{"id":849,"date":"2022-10-12T19:10:02","date_gmt":"2022-10-12T19:10:02","guid":{"rendered":"https:\/\/sites.rutgers.edu\/changing-course\/?p=849"},"modified":"2022-11-22T21:11:35","modified_gmt":"2022-11-22T21:11:35","slug":"making-priorities-a-priority","status":"publish","type":"post","link":"https:\/\/sites.rutgers.edu\/changing-course\/making-priorities-a-priority\/","title":{"rendered":"Making Priorities a Priority!"},"content":{"rendered":"

In this issue of Changing Course, <\/em>we will examine how to make priorities<\/strong> a priority<\/strong>. According to the National Council of State Boards of Nursing (NCSBN) 2021 RN Practice Analysis, new-to-practice nurses spend an average of 7 hours per shift managing care and establishing priorities<\/strong> and 97.6% of new nurses report that they prioritize<\/strong> the delivery of client care with an average frequency of 4.38 times per day on a scale of “0” times to “5+” times per day (2022b). Additionally, the average importance rating for prioritizing<\/strong> by new nurses is 4.48 on a scale of “1” (not important) to “5” (critically important) (NCSBN, 2022b). The NCSBN periodically performs a practice analysis to evaluate the validity of the National Council Licensure Examination (NCLEX\u00ae) test plan. Not only is the practice analysis critical to support a psychometrically sound licensing exam, it also outlines job responsibilities and activities and their relative importance and frequency for new-to-practice nurses (Williams et al., 2014).<\/h4>\n

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Connecting Clinical Judgment and Prioritizing<\/strong><\/h3>\n

Clinical judgment is highly dependent on the ability to prioritize. <\/strong>The NCSBN defines clinical judgment as the outcome of critical thinking and decision making that involves using “nursing knowledge to observe and assess presenting situations, identify prioritized<\/strong> client concerns, and generate the best possible evidence-based solutions in order to deliver safe care” (2022b p. 5). The process of clinical judgment is outlined in the Clinical Judgment Measurement Model used in the next-generation NCLEX\u00ae (NGN). When developing clinical judgment, student nurses must learn how to recognize and analyze relevant cues and then prioritize<\/strong> the most important client needs (see Figure 1).<\/h4>\n

Figure 1<\/strong><\/h4>\n

Nursing Clinical Judgment Measurement Model<\/em>\"Clinical<\/h4>\n

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(NCSBN, 2022a)<\/h4>\n

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The ability to prioritize<\/strong> must be cultivated at the onset of the student nurse’s educational journey to foster clinical judgment, ensure success on the NGN and most importantly to graduate nurses that are ready for practice. This is why it is essential for nurse educators to make priorities<\/strong> a priority<\/strong>!<\/h4>\n

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The Prioritizing Priorities Activity<\/strong><\/h3>\n

Nursing students and new-to-practice nurses use rule-based analytic thinking rather than intuitive thinking processes; therefore, structured methods are a good strategy when teaching prioritization<\/strong> (Cader et al., 2005). The Prioritizing Priorities<\/strong> activity provides an organized way for students to practice prioritizing<\/strong>. There are several steps to this activity.<\/h4>\n

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The first step is to provide students with an introduction to prioritization<\/strong> in nursing which includes common prioritizing<\/strong> strategies like “airway, breathing, circulation (ABC)”, safety versus risk, Maslow’s Hierarchy of Needs, and time-sensitive vs routine. I prefer to use Assessment Technology Institute’s (ATI’s) Priority-setting Frameworks<\/a>. There are other frameworks that you can use like Kaplan’s RN Decision Tree<\/a>.<\/h4>\n

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Next, students complete 15 NCLEX\u00ae type questions. For the activity to have the most meaning, I recommend the students select questions in the topical area they are studying. For example, in pediatrics, students select pediatric questions. Currently, my students use ATI Learning Systems<\/a> to create their quizzes, but PrepU<\/a>, Davis Edge<\/a>, Elsevier Adaptive Quizzing<\/a>, UWorld<\/a>, or any other quizzing platform will work.<\/h4>\n

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After completing the questions, students select 5 of the questions and copy them with the answer choices to another document. Now they reflect on how they answered each of the five questions and provide their reasoning below the question.<\/h4>\n

Some things to consider during reflection include:<\/h4>\n