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Nursing Management and Professional Concepts 2e: 2.2 Tenets of Prioritization

Nursing Management and Professional Concepts 2e
2.2 Tenets of Prioritization
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table of contents
  1. Cover
  2. Title Page
  3. Copyright
  4. Table Of Contents
  5. Introduction
  6. Preface
  7. Standards and Conceptual Approach
  8. Chapter 1 - Overview of Management and Professional Issues
    1. 1.1 Overview
  9. Chapter 2 - Prioritization
    1. 2.1 Prioritization Introduction
    2. 2.2 Tenets of Prioritization
    3. 2.3 Tools for Prioritizing
    4. 2.4 Critical Thinking and Clinical Reasoning
    5. 2.5 Time Management
    6. 2.6 Spotlight Application
    7. 2.7 Learning Activities
    8. II Glossary
  10. Chapter 3 - Delegation and Supervision
    1. 3.1 Delegation & Supervision Introduction
    2. 3.2 Communication
    3. 3.3 Assignment
    4. 3.4 Delegation
    5. 3.5 Supervision
    6. 3.6 Spotlight Application
    7. 3.7 Learning Activities
    8. III Glossary
  11. Chapter 4 - Leadership and Management
    1. 4.1 Leadership & Management Introduction
    2. 4.2 Basic Concepts
    3. 4.3 Implementing Change
    4. 4.4 Spotlight Application
    5. 4.5 Learning Activities
    6. IV Glossary
  12. Chapter 5 - Legal Implications
    1. 5.1 Legal Implications Introduction
    2. 5.2 Understanding the Legal System
    3. 5.3 Professional Liability and Your Nursing License
    4. 5.4 Frequent Allegations and SBON Investigations
    5. 5.5 Protecting Your Nursing License
    6. 5.6 Other Legal Issues
    7. 5.7 Spotlight Application
    8. 5.8 Learning Activities
    9. V Glossary
  13. Chapter 6 - Ethical Practice
    1. 6.1 Ethical Practice Introduction
    2. 6.2 Basic Ethical Concepts
    3. 6.3 Ethical Dilemmas
    4. 6.4 Ethics Committees
    5. 6.5 Ethics and the Nursing Student
    6. 6.6 Spotlight Application
    7. 6.7 Learning Activities
    8. VI Glossary
  14. Chapter 7 - Collaboration Within the Interprofessional Team
    1. 7.1 Collaboration Within the Interprofessional Team Introduction
    2. 7.2 IPEC Core Competencies
    3. 7.3 Values and Ethics for Interprofessional Practice
    4. 7.4 Roles and Responsibililites of Health Care Professionals
    5. 7.5 Interprofessional Communication
    6. 7.6 Teams and Teamwork
    7. 7.7 Conflict Resolution
    8. 7.8 Nursing Responsibilities in Interprofessional Collaborative Practice
    9. 7.9 Spotlight Application
    10. 7.10 Learning Activities
    11. VII Glossary
  15. Chapter 8 - Health Care Economics
    1. 8.1 Health Care Economics Introduction
    2. 8.2 Trends Related to Increased Health Care Costs
    3. 8.3 Health Care Funding
    4. 8.4 Health Care Reimbursement Models
    5. 8.5 Budgets and Staffing
    6. 8.6 Resource Stewardship and Case Management
    7. 8.7 Spotlight Application
    8. 8.8 Learning Activities
    9. VIII Glossary
  16. Chapter 9 - Quality and Evidence-Based Practice
    1. 9.1 Quality and Evidence-Based Practice Introduction
    2. 9.2 Quality Care
    3. 9.3 Measuring and Improving Quality
    4. 9.4 Evidence-Based Practice and Research
    5. 9.5 Spotlight Application
    6. 9.6 Learning Activities
    7. IX Glossary
  17. Chapter 10 - Advocacy
    1. 10.1 Advocacy Introduction
    2. 10.2 Basic Advocacy Concepts
    3. 10.3 Individual and Interpersonal Advocacy
    4. 10.4 Community and Organization Advocacy
    5. 10.5 Policy Advocacy
    6. 10.6 Steps to Becoming an Advocate
    7. 10.7 QSEN: Advocating for Patient Safety and Quality Care in Nursing Education
    8. 10.8 Spotlight Application
    9. 10.9 Learning Activities
    10. X Glossary
  18. Chapter 11 - Preparation for the RN Role
    1. 11.1 Preparation for the RN Role Introduction
    2. 11.2 Preparing for the NCLEX
    3. 11.3 Obtaining Your Nursing License
    4. 11.4 Applying for a Nursing Position
    5. 11.5 Transitioning to the RN Role
    6. 11.6 Lifelong Learner
    7. 11.7 Spotlight Application
    8. 11.8 Learning Activities
    9. XI Glossary
  19. Chapter 12 - Burnout and Self-Care
    1. 12.1 Burnout & Self-Care Introduction
    2. 12.2 Stress in the Health Care System
    3. 12.3 Identifying Stress in Self
    4. 12.4 Acknowledging Stress in Others
    5. 12.5 Organizational Stress & Retention Cycle
    6. 12.6 Mitigating Stress With Self-Care
    7. 12.7 Emerging Models
    8. 12.8 Spotlight Application
    9. 12.9 Learning Activities
    10. XII Glossary
  20. Answer Keys
    1. Chapter 1
    2. Chapter 2
    3. Chapter 3
    4. Chapter 4
    5. Chapter 5
    6. Chapter 6
    7. Chapter 7
    8. Chapter 8
    9. Chapter 9
    10. Chapter 10
    11. Chapter 11
    12. Chapter 12
  21. Appendix: Classroom Activities
  22. Master Glossary

