Need quicker and more reliable diagnosis information? Start treating your patients with professionally-recommended steps using the 3 best tips on prioritizing your patients' needs:
Your job as a doctor or nurse is to provide your patients with the very best care possible. In most cases, especially with patients who are in crisis, it’s not possible to treat every condition or issue at the same time. Often, you need to prioritize the various things affecting the patient to determine the correct order of treatment. For example, you don’t want to be focused on a patient’s sprained ankle while they are having trouble breathing.
As you spend time working as a healthcare provider, you’ll naturally improve your assessment and treatment skills. Real-world experience is invaluable when it comes to improving your skills. But it’s also important to have a working knowledge of the common algorithms and methods healthcare providers use to prioritize care, including the ABCDE approach and Maslow’s Hierarchy of Needs.
Table of Contents:
Maslow’s Hierarchy of Needs
Maslow’s Hierarchy of Needs is one of the first things to know when starting a career in nursing. Named for psychologist Abraham Maslow, the concept is to identify a person’s basic needs in order of importance.
Maslow’s Hierarchy of needs is usually illustrated as a pyramid. The needs listed near the bottom of the pyramid are the most important. They must be met before a person can focus on the needs near the top of the pyramid. As a nurse or doctor, your priority is to provide care to your patients to ensure those basic needs at the bottom of the pyramid are met.
Physiological Needs
The basic physiological needs are food, water, warmth, and rest. Located at the bottom of the pyramid, these are the most crucial things to focus on when you are caring for your patient.
Safety Needs
This section of the hierarchy involves the need for safety and security. Together with physiological needs, safety needs make up the components of “basic needs.”
Love and Belongingness Needs
Next on the hierarchy is the need for friendship and/or intimate relationships. These count as psychological needs.
Related Article: Tips for Building Patient Rapport
Esteem Needs
The other set of psychological needs is related to self-esteem. Feelings of prestige and accomplishment are examples of the fulfillment of these needs.
Self-Actualization Needs
The top of the pyramid is reserved for “being” needs. Self-actualization is the concept of a person achieving their full potential. Not everyone achieves fulfillment in this area.
While it’s important to understand Maslow’s Hierarchy of Needs, remember that your focus as a healthcare provider is on the sections near the bottom of the pyramid.
The ABCDE Approach
One of the most effective approaches to assessing a patient’s needs, the ABCDE approach allows for nurses and doctors to diagnose the issues and find a solution for a patient in emergency situations. This standardized algorithm is designed to make it easy for healthcare providers to identify and treat the most urgent issues first to give the patient the best chance of survival. The ABCDE approach also increases efficiency when a team of medical providers is working together, enabling them to focus on treating the patient without needing to spend time conferring on each step.
Related Article: The ABCDE Approach to Cardiac Arrest Management
Airway
The first step for patient survival is to make sure they have a viable airway. Thus, step A is to assess the patient to verify whether they have a patent airway or whether it’s partially or completely obstructed.
A patient with an unobstructed airway can speak normally whereas a partially obstructed airway will affect the voice and cause breathing to sound abnormal. With a completely obstructed airway, the patient will not be able to breathe despite significant effort, which is often visible as “see-saw respirations” of the chest and abdomen.
Depending on the patient’s condition and the available equipment, you can attempt to open the airway. Some common treatment options are using the head-tilt and chin-lift maneuver, removing the obstruction with suction equipment, and using alternative back blows and abdominal thrusts. High-concentration oxygen should be provided once the airway is clear.
Breathing
The next step is to assess the quality of the patient’s breathing. Look for signs of respiratory distress, measure the respiratory rate, observe the depth of each breath, and use a pulse oximeter, if possible. You can also percuss and auscultate the chest to determine if there are issues with the lungs. It’s important to provide oxygen with a bag-mask, if available, or rescue breaths.
