Are you a nurse who often feels overwhelmed by all your job’s competing tasks and demands? Do you ever need help prioritizing patient care when so much seems urgent? If so, then this blog post is for you! We all know that nurses play a vital role in providing quality health care, but learning how to manage their workload is an essential skill.
This blog will discuss the fundamental principles of nursing prioritization—including ABCs (Airway, Breathing, and Circulation) and reliability strategies—to help nurses better identify patients’ needs and balance their professional obligations. Through this post, we hope to provide resources to help build confident prioritization skills for any experience level. Read on for more information about the basics of nursing prioritization.
Table of Contents
Nursing Prioritization For Patient Care (ABCs)
The key to effective nursing prioritization is understanding the patient’s needs. Nurses must always be aware of how their patients are doing and ensure they are providing appropriate care. The ABCs are a simple way to remember the steps nurses should take when determining a patient’s condition:
- Airway: Is the patient’s airway free from obstruction? Are they able to breathe normally?
- Breathing: Is the patient breathing adequately? Are there any signs of distress or difficulty with respiration?
- Circulation: Is the patient’s heart rate and rhythm average? Are their blood pressure and oxygen saturation levels okay?
Using these factors, nurses can quickly assess the patient’s condition and prioritize their care accordingly.
Maslow’s Hierarchy of Needs
Current nurses are likely familiar with Maslow’s Hierarchy of Needs. Abraham Maslow established that humans have specific needs which must be met before progressing to other, higher needs. This concept is depicted in a pyramid, where foundational conditions at the bottom must be fulfilled before addressing more complex requirements at the top.
Maslow’s hierarchy is essential to keep in mind when prioritizing patient care. Nurses should prioritize treatments that meet the most basic physical and safety needs at the bottom of the pyramid. This includes ensuring proper airway, breathing, and circulation and providing a therapeutic environment for the patient. Once these basics are taken care of, nurses can move on to addressing more complex needs, such as emotional support or activities of daily living.
- Physiological needs
- Safety needs
- Love and belonging needs
- Esteem needs
- Self-actualization
Physiological needs –
This is the foundation of Maslow’s hierarchy and includes the most basic needs for survival, such as air, water, food, shelter, sleep, and reproduction. Nursing prioritization would include ensuring that a patient has a clear airway, adequate breathing, and proper circulation.
Safety needs –
The next level in Maslow’s hierarchy deals with the need for safety and security. This includes physical safety, emotional stability, financial security, and protection from harm. In terms of nursing prioritization, this would involve addressing any potential threats to a patient’s well-being, such as preventing falls or providing appropriate pain management.
Love and belonging needs –
Individuals need love, affection, and a sense of belonging at this level. This includes relationships with family, friends, and a community. In terms of nursing prioritization, this could involve providing emotional support or facilitating communication between the patient and their loved ones.
Esteem needs –
The fourth level in Maslow’s hierarchy deals with self-esteem, self-respect, and recognition from others. In terms of nursing prioritization, this could involve promoting patient autonomy and independence and acknowledging their accomplishments and contributions.
Self-actualization –
The top level of Maslow’s hierarchy is self-actualization, which involves reaching one’s full potential and achieving personal growth. Nursing prioritization could involve supporting a patient’s goals for recovery or providing resources to help them cope with their illness or condition.
Examples of Maslow’s hierarchy of needs
Aside from its psychological application, numerous disciplines have found Maslow’s model to be a valuable pedagogical tool. In education, professionals refer to the hierarchy when assessing challenges in students’ education or behavior, aiming to identify unmet needs.
Similarly, the hierarchy is utilized in certain business leadership theories as a guide to support employees and foster a healthy organization.
Advocates for race and social justice employ this hierarchy as a model to elucidate how fundamental disparities impede the upward mobility of underserved individuals.
“Experiencing food insecurity, inadequate housing, or being overworked does not inherently preclude us from experiencing moments of genuine happiness, contentment, and ease,” states the YWCA, a women’s rights organization, in an article on race, poverty, and well-being.
“However, these experiences create disadvantages in pursuing a well-lived life. They present barriers that must be overcome, challenges that must be faced, and instill worry regarding the possibility of our most basic needs going unmet, jeopardizing our primary aspiration: to live.”
Within this sphere, some individuals reframe Maslow’s hierarchy as one of rights or inequities to effectively illustrate how discrimination leads to the denial of these needs.
Why the hierarchy of needs is important
While Maslow’s hierarchy of needs is widely recognized and helpful, it is important to acknowledge that it represents just one perspective on human psychology and is not considered an absolute scientific truth. Critics of Maslow’s model argue that it may be too arbitrary and suggest that human needs exist on a more fluid spectrum.
