On a daily professional basis, nurses make decisions about which problems and needs demand immediate attention and which can be addressed later.
Establishing priorities is a key ability that all nurses must not only possess but also exercise (Husted, Husted, Scotto & Wolf, 2015). Prioritization is the process of arranging nursing concerns in a specific order based on the concept of priority or urgency.
Several factors contribute to or impact correct nurse priority, particularly in the case of head and leg injuries and shock. Proper prioritization of nurses is affected by the expertise of the individual nurses. Expertise implies the skills as well as knowledge of different nurses in a particular field. It is unwise to rush into prioritizing issues that fall outside the areas of specialization of an individual nurse. Making priorities for problems that fall outside the areas of specialization would imply that the treatment process is slowed as the nurse with the particular expertise is sought to handle the problem before the next stage is dealt with (Husted, Husted, Scotto & Wolf, 2015). Nurses would, therefore, prioritize areas that they are well conversant with and manage the challenge at their level before taking it to the next step. For instance, a nurse who is specialized in dealing with oxygen saturation would prioritize managing the problem before moving to issues that relate to body temperature. In eventuality, all the priority decisions that are made by the nurse revolve around things that they are conversant with, being given principal concern before moving to the ones that can only be managed by other professionals.
Condition of the patient
Nurses tend to set priorities based on the terms of the patients whom they are tending to. The state of the patient can be referred to as the clinical or medical status of the patient as presented by a doctor's report or any other clinician's assessment report (Carnevali& Thomas, 1993). A single patient may have different medical issues upon arrival in a hospital or a health clinic. The medical issues could be considered as challenges that nurses are bound to deal with, within the period of the patient's stay in the facility. Nurses have to assess the clinical status of the patient and identify the conditions that require priority as well as the ones that can be dealt with at a later time. Critical conditions are mostly given the priority while the less dangerous conditions are preferably treated at a later date. For instance, the status of the patient may influence the decision on choosing to prepare for a performance of a lumbar puncture on an individual.
Availability of resources
Resources available at the disposal of a nurse have a great impact on the eventual decision that the nurse makes. Various resources are required in medical facilities to assist in proper care for the patients. However, in some cases, the facilities have limited resources to perform specific tasks. As such, nurses are charged with the responsibility of coming up with decisions that favor the need to solve the problem at hand while at the same time utilizing the limited resources available at the disposal of the nurse (Coulter, 2011). For example, if Mrs. A starts vomiting, a nurse could decide to utilize the backboard to the role the patient to her side in an attempt to solve the problem of vomiting. Regardless of the various methods available for managing the condition of vomiting, a nurse could decide to use the backboard to log-roll the patient since the board could be only available or most efficient resource. The decision is as such hugely influenced by the resources available at the disposal of the nurse when presented with the vomiting problem.
Models and philosophies of care
Decisions made by nurses follow the existing models and theories of providing care. The models and views are the published works of American theorists which have been argued upon at length about provision of attention (Dean, 2010). The models and theories guide the manner in which nursing challenges are supposed to be handled by the medical practitioners hence influencing the decisions that nurses make in the long run. Nurses make decisions that are in line with models and philosophies of care under the assumption that the models and theories function in the best interest of service provision (Dean, 2010). For instance, the decision made on the best way to document the level of consciousness of Mrs. A in the case study is influenced by an apparently established model that functions to guide the assessment of the nurse. The nurse is thus bound to make decisions that are in line with such guidelines that are embedded in models. It is as such justifiable that the nurses make decisions that are in line with the models and the philosophies of nursing.
Nurse-patient relationship
The nurse-patient relationship is another reason that affects the decisions that are made by nurses. Nurses and patients can either be new to one another or may be having some history in accordance a particular disease. Nurses with a well-established professional relationship with their clients are likely to make decisions that are based on experiences or events that they have shared at some point in time. Some patient problems are recurrent hence require continued experience of the same conditions (Grover, 2007). For instance, in responding to the complication that the nurse is most concerned about in the present, it is important to consider the professional relationship that has existed between the patient and the nurse hence triggering the need to consider the various health issues that the effect the patient periodically. Again, the relationship assists the nurse to come up with a treatment program for the patient that in turn guides on decisions that are to be made in the present as well as those that are to be done in the future. The influence of relationship between the nurse and the patient justifies why some priority decisions are made ahead of others.
Conclusion
Conclusively, decision-making is an important responsibility of any professional. Nurses are not excluded from making decisions when executing their duties. In most cases, the nurses make decisions that revolve around priority in selecting the problems that should be dealt with ahead of others as well as those that should come later in the pecking orders. The prioritization is majorly influenced by factors such as models and philosophies of care, the relationship between the nurse and the patient, expertise of the nurse, availability of resources and the condition of the patient.
References
Carnevali, D., & Thomas, M. (1993).Diagnostic reasoning and treatment decision making in nursing. Philadelphia: Lippincott.
Coulter, A. (2011).Engaging patients in healthcare. Berkshire, England: Open University Press.
Dean, M. (2010).Improving decision making in healthcare operations.
Grover, J. (2007).Healthcare. Detroit: Greenhaven Press.
Husted, G., Husted, J., Scotto, C., & Wolf, K. (2015).Bioethical decision making in nursing. New York: Springer Publishing Company.
