Prioritizing Patient Care: A Guide for Healthcare Students

Article summary: Healthcare students can prioritize patient care by assessing acuity and urgency using structured clinical frameworks. Start with airway, breathing, and circulation, then evaluate safety risks, acute versus chronic conditions, and unexpected or sudden changes in status. Actual, active problems take priority over potential risks. In emergency and inpatient settings, patients with life-threatening conditions, unstable vital signs, or new or worsening symptoms should always be seen before stable patients with routine needs.

Healthcare students, if patient prioritization is something you struggle with on exams or rotations, we have just the guide for you! Learn the structured triage used in hospitals, emergency rooms, and urgent care settings, and understand how to apply it in your studies. Just follow our prioritization guide below and recall helpful mnemonics for your next exam or clinical shift. 

Understanding the Basics of Patient Prioritization

Deciding which patient needs care first based on acuity is prioritization! It’s used in emergency rooms, post-anesthesia care units, hospital floors, urgent care, and inpatient units. No matter what kind of medical professional you are, you must remember:

• ABCs: Assess airway, breathing, and circulation.
• Safety first: Evaluate a patient’s risk for falls, infection, and more.
• Acute vs. chronic: Identify whether patients present with a sudden-onset illness or injury or have a chronic condition.
• Unexpected vs. expected: Recognize when symptoms are abnormal for the patient’s condition.
• Maslow’s Hierarchy of Needs: Lower-acuity patients can be prioritized according to their physiological needs, safety and belonging, esteem, and