How to prioritize new admissions to floor? Highest Priority?

[question seeker]

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i'm trying to locate a question from my nclex of a few years ago to see if it still exists.

the question related to which floor patient has the highest priority. there were 4 scenarios, 3 questions of which were for patients already on the floor, and the 4th patient was a new admit.

the question was which patient had the highest nursing priority. the correct answer was the new admit because a new admit is considered unstable until assessed (at least this is how i remember it). am i incorrect?

could anyone refer me to a text or nclex study guide which still has this scenario?

thanks

[CABG patch kid, BSN, RN]

That would be impossible to answer without knowing about the other 3 floor patients.... Also, I don't think you're supposed to give out real questions and answers for NCLEX? I could be wrong...

[MichelleB34]

It would be hard to say without seeing the question. But my approach has alway been to make sure my patients are stable and settled before I bring up an admit from the ER. My first responsibility is to the patients I already have. Also you should see your sickest patient first or possibly your fresh postop patient. It depends what is going on.

[mommyX2]

I disagree. I think the new admit should at least be looked at first. Just last night the nurses were given a pt from the er. They looked at the patient and recognized that they were in respiratory failure. Pt was down in the ICU within an hour of coming up. ER can be wrong in their assessment of an acuity.

[canoehead, BSN, RN]

If the ER patient is in the ER they are under someone else's care- are you talking about that? Then they would have lowest priority (though as an ER nurse I risk a lynching saying that.)

If you're talking about someone who just arrived to the floor I'd go in there first, to eyeball and get a quick set of vitals. Patients have arrived in transfer from many an outside department in life threatening states, and it becomes your responsibility once you've taken them on as an assignment. I've coded 3 patients immediately after receiving a good report. That's one every 6-7 years, and that's a LOT if you're the one holding the bag. No, you don't get a "good job" citation, but you'll go home knowing you made a difference.

Not on the NCLEX, but in real life, a good look from the door COUNTS as a useful assessment. They're breathing, they have color, no excruciating pain, and they have a call bell? Good news. If they are sitting up talking to their visitors you have no worries because 1) they feel well enough to chat, and 2) family will call if something horrible happens. Even if you are run off your feet you can still walk by the door and take a look, then ask someone to check further if you are concerned. (as you dash to get central line set ups :))

I've heard and seen charted RN's saying they haven't even seen the patient 3 hours after shift change because they were soo busy. That's inexperience, for the first few months, incompetence for the next few years, and exaggeration after about five years or so, because they wouldn't still have a job if they worked that way. As a new nurse you should probably avoid saying anything like that, because older RN's will have another reason to watch you. Just do walking rounds (no talking, just walk by) when you come on, and then get down to business.