Nursing Assignment3_436

Reflection on the Prioritization of Care Simulation

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Reflection on the Prioritization of Care Simulation

Prioritization of care in clinical judgment is the capacity of the clinician to determine urgent and/or life-threatening patient conditions that require advanced care or intervention to improve the patient's medical outcome. Prioritization of care allows health care professionals to understand the importance of the principle and when, how, and to whom early intervention needs to be applied in order to achieve the best patient outcome (Schuttner et al., 2025). Prioritization of care in clinical judgment is a key nursing competency. The growing population and diversity of patient conditions that need to be catered for by a limited number of personnel require the ability to prioritize patient conditions and plan the path of care accordingly.

I have become more aware of how patient acuity guides every clinical decision. Understanding patient acuity is essential, as early signs of deterioration, such as physiological changes, instability, altered consciousness, respiratory distress, bleeding, or changes in appearance, should always prompt clinical concern from admission onward (Gaughan, 2022). The simulation has taught me that changes in patient condition demand prompt reassessment. The two reasons why patients may require a change in care include deterioration in their condition and a need for faster or more complex care. Any sustained or increasing level of these indicators warrants attention. It is equally important to determine how urgent the change in patient condition is and whether it warrants a communication to the medical officer. A patient is considered to be unstable if a sudden worsening of their condition would not be surprising and if a clinical decision is necessary.

I now understand clearly the consequences of delayed recognition. Insufficiently recognized deterioration leads to missed opportunities for intervention and prevents optimal outcomes (Papathanasiou et al., 2024). Nurses can play an important role in the early identification of aggressive deterioration, allowing for early intervention. In general, when patients demonstrate perceptible changes in their condition, someone should talk with them, their family, or their nurse, for they may be warning of developing or escalating problems. Such subtlety should not imply indecision but lead an experienced practitioner to conclude that care is provided at an appropriate time.

I appreciate how evidence strengthens confidence in decision-making. Gamborg et al. (2023) state that in the absence of credible support or research, clinical judgement must lean towards evidence. Prompt intervention when a patient is clinically deteriorating reduces the risk of adverse patient outcomes. Triaging patients, including those in the ED, is common practice. Triage means allocating or designating in order of need, degree of urgency, or other desired outcomes. Even when working in a fast-paced environment, such as the ED, prioritising treatment on the basis of patient status remains vital and relies on continuous monitoring and periodic reassessment. I understood the role of communication and shared understanding. Clear, comprehensive handoffs allow efficient continuity of care. Patient safety should guide the format, with patient and family involvement fostering trust, satisfaction, compliance, and effective triage.

The simulations also helped me to learn the importance of acting without delay. Actions should be initiated without delay when there is a significant change in a patient’s condition that is perceived as an early sign of deterioration. Prompt intervention is associated with improved outcomes. If concerned about the stability of the condition or the level of urgency, nursing colleagues can be called upon for advice. Emergency discussions should be initiated when there is concern about stability, irrespective of current level of urgency.

I have learned that monitoring is never passive. Continuous observation ensures ongoing assessment of patient conditions. Monitoring during patient care is crucial. Recognition of a change in condition is the trigger for the care provider to perform an intervention such as a notification of a doctor or specialist, commencement of a new task, or change of priority for ongoing care. Care plans should be updated to incorporate escalations in care and detail the rationale for decisions taken.

The main take away for me was that prioritization is central to professional nursing practice. Clinical judgment involves a synthesis of knowledge, experience, decision-making skills, clinical skills, and cognitive skills. At the centre of clinical judgment is prioritization of care, that is, determining how or if an individual patient needs to be treated, and when to do so. Providing the clinical observations necessary for detecting patient deterioration demands systematic and continuous monitoring. Fairness, equity, transparency, and minimizing individual bias still matter in these environments, as does maintaining respect for individual patients and their rights and dignity.

References

Gamborg, M. L., Mehlsen, M., Paltved, C., Vetter, S. S., & Musaeus, P. (2023). Clinical decision-making and adaptive expertise in residency: a think-aloud study.  BMC medical education,  23(1), 22. https://doi.org/10.1186/s12909-022-03990-8

Gaughan, M. R. (2022).  Exploring Nurses’ Experiences Caring for Patients in a Deteriorating State (Doctoral dissertation, State University of New York at Buffalo).

Papathanasiou, I., Tzenetidis, V., Tsaras, K., Zyga, S., & Malliarou, M. (2024, January). Missed nursing care; prioritizing the patient’s needs: an umbrella review. In  Healthcare (Vol. 12, No. 2, p. 224). MDPI. https://doi.org/10.3390/healthcare12020224

Schuttner, L., Theis, M., Wong, E., Staloff, J., McQueen, R. B., Nelson, K., ... & Rosland, A. M. (2025). Patient-Centered Prioritization of Health Care Processes for Multimorbidity.  JAMA Network Open,  8(12), e2549693. https://doi.org/10.1001/jamanetworkopen.2025.49693