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Patient Prioritization

Nursing prioritization can seem like quite the beast for a nurse, especially if you work in a specialty unit like I do. I’ll break down how I prioritize my tasks throughout a shift so you can gain some insight. First of all, in my opinion, patient assessment and care come FIRST. This means assessing the ABCs and taking care of tasks that are time sensitive and cannot wait (STAT imaging, boluses, cardiac meds/Abx, respiratory treatments, etc).

When assessing the ABCs, make sure you actually look at your patient and don’t just go by the numbers on their monitor (but those are important too). For airway, check for obstructions, set in place aspiration precautions, evaluate need for intubation, and assess trach complications if applicable. For breathing, monitor oxygen sats, for difficulty breathing, and adjust their position if need be. For circulation, monitor BP, fluids, pulses, ECG for dysthymias, and utilize CV meds/vasopressors if needed. In addition to these, assess the patient’s mental status and LOC. If you can’t find a reason for a change in vitals, check alternative causes like BG, pain, and urinary/bowel elimination issues.

Once the ABCs are stable and my assessment is complete, I pass meds as they’re due, chart my documentations (lower priority, but don’t neglect this), and perform bed baths and linen changes. If the need arises to contact a physician, especially if at night, do so as early in the shift as possible and check to see if other nurses on the unit also need to speak to this doctor. They’ll appreciate it and so will the provider. If you’re in the hustle and bustle of a chaotic shift and have to delay documentation for the sake of your patient’s care, I suggest keeping a folded piece of paper in your pocket to jot down important times for events so you can chart your notes later with the utmost accuracy. Hope these tips on prioritization help!

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