour is slower than expected, so you inform the senior and plan referral from a health centre; reaching the action line means a decision must be made now.
   • If you know it, mention that some facilities now use the WHO Labour Care Guide, a newer tool built on the same idea.

6. 6“How do you hand over your patients at the end of a shift?”

   Why they ask: Many errors happen at handover, when information gets lost between shifts. The panel wants a clear structure, the key facts for each patient and the tasks still pending.

   How to answer

   • Use a structure such as SBAR: situation, background, assessment, recommendation.
   • Hand over at the bedside when you can, so the next nurse sees the patient with you.
   • Start with the sickest patients, then pending results, medicines due soon and anyone waiting for referral.
   • Make sure the written notes say the same as your spoken handover.

   I hand over at the bedside using SBAR. For each patient I give the situation, the background, my assessment and what needs doing next. I start with the sickest patients, then pending lab results and medicines due in the next hours. On a busy night in the maternity ward, I handed over a woman who had bled more than usual after delivery. I told the morning midwife the time of the last check, how the uterus felt, and that the doctor wanted her haemoglobin result before noon. She knew exactly what to watch, and the result was followed up on time.

7. 7“A patient's brother asks you for her diagnosis, but she asked you to keep it private. What do you do?”

   Why they ask: In close communities, families often expect to be told everything. The panel checks that you respect confidentiality and the patient's choice while still treating the family kindly.

   How to answer

   • Say clearly that an adult patient decides who is told, unless the law or the facility's policy says otherwise.
   • Explain politely to the brother that you cannot share it, and suggest he speaks with her directly.
   • Offer to help her talk to her family if she wants, and never discuss patients in corridors or with unknown callers.

8. 8“Tell us about a time you dealt with an angry or frightened family.”

   Why they ask: Families in wards and delivery rooms are often scared. The panel checks that you stay calm, listen, explain in plain words and keep the patient's care going.

   How to answer

   • Use one real situation: what happened, what you said and what changed.
   • Show that you listened first, then explained what was being done and why, in simple Somali.
   • If there was a real problem, such as a long wait, say how you raised it with the in-charge.

   At an MCH in Hargeisa, a father became angry because his newborn had been moved to the newborn corner and nobody had told him why. I asked him to sit with me, listened, and apologised that no one had explained. I told him in simple Somali that the baby was breathing a little fast, so we were watching her closely and keeping her warm, and I took him to see her. He calmed down. Afterwards I suggested to the in-charge that one staff member always updates the family when a baby is moved, and we started doing that.

Example answers are in English, the language most panels use. Say it in your own words.

Topics to revise

• Vital signs and early warning scoresTemperature, pulse, breathing rate, blood pressure, oxygen saturation and level of consciousness (AVPU: alert, responds to voice, responds to pain, unresponsive). Many hospitals use an early warning score that adds points for abnormal values and tells you when to call the doctor. They may ask what you do when the score rises.
• Triage (ETAT for children)Triage sorts patients by urgency, not by order of arrival. ETAT for children uses three groups: emergency signs (blocked airway or breathing problems, shock, coma, convulsions, severe dehydration) treated at once, priority signs seen next, and non-urgent cases who wait in the queue. Expect: “Three patients arrive together. Who do you see first?”
• Rights of medication administrationThe checks before every dose: right patient, drug, dose, route, time and documentation; many hospitals add right reason and right response. Know them by heart and be ready to say how you check each one at the bedside, and that high-alert medicines get a second check.
• Hand hygiene: WHO 5 MomentsClean your hands before touching a patient, before a clean or aseptic procedure, after a risk of contact with body fluids, after touching a patient, and after touching the patient's surroundings. Use alcohol hand rub when hands look clean, and soap and water when they are visibly dirty.
• PPE donning and doffingPutting on (donning): gown, mask, eye protection, then gloves. Taking off (doffing): gloves, eye protection, gown, mask, then hand hygiene. Taking items off in the wrong order contaminates your hands and face. A skills station often asks you to show this.
• Sharps and healthcare wasteNever recap a used needle; drop it straight into the safety box, and close the box when it is three-quarters full. Separate waste into the colour-coded bins your facility uses (sharps, infectious, general). They may ask what you do after a needle-stick injury: wash the wound, report at once and follow the facility's exposure protocol.
• Antenatal care (ANC)Planned contacts during pregnancy to check blood pressure, weight, the baby's growth and heartbeat, and anaemia, and to give tetanus vaccination, iron and folic acid, and advice on birth preparedness and danger signs. WHO's current model recommends at least eight contacts. Be ready to list what you do at a first visit.
• Danger signs in pregnancyVaginal bleeding, fits, severe headache with blurred vision, fever, severe abdominal pain, fast or difficult breathing, swelling of the face and hands, reduced baby movements, and waters breaking before labour. Any of these means urgent assessment and usually referral. Midwife panels often ask you to list them and say what you do first.
• Partograph (alert and action lines)A one-page chart of labour progress, the baby's condition and the mother's condition. If cervical dilatation crosses the alert line, labour is slower than expected: tell the senior and plan referral if you are at a health centre. At the action line, a decision must be made. Some facilities now use the WHO Labour Care Guide instead.
• AMTSL (third stage of labour)Active management of the third stage of labour prevents heavy bleeding after birth: a uterotonic medicine, usually oxytocin, soon after the baby is born; controlled cord traction by a trained provider; and checking that the uterus stays firm after the placenta is out. Bleeding after birth is a major cause of maternal death, so midwife panels often ask this.
• SBAR and documentationSBAR (situation, background, assessment, recommendation) is a short structure for calling a doctor or handing over a patient. Good notes are written at the time, dated, timed, signed and factual, never written later from memory. You may be asked to give an SBAR phone call out loud.
• Consent and confidentialityBefore a procedure, explain what you will do and why, and get the patient's agreement; for a child, the parent or guardian agrees. What a patient tells you stays between the care team, unless the law or the facility's policy requires otherwise. Panels test this with a relative, a phone caller or a colleague asking for details.

Practical tasks you may get

1. 1Skills station on vital signs: you take a full set on a volunteer or a model and record it. Practise with a colleague the day before, say each step out loud, and state what you would do if a value were abnormal.
2. 2Hand hygiene and PPE demonstration: you may be asked to wash your hands in the WHO steps and to put on and take off PPE. Practise the order until it is automatic; the assessor watches for you touching your face or the outside of your gloves.
3. 3Written case, 30 to 60 minutes: three patients arriving at once, or a woman in labour whose partograph is crossing the alert line. Answer in order: assess, act within your level, escalate, communicate with the family, document.
4. 4Drug chart check: you get a prescription chart with hidden errors, such as a missing dose time, a wrong route or a drug the patient is allergic to. Read slowly, apply the rights one by one, and say you would call the prescriber rather than guess.
5. 5Short health talk: five minutes to a pretend mother on newborn danger signs or exclusive breastfeeding. Use plain Somali, one idea at a time, and ask her to repeat the key points back to check she understood.

Mistakes to avoid

• Naming protocols without giving one real step from them, so the panel cannot tell whether you have used them.
• Describing treatment outside your level or licence, such as deciding a medicine on your own, to sound capable.
• Saying you would wait for the doctor's round when a patient already shows danger signs.
• Forgetting the family and the record in case answers; panels score communication and documentation as part of care.
• Claiming a training or skill you do not have; the skills station or a phone call to the trainer will show it.
• Giving a real patient's name or details that identify them while telling a story in the interview.

Quick check

5 questions. Answer each one to see the explanation.