Question about Priority

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Specializes in geriatrics,emergency,hospice.

Hi All,

I have a question about priority and nclex. According to Kaplan, a nurse who floats to another unit ( lets say a pacu nurse floats to med-surg) should get the patient who is stable with a predictable outcome. According to the Priority,Delegation, Assignment book by Linda Lacharity, that pacu float nurse can take care of a patient who is immediately post op, or just received from pacu. So...I am confused. Would the float nurse take care of someone who is stable with a predictable outcome or can they utilize thier specialized skills to a patient that is unstable, but would be something they have experience with? If anyone can shed some light on this situation or these types of questions I would be really grateful! Thanks!

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Specializes in LTC, Med/Surg.

This is how I learned it, anytime someone floats from another department in NCLEX hospital you are supposed to treat them as a brand new nurse, no matter where they came from or how many years they have worked. So, they should always take the stable patient with the predictable outcome because they are "a brand new nurse". That's according to the Hurst Review. Hope that helps!

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Specializes in geriatrics,emergency,hospice.

Thanks...thats the impression I was under. Alot of people say the priority delegation book by Lacharity is great, and I agree except for these specific types of questions. That book makes it a little confusing for these specific questions.

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Specializes in geriatrics,emergency,hospice.

Anyone has any thoughts on this? Thanks!!

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I also agree with giving this person the stable patient. It just makes sense to me.

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Specializes in geriatrics,emergency,hospice.

Thanks for your reply. The specific question, and others like this I am having problems with is: As charge nurse, which patient will you assign to a nurse pulled to your unit from the SICU? A) Pt w/ kidney stones scheduled for lithotripsy- B) Newly post op patient with a renal stent placement- C) Newly admitted pt w/ acute UTI- D) pt with chronic renal failure needing teaching on peritineal dialysis. The correct answer is B. But..to me, the correct answer should be C..the pt with a UTI because it would have a predictable outcome, even though the pt would need teaching. I'm having a hard time figuring this out because in school I was taught to treat a float nurse like a new grad and give them the most stable pt. Just seems to me that a post operative pt is not the most stable. Am I missing something??

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Specializes in OR-DR-PACU.

As I have understand after finishing that same book, the answer is correct (letter B) not letter C. Letter C cannot be considered as stable considering that he is NEWLY admitted, it still needs assessment from the charge nurse, he/she has not been asessed before. Besides, the I've learned in my Miller review this quote which will help you understand more: "Skills of the nurse, Needs of the patient". Letter B, which is the post-op patient is more appropriate patient for the floated SICU nurse. The SICU nurse would be able to take care of the post-op patient.

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Specializes in ED, Geriatrics/Alzheimers, Peds.

I also am having issues with that book. Some of the answers are not what Kaplan has said, or what we were taught in school.

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Specializes in ED, Geriatrics/Alzheimers, Peds.
Thanks for your reply. The specific question, and others like this I am having problems with is: As charge nurse, which patient will you assign to a nurse pulled to your unit from the SICU? A) Pt w/ kidney stones scheduled for lithotripsy- B) Newly post op patient with a renal stent placement- C) Newly admitted pt w/ acute UTI- D) pt with chronic renal failure needing teaching on peritineal dialysis. The correct answer is B. But..to me, the correct answer should be C..the pt with a UTI because it would have a predictable outcome, even though the pt would need teaching. I'm having a hard time figuring this out because in school I was taught to treat a float nurse like a new grad and give them the most stable pt. Just seems to me that a post operative pt is not the most stable. Am I missing something??

My first thought when reading that question was that the SICU nurse should be able to handle a newly post-op pt w/ a renal stent placement since those nurses are used to dealing with critical surgical patients. I wouldn't chose that answer though if it was a med-surg nurse for example.

Hope that helps some.

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Specializes in geriatrics,emergency,hospice.

Yea I understand that a PACU or SICU nurse is more than qualified, but that isnt what Kaplan taught or what I learned in nursing school, so...I am confused on what to pick should these questions come up on NCLEX. That's where the confusion lies, I guess.

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Specializes in ED, Geriatrics/Alzheimers, Peds.

The way I try to eliminate those answers are if any pts are :

to be discharged

newly admitted

needing teaching/education

not stable

then they would not be delegated to an LPN. Maybe "newly post-op" wouldn't be considered an issue in this situation? Sorry cuoldn't help more.

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Specializes in geriatrics,emergency,hospice.

Thats ok. Thanks for the help. The thing of it is, is that the NCLEX world of nursing is so different than the real world of nursing...ya know what I mean. I just dont know what to pick for the NCLEX. 2 very good sources for studying are conflicting each other...oh well. Maybe I will luck out and not get one of those questions :bugeyes:

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