Question 1

Why do you want to work in critical care?

Accepted Answer

I can tell you the shift that made my mind up. I was on a medical ward, and one of my patients, a man in his sixties with pneumonia, was getting worse through the afternoon. His NEWS2 kept creeping up, I escalated, and the outreach nurse came. I watched her work, and what struck me wasn't the speed. It was how carefully she looked at him, how she explained everything to his wife, and how she pulled the whole plan together. He went to ICU that evening. A few weeks later he came back to our ward on his way home. He was weak and he couldn't remember most of his stay, but he remembered one nurse who used to tell him the date and hold his hand when he was frightened. That has stayed with me. Critical care is full of technology, but the bit that mattered to him was a nurse at the bedside who treated him as a person while he couldn't speak for himself. That's what I want to be part of. I like the idea of really knowing one patient across a shift, noticing the small changes before they become big ones, and understanding why each infusion and setting is there. I'm also realistic. I know patients die in ICU, that families go through the worst days of their lives there, and that the learning curve is steep. I've spoken to nurses on the unit about the competency framework and the support for new starters, and that's reassured me that I won't be expected to know everything on day one. I want the challenge, but I want to grow into it safely.

Question 2

You take over a sedated, ventilated patient at the start of a night shift. Talk us through your first hour.

Accepted Answer

The first thing I'd do is get a proper bedside handover, ideally with the day nurse at the bed rather than at the desk, so we can look at the patient, the ventilator and the pumps together. I'd want the story of why they're here, the plan from the ward round, any events in the day, their sedation target and their ceiling of treatment, if one has been decided. Before anything else I'd do my bedside safety checks. I check the emergency equipment is there and working: suction, a bag-valve-mask with oxygen, the airway trolley nearby, and the right size spare tube. I'd confirm the tube position at the teeth or lips against what's documented, check the cuff, and make sure the ventilator alarms are set sensibly and actually audible. Then I'd go through every infusion against the prescription, line by line, tracing each one back to the right lumen and checking the rate, the concentration and how much is left, so I'm not caught out by a syringe running out at two in the morning. After that I'd do a full A to E assessment. I'd look at the ventilator mode and settings, how they're breathing with it, their chest, secretions and the latest blood gas. For circulation I'd check the arterial line is zeroed and levelled before I trust the numbers, and look at the trend, not just one reading. I'd assess sedation and delirium with the tools we use, check pupils, glucose, temperature, fluid balance and urine output, and look at pressure areas and lines. The last thing is planning the night:…

Question 3

A patient's daughter catches you at the bedside and asks, 'Is my dad going to die?' How do you respond?

Accepted Answer

The first thing I'd do is stop what I'm doing, if it's safe to, and give her my full attention. A question like that usually comes after hours of worrying, and how I respond in the next minute matters a lot to her. If we're at the bedside I might suggest we sit down nearby, or step into the relatives' room if someone can watch her dad. I'd want to understand what she already knows and what's prompted the question, so I'd gently ask something like, 'Can you tell me what you've understood from the doctors so far?' Sometimes the answer is that nobody has really explained, and sometimes she's heard the words but they haven't landed yet. I'd be honest without guessing. If he's very unwell, I'd say so in plain words: 'Your dad is very poorly. His lungs and his heart are both needing a lot of support at the moment, and we're worried about him.' I wouldn't give a prognosis or a percentage, because that isn't mine to give and I could get it wrong. But I wouldn't brush her off either. I'd tell her what we're doing for him tonight, what I'm watching for, and that I'll be with him all shift. Then I'd make sure she gets the full conversation with the consultant, ideally soon and with me there, so I know exactly what's been said and can support her afterwards. I'd let the nurse in charge know she's asked, check she has someone with her and knows how to phone the unit, and document the conversation. If she wants to sit with him and talk to him, I'd encourage that. Families often feel…

Question 4

What is a VAP prevention bundle, and how do you make sure it actually happens on your shift?

Accepted Answer

Ventilator-associated pneumonia is a chest infection that develops in a patient who's had a breathing tube in for a while. It matters because it can lengthen their time on the ventilator and in ICU, and it can be serious. A bundle is a small set of evidence-based measures that work best when they're all done together, consistently, rather than picked and chosen. The elements vary a little between units, so I'd always follow our local policy, but the core usually includes keeping the head of the bed raised, normally around thirty to forty-five degrees unless there's a reason not to; daily sedation review and assessing whether the patient is ready to wean; good mouth care, including toothbrushing; regular checks of the endotracheal tube cuff pressure; and using subglottic suction where the tube has that port. Some units have moved away from routine chlorhexidine mouthwash, so I'd check what our current guidance says rather than assume. Making it happen is the real skill. On a busy shift it's easy for the bed to slip flatter after a turn, or for mouth care to be put off because the patient is unstable. So I build the bundle into my routine rather than treating it as extra jobs. I check the bed angle every time I reposition, I do mouth care at set times and write it on the chart straight away, and I check cuff pressure at the times our policy sets. If sedation hasn't been reviewed on the ward round, I'll raise it with the doctor. I also think it helps to be open about it. If I…

Question 5

How do you assess sedation and delirium in a ventilated patient, and why does it matter?

