Prioritizing

[Zooey72]

Just had my nursing orientation today and what strikes me with the difficulty of nursing school is learning how to prioritize. I get where there is no right answer, but what is "most right".

To that end, they really do have to teach you how to prioritize what they say the right answer is don't they? A poster asked a question a while back that was along the line of "A patient has been given a sedative and needs rest. You have to get an answer to a personal question, what do you do?"

A. Ask the spouse

B. Ask the child

C. Ask the sister

D. Wait for the patient to wake up

That may not have been the exact question, but it was something like that. I don't know which one of those answers is right, but I need to know what I am supposed to do if that situation comes up and/or it being on my test. There are no wrong answers, but there is only one that is right.

Part of it almost comes across like flowchart logic, and that is fine. I will learn whatever it is I need to learn. The idea of "Thinking out of the box" is fine, I can do that as well. But hypothetical situations can go either way on a lot of these it seems, and I just want to know what answer it is they want.

"You see 1933 Hitler hit by a car, do you save his life if you are not on the clock"? I know the answer is "we save everyone", but the logic is flawed when you consider the 52 million people who directly died because of him.

I guess my question is are we given parameters and rules to follow? As with the above example "we save everyone". Ok, check, the parameter is no matter how horrid the person is we save them; that takes precedent over everything. But with the first question I hope they teach us the same priorities such as "The spouse is always the one you talk to first", or whatever the best answer is. They can throw other variables in to foul me up, I can deal with that. But even with variables I would think the right answer should be based off of how to prioritize, and that we are taught how to prioritize.

[pmabraham, BSN, RN]

My personal belief system is that while we don't give up our ethics, personal feelings, and beliefs when we go into nursing, we do go into nursing to help others who often do not feel the same way we do, and can easily be the outcasts of any society.

So yes, we may have to cheerfully, professionally, and with excellence take care of people who could be the next Hitler. I'm strongly pro-life; and I may be put into a position to care for an injured/sick doctor who chooses to murder innocent unborn babies; and, should that occur, I can only hope and pray I would do my very best to help that doctor become healthy and well; and do do so in the most loving and professional manner with excellence of service with humility. The logic is not flawed; it is part of being a servant.

In my opinion, the best book on prioritization is "Prioritization, Delegation, and Assignment" by Linda A. LaCharity, Candice K. Kumagi, and Barbara Bartz.

[windsurfer8, BSN, RN]

Prioritize and execute. What part of this are you struggling with? I am a psych nurse...if I have a patient who is clenching his fists and pacing...and another with an order for a ibuprofen for a headache....I must first diffuse the agitated patient. SAFETY is first....as a nurse I know that deescalating the agitated patient is my priority from both a macro and micro. Micro because I provide the agitated needed patient care. Macro because I am also protecting the other patients from possible violence. It takes some abstract thought which you will develop.

The idea of the "right" answer is a little different...and here is why. In nursing you will make a lot of decisions based on the information you have at that moment. IF You make the "wrong" decision and you get called before the man you need to be able to explain WHY you did what you did. If you say "I just did it" you may as well turn in your badge. If you can explain step by step why you did with both quantifiable and qualitative data you empower yourself and shows you are logically thinking through a situation.

I find NCLEX questions to be simple even about areas I am not familiar with because prioritizing is so ingrained in my life now.

[littlemissbookworm]

For answering prioritizing questions, the best way to learn the "best answer" is to do practice questions. Do as many as you can and you will begin to pick up on the trends.

Prioritizing is an important aspect of nursing. If you have three patients that need something and the other nurses can't help, who do you see first? Or if you have quite a few things that need to be done during the day (pre operative checklist, catheter removal, etc.), which should you do first? It's something that you learn with experience, but prioritizing questions that you do in school are designed to have you think outside the box.

[Horseshoe, BSN, RN]

There are no wrong answers, but there is only one that is right.

In my nursing curriculum, there definitely were answers that were "wrong." Usually there would be a couple which you could argue were "correct," but one of them was the MOST correct, or the most appropriate action given the circumstances. But yeah, they would put in some distractors which were most definitely "wrong."

[3peas]

Nursing is ALL about prioritization, safety, delegation when appropriate. Your program will teach you how to think like a nurse. Don't panic, you're just starting out.

P.S. In the above example question there are policies/rules about who can make life or death decisions for family members first is always spouse, then children, then other other family members, friends, if none are available hospital personnel. The question states sedation, needs rest, personal question. Answer is to let the patient rest b/c not a life or death situation. The key to answering questions is paying attention to the details, because they know you will know the order of who to ask, but did you pay attention to the situation?

[HouTx, BSN, MSN, EdD]

Relax. Take a breath. You're at the very beginning of the educational process. The curriculum is sequentially arranged, so that you will absorb more and more information at the same time you're gaining new skills & applying both in an actual clinical setting. Trust the process. The 'tests' along the way will be appropriate to the level you have achieved. One step at a time.

As you progress, you'll pick up on the basic algorithms such as: Physical prioritization is always based on Airway, Breathing, Circulation, C-spine (in that order) & keeping the patient safe / preventing further deterioration ..... the best answer is the one that maintains the airway.

I don't want to spoil the ending for you, but it will all turn out OK.