This is a wonderful test that was developed by Dr. Dorothy del Bueno in effort to test a nurses’ critical thinking, interpersonal relation, and technical skills. The test consists of several short video’s that are played, in which the nurse is required to recognize the problem, assess what interventions needed to take place, what he or she would expect the physician to order. Prioritize how and when those interventions are to take place while also taking into consideration conflict resolution, customer satisfaction, team building, and safety in performance and use of equipment.

Here is where the first problem lies. There is not a test developed for every nursing field that there is. If I’m hired for telemetry and take the Med/Surg test, then how does that prove my competency for the telemetry floor? If I’m hired for rehab, and take the Med/Surg test, then how does that prove my competency for things such as how to manage the care of a patient who is trying to walk again, verse a patient who is having an acute stroke? If they are going to use this for competency-based assessment, they need to have it for the specialty that we are competent in.

When you take this test, you will get about a twenty-second video of a patient that is having some kind of acute distress, and you are suppose to figure out what is going on with that patient, what you should do first, and then progress from there until the patient is stable.
Here lays the second problem is the fact, that you are expected to write every little thing down that you can think of to do. You also have to think up a diagnosis which you think that the physician is going to assign to the patient. Since when are nurses trained to diagnose what is wrong with the patient?

What effect does this test have on travel nursing and why is it so controversial? That is because the test was designed to assess a nurse’s strengths and weakness for an orientation process that is tailored to that nurse. But, what the hospitals are now doing is using the test to “weed out” travel nurses that are “incompetent.” I have heard numerous stories where the first week of orientation was going great, the hospital really liked the nurse, the nurses’ professionalism and competence was being proofed daily with every day situations, and then their contract is cancelled because all of a sudden some test says that they are incompetent. Now she has no job, but she still has a three month lease on an apartment.

Let’s just say that I have accepted a job in Naples, FL (several hospitals there are known for using the PBDS testing for travelers). By the time I travel from Pocatello, Idaho to Naples, Florida, I would spend $5023 on travel expenses and a three month lease. My question now is what nurse in her right mind would take that kind of gamble on a test that is not being used as it was originally designed?

Unfortunately, there are some nurses who do take this gamble, and that is why the hospitals continue to use this testing system. I don’t have a problem with a testing system to prove competency, but it needs to be arranged before a nurse drives across country only to have her contract cancelled. I don’t even have a problem with the PBDS test, as long as it is being used to see where nurses are lacking and orientation is customized around what the nurse is lacking in. Travelers are expected to receive very minimal orientation and hit the floor running; therefore, extended customized orientation is not an option.

Written by Epstein LaRue, RN, BS, author of the number one rated nursing, trends, issues, and roles book series, “Highway Hypodermics.” For more information on travel nursing including travel company profiles, travel company evaluations, and hospital evaluations, visit her website at


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