Accepted Answer

Sedation and delirium are two things I'd be thinking about for every ventilated patient, every shift. Most units I know use the Richmond Agitation-Sedation Scale, or RASS, which runs from deeply unrousable through calm and alert to very agitated. The team sets a target for each patient, and my job is to assess against it regularly and titrate within the prescribed range, rather than just leaving infusions where they are. It matters both ways. Too much sedation can mean a longer time on the ventilator, more risk of chest infection, muscle weakness and delirium. Too little, and the patient might be distressed, fighting the ventilator or at risk of pulling out their tube or lines. So the goal for most patients now is the lightest sedation that's safe for them, and that's a decision I'd always make with the team, especially for someone who needs deep sedation for a clinical reason. For delirium, we use a screening tool such as CAM-ICU once the patient is rousable enough to be assessed. It looks at whether there's an acute change or fluctuation in their mental state, whether they can pay attention, and whether their thinking is disorganised or their level of consciousness altered. I'll be honest, the first few times I did it I found it awkward with a patient who couldn't speak, but with practice the squeeze-my-hand attention test becomes second nature. If someone screens positive, I'd tell the doctor so they can look for causes like infection, pain, withdrawal, drugs or low…

Question 6

A young woman is admitted to ICU after an assault. Her partner visits often and you notice she becomes distressed whenever he arrives. What would you do?

Accepted Answer

The first thing is to take what I've noticed seriously. A patient in ICU might be sedated, intubated or too weak to tell us anything, so her reactions might be the only clue we have. A sudden rise in heart rate, agitation or tears every time one particular visitor arrives is something I'd want to understand, not explain away. I wouldn't confront the partner or ask him questions about the injuries, because that could put her at more risk, and it isn't my role to investigate. If she's awake enough to communicate, even with a letter board or yes and no answers, I'd look for a moment when she's alone and gently check whether she feels safe and whether she wants him to visit. She has the right to decide who visits, and if she says no, I'd make sure that's respected and that the whole team knows. I'd tell the nurse in charge straight away and raise it with the consultant, because the circumstances of her admission already involve violence and the police may be involved. I'd contact the adult safeguarding team for advice and follow the trust's process for raising a concern. Domestic abuse is a safeguarding issue under the Care Act, and there may be routes like an independent domestic violence adviser that the team can bring in. If there are children at home, that needs to be shared too, because their safety matters as well. I'd document exactly what I observed, factually, with times, not my opinions. If at any point I felt she or the staff were in immediate danger, I'd call…

Question 7

Which NHS value matters most to you in intensive care, and why?

Accepted Answer

The NHS values are working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives, and everyone counts. In ICU I think respect and dignity is tested more than anywhere, because so many of our patients can't speak, can't move and can't see what's being done to them. I saw this clearly on my critical care placement. We had a ventilated patient who was deeply sedated, and during a busy ward round several people were standing round the bed talking about him as if he wasn't there, and his gown had slipped. The nurse I was working with quietly covered him, said his name, and told him who was there and what was happening. Nobody had to be told off. It just changed the tone around the bed. That's stayed with me. Now I always talk to my patients before I touch them, even if they're sedated, because we can never be sure what they can hear. I keep curtains drawn for personal care, I make sure they're covered, and I try to find out from families what they'd want, whether that's how they like their hair, the radio station they listen to or the name they prefer to be called. Respect also means respecting their wishes when they can't express them, which is why I take the conversations about what matters to them so seriously. Being in ICU strips away a lot of a person's control, and I think a nurse's job is to give back as much of it as we can.

Question 8

Critical care can be emotionally draining. How do you look after yourself after a difficult shift, such as a patient's death?

Accepted Answer

I don't think it's possible to work in ICU and not be affected sometimes, and I'd be worried if I wasn't. On my placement I looked after a man in his forties whose treatment was withdrawn after a cardiac arrest. His family were with him, and it was peaceful, but I went home that night and couldn't stop thinking about his children in the relatives' room. What helped was talking it through. The next day my mentor asked how I was, and we had a proper conversation about it. She told me she still thinks about some of her patients years later, and that feeling sad wasn't a sign I wasn't coping. That was an important lesson for me. Day to day, I try to have a few simple habits. I take my breaks, even on a busy shift, because I make worse decisions when I'm exhausted. On the way home I have a bit of a routine, usually a walk or a call with a friend, that helps me leave work behind. I protect my sleep around nights as best I can, and I keep up things outside work that have nothing to do with hospitals. I'd also use the formal support. I'd go to debriefs after difficult events, such as hot debriefs after an arrest or a team reflection after a hard death, and I know many trusts have staff wellbeing services, psychological support and Professional Nurse Advocates for restorative supervision. And I think it's part of my job to look out for colleagues too. If I noticed someone going quiet or struggling, I'd check in with them, because that check-in mattered so much to me.

Critical Care & ICU Nursing Interview Questions & Answers

About this NHS interview question bank

Free NHS interview questions and model answers

Question 1: Why do you want to work in critical care?

Question 2: You take over a sedated, ventilated patient at the start of a night shift. Talk us through your first hour.

Question 3: A patient's daughter catches you at the bedside and asks, 'Is my dad going to die?' How do you respond?

Question 4: What is a VAP prevention bundle, and how do you make sure it actually happens on your shift?

Question 5: How do you assess sedation and delirium in a ventilated patient, and why does it matter?

Question 6: A young woman is admitted to ICU after an assault. Her partner visits often and you notice she becomes distressed whenever he arrives. What would you do?

Question 7: Which NHS value matters most to you in intensive care, and why?

Question 8: Critical care can be emotionally draining. How do you look after yourself after a difficult shift, such as a patient's death?

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