Circulation
Step C involves assessing the patient’s circulation. There are several signs of insufficient circulation: changing skin color, sweating, hot or cool limbs, and abnormal pulse rate. Calculating the patient’s capillary refill time and taking their blood pressure can provide additional information about the state of circulation. Unless the patient is in cardiac arrest, you should give intravenous fluids to someone with a fast heart rate and/or cool limbs.
Disability
This step is about assessing the patient's consciousness and potential causes of decreased consciousness. Two common assessment methods are the AVPU method and the Glasgow Coma Scale. It’s also important to determine if the patient has been administered any sedative or analgesic drugs. Treatment will depend on the cause of the patient’s unconsciousness
Exposure
It is usually necessary to make a complete physical examination of the patient. When removing the clothes to expose the body, it’s vital to respect the patient’s dignity and consider heat loss. During a physical exam, you can look for more clues about the patient’s condition, such as signs of trauma, bleeding, skin abrasions, and needle marks.
Tips and Questions to Ask
While assessing your patients and their diagnosis, there are some helpful questions and tips you should keep in mind during the process. Use these to guide your actions while you are assessing your patients and developing a treatment plan.
Important Questions to Assess
There are countless questions you can ask your patient, but some are more helpful than others. Here are some of the best options:
- “Why are you here?” Encourage the patient to describe the complaint they are seeking treatment for.
- “Are you feeling pain?” If the answer is yes, continue to ask questions about the location, severity, and timing of the pain.
- “What is your medical history?” You need to know if the current condition may be related to past illnesses or injuries. Also, make sure to document any allergies and current medications.
- “Are their possible contributing factors?” Encourage the patient to discuss any potential relevant factors, such as alcohol/drug use, sexual history, occupation, mental health, diet, and living situation. (These questions may not always be necessary, so use your best judgment.)
The urgency of these questions may depend on the patient’s condition. Focus first on acute problems that you can treat quickly, and then think about treating non-life-threatening chronic conditions.
Professional Nursing Tips
Performing a physical assessment is a crucial part of nursing. Here are the four basic techniques to master:
- Inspection: Take the time to assess each body system visually. You should also be aware of abnormal sounds and/or odors.
- Palpation: Touch the patient using various levels of pressure and different parts of your hands. For example, use light palpation with the finger pads to search for surface abnormalities, but use deep palpation to assess internal organs.
- Percussion: Identify the shape and position of organs using quick, sharp taps with your fingers or hands. You could use this method to determine if an organ is filled with fluid, for example.
- Auscultation: Use a stethoscope to listen to the heart, bowels, and lungs.
You may have to use additional methods to assess your patients, but these four techniques are an excellent place to start. Generally, you want to focus first on things that must be addressed right away (to prevent serious illness or harm). Then you can move on to things that should be addressed soon, and after that, issues to treat in the near future.
Give Your Patients the Best Care by Prioritizing Their Needs
When you’re assessing, diagnosing, and treating a patient, it’s essential to make sure you are focusing on the most important areas first. By using the ABCDE approach together with Maslow’s Hierarchy of Needs, you can make sure you are assessing the right things and giving your patient the best possible care. Understanding these concepts and figuring out how to apply them in the real world is something that comes with the right training courses and a lot of time on the job.
One of the best ways to make sure you have the training you need to care for your patients properly is to keep all your key certifications up to date. Being certified in Advanced Cardiac Life Support (ACLS), Basic Life Support (BLS), and Pediatric Advanced Life Support (PALS) ensures you are ready to react quickly and correctly when dealing with patients in crisis. These certifications can qualify you for new career opportunities as well.
For most doctors and nurses, attending an in-person certification course during traditional business hours isn’t realistic. That’s why we offer all our certification programs online. With eMedCert, you can get your ACLS, BLS, and PALS certification (or recertification) online on your own time. Just purchase the program and take as long as you need to study the material. You can take the online exam as many times as necessary. For the best price, purchase a certification or recertification bundle which includes a free BLS course with the purchase of both ACLS and PALS, and update all your essential credentials at once.