Nevertheless, many experts still find the concept valuable for understanding personal well-being and exploring broader questions of human potential. “It encompasses both our deepest deficiencies and challenges, as well as our highest strengths,” explained psychologist Scott Barry Kaufman in an interview with mindbodygreen.
Writing for the Berkeley Well-Being Institute, Charlie Huntington highlighted that Maslow saw his hierarchy as part of a motivational theory. We can gain insights into our motivations by examining how our behaviors align or deviate from the hierarchy.
Prioritization without the ABCs
The ABCs are a great starting point for prioritizing care, but there are other considerations. In addition to the patient’s current condition, nurses must consider potential risks or threats that could affect their health and safety. This includes things like allergies, medication interactions, and other medical conditions.
Nurses should also keep in mind the importance of communication and documentation. Documenting all patient care activities is essential so other healthcare team members can stay informed and provide necessary follow-up care. Communication between nurses and physicians ensures patients receive the best possible care.
Reliability Strategies for Nursing Prioritization
In addition to Maslow’s Hierarchy of Needs, nurses can use several strategies to ensure reliable care. These include:
- Being aware of your limitations – nurses must recognize their strengths and weaknesses to manage their workload responsibly.
- Documenting all care given to the patient – documenting each step of care helps ensure the patient receives the best possible treatment.
- Utilizing evidence-based practices – utilizing research-backed methods can help nurses make more informed decisions about prioritizing patient care.
- Communicating effectively with other health professionals – nurses need to communicate clearly and effectively with other healthcare team members to ensure coordinated care.
- Asking questions when appropriate – nurses should never be afraid to ask questions if something seems unclear or uncertain; this could prevent mistakes from occurring later on.
- Being mindful of the patient’s needs – nurses should always be aware of the unique aspects of each patient’s situation and adjust their approach accordingly.
These strategies help nurses stay organized, on top of their tasks, and provide the best quality care for patients.
The Nursing Process
The nursing process is an essential tool for prioritizing care. This process includes five steps:
- Assessment– The first step of this process—assessment—involves collecting information about the patient’s condition to identify needs and problems.
- Diagnosis– During the diagnosis stage, nurses use the collected data to identify the root causes of the problem.
- Planning– The planning stage is then used to create a care plan to address the patient’s needs and goals.
- Implementation– In the implementation step, nurses begin carrying out the care plan.
- Evaluation– Finally, in evaluation, nurses assess how well their interventions have worked.
Family nurse practitioners utilize the nursing process to provide care for their patients. This includes assessing, diagnosing, planning, implementing, and evaluating treatments. For example, suppose a patient is prescribed pharmacologic therapy for an infection but does not experience symptom resolution after treatment. In that case, the family nurse practitioner will reassess the situation and potentially prescribe an alternative therapeutic regimen.
In certain states, nurse practitioners have the autonomy to prescribe medications independently. Elsewhere, they are pushing for full practice authority. In any case, the nursing process is used to structure and prioritize patient care.
The nursing process helps guide nurses in providing the most appropriate care for each patient. This process allows nurses to prioritize the right treatments and interventions for their patients’ needs.
Tools for Prioritizing Care in Nursing
In addition to the nursing process, several tools help nurses prioritize care. One example is the Nursing Prioritization Model (NPM), which allows nurses to identify and prioritize patient needs by assessing their condition. This model also considers the patient’s physical and psychological conditions to determine a course of action.
The NPM is based on Maslow’s hierarchy of needs, with each level representing a different set of patient needs. Using this model, nurses can determine how to address patients’ needs and provide the most effective care.
Another tool is the Nursing Task Prioritization System (NTPS), which helps nurses prioritize tasks related to patient care. The NTPS uses a numerical rating system from 0-10, with higher numbers indicating more essential tasks. This system allows nurses to quickly identify and prioritize the most pressing needs of their patients.
Finally, tools such as the Emergency Severity Index (ESI) and the Rapid Emergency Assessment of Needs (REAN) can help nurses determine a patient’s condition’s urgency or priority level. These tools use a rating system that allows nurses to prioritize care based on the acuity or complexity of the situation.
Professionals Standard for Prioritizing
Prioritizing tasks can be a challenging aspect of daily life. Whether it’s managing workload at your job, school assignments, or even personal to-do lists, it can be overwhelming to determine what needs to be done first. Finding a system that works best for you and helps you stay organized and productive.
This paragraph will discuss LEVEL PRIORITY and how it can help you prioritize your tasks effectively.