2.2 Tenets of Prioritization

Prioritization

As new nurses begin their career, they look forward to caring for others, promoting health, and saving lives. However, when entering the health care environment, they often discover there are numerous and competing demands for their time and attention. Client care is often interrupted by call lights, rounding physicians, and phone calls from the laboratory department or other interprofessional team members. Even individuals who are strategic and energized in their planning can feel frustrated as their task lists and planned client-care activities build into a long collection of “to dos.”

Without utilization of appropriate prioritization strategies, nurses can experience time scarcity, a feeling of racing against a clock that is continually working against them. Functioning under the burden of time scarcity can cause feelings of frustration, inadequacy, and eventually burnout. Time scarcity can also impact client safety, resulting in adverse events and increased mortality.[1] Additionally, missed or rushed nursing activities can negatively impact client satisfaction scores that ultimately affect an institution’s reimbursement levels.

It is vital for nurses to plan client care and implement their task lists while ensuring that critical interventions are safely implemented first. Identifying priority client problems and implementing priority interventions are skills that require ongoing cultivation as one gains experience in the practice environment.[2] To develop these skills, students must develop an understanding of organizing frameworks and prioritization processes for delineating care needs. These frameworks provide structure and guidance for meeting the multiple and ever-changing demands in the complex health care environment.

Let’s consider a clinical scenario in the following box to better understand the implications of prioritization and outcomes.

Scenario A

Imagine you are beginning your shift on a busy medical-surgical unit. You receive a handoff report on four medical-surgical clients from the night shift nurse:

  • Client A is a 34-year-old client post-op Day 1 from a total knee replacement who had an uneventful night. It is anticipated that she will be discharged today and needs health teaching for self-care at home.
  • Client B is a 67-year-old male admitted with weakness, confusion, and a suspected urinary tract infection. He has been restless and attempting to get out of bed throughout the night. He has a bed alarm in place.
  • Client C is a 49-year-old male, post-op Day 1 for a total hip replacement. He has been frequently using his patient-controlled analgesia (PCA) pump and last rated his pain as a “6.”
  • Client D is a 73-year-old male admitted for pneumonia. He has been hospitalized for three days and receiving intravenous (IV) antibiotics. His next dose is due in an hour. His oxygen requirements have decreased from 4 L/minute of oxygen by nasal cannula to 2 L/minute by nasal cannula.

Based on the handoff report you received, you ask the nursing assistant to check on Client B while you do an initial assessment on Client D. As you are assessing Client D’s oxygenation status, you receive a phone call from the laboratory department relating a critical lab value on Client C, indicating his hemoglobin is low. The provider calls and orders a STAT blood transfusion for Client C. Client A rings the call light and states she and her husband have questions about her discharge and are ready to go home. The nursing assistant finds you and reports that Client B got out of bed and experienced a fall during the handoff reports.

It is common for nurses to manage multiple and ever-changing tasks and activities like this scenario, illustrating the importance of self-organization and priority setting. This chapter will further discuss the tools nurses can use for prioritization.

  1. Cho, S., Lee, J., You, S. J., Song, K. J., & Hong, K. J. (2020). Nurse staffing, nurses prioritization, missed care, quality of nursing care, and nurse outcomes. International Journal of Nursing Practice, 26(1), e12803. https://doi.org/10.1111/ijn.12803 ↵
  2. Jessee, M. A. (2019). Teaching prioritization: “Who, what, & why?” Journal of Nursing Education, 58(5), 302-305. https://doi.org/10.3928/01484834-20190422-10 ↵

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2.3 Tools for Prioritizing
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                                by Chippewa Valley Technical College

            Nursing Management and Professional Concepts 2e Copyright © by Chippewa Valley Technical College is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.
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