FIRST-LEVEL PRIORITY PROBLEMSAirway, Breathing, Circulation (ABCs)
ABC’s
The highest priority issues are health problems that immediately threaten life and demand urgent attention. These encompass critical matters related to the ABCs: airway, breathing, and circulation. Examples include securing an airway, providing respiratory support, and managing sudden perfusion and cardiac concerns.
SECOND-LEVEL PRIORITY PROBLEMSMAA-U-AR
“MAA U ARe 2nd”
Secondary-level issues encompass critical health conditions requiring prompt intervention to prevent further deterioration. Prioritization can be achieved by employing the MAA-U-AR method, which stands for mental status change, acute pain, acute impaired urinary elimination, untreated medical problems, abnormal diagnostic test results, and risks.
Mental Status Change
Brain and Delta-sign
Alterations in mental status signify broad alterations in brain function, encompassing confusion, amnesia, diminished alertness, impaired judgment or cognition, and more. Failure to address changes in mental status may result in harm, falls, or irreversible brain damage.
Acute Pain
Acute-sign Pain-bolt
Acute pain may indicate the existence of actual or potential tissue damage, serving as an indication that something is amiss. Untreated pain can result in muscle tension, limited mobility, skin breakdown, or infection.
Acute Urinary Elimination Problems
Acute-sign Urine Retained in the Bladder
Acute urinary elimination problems may indicate obstructions in the bladder or urethra. Untreated urinary retention can lead to complications such as urinary tract infections, bladder damage, and chronic kidney failure.
Untreated Medical Problems
Unsolved Medical Problem-cube
Untreated medical conditions can result in rapid deterioration of a patient’s health or even mortality. A prime example is a diabetic patient who requires insulin; the absence of insulin may lead to the development of diabetic ketoacidosis.
Abnormal Laboratory Values
Abnormal Test-tubes
Abnormal laboratory values may indicate potentially significant issues and warrant further investigation. They could suggest underlying concerns related to the liver, heart, or kidneys.
Risk of Infection, Safety or Security
Infectious bacteria, Safety-pin and Security
It is crucial to address infections promptly to prevent further deterioration. Infections can result in inflammation, pain, impaired wound healing, sepsis, and even mortality. Safety and security concerns can also significantly heighten the risk of falls, injuries, and trauma.
THIRD-LEVEL PRIORITY PROBLEMSLong-Term Treatments
Long-ruler Treat
The third-level priorities encompass crucial aspects of patient health that can be addressed after addressing more critical health issues. Treating these problems requires long-term interventions, including addressing knowledge gaps, mobility limitations, family coping, activity levels, and rest.
What is an example of Prioritising in nursing?
For example, if a nurse cares for an elderly patient who has just been admitted to the hospital, they would first assess the patient’s condition and identify any immediate needs. The nurse’s priorities may be care based on Maslow’s hierarchy of needs and ensuring that the patient is provided with adequate food, water, and rest. Once the patient’s physiological needs have been met, the nurse can provide emotional and psychological support by talking to them and helping them feel safe and secure.
To determine a care plan, the nurse may assess potential medical issues, such as pain or other symptoms. The nurse can prioritize tasks related to this plan by utilizing the Nursing Task Prioritization System (NTPS). The nurse may also use the Emergency Severity Index (ESI) or Rapid Emergency Assessment of Needs (REAN) to determine if urgent care is needed.
Final Words
Patient prioritization is a critical component of nursing care. It helps nurses ensure that they provide the most appropriate care for their patients in the most efficient manner possible.
Nurses can effectively prioritize patient needs and provide necessary treatments by using tools such as the Nursing Process, Nursing Prioritization Model (NPM), and Nursing Task Prioritization System (NTPS). Utilizing these tools can help nurses provide the best possible care to their patients.
This content is written for educational purposes and does not constitute medical advice. If you have any questions, please consult a licensed healthcare professional.
References:
https://online.marymount.edu/blog/abcs-nursing-prioritization
https://edition.cnn.com/world/maslows-hierarchy-of-needs-explained-wellness-cec/index.html
https://simplypsychology.org/maslows.html
Mrs. Marie Brown has been a registered nurse for over 25 years. She began her nursing career at a Level I Trauma Center in downtown Chicago, Illinois. There she worked in the Emergency Department and on the Surgical Intensive Care Unit. After several years, she moved to the Midwest and continued her nursing career in a critical care setting. For the last 10 years of her nursing career, Mrs. Brown worked as a flight nurse with an air ambulance service. During this time, she cared for patients throughout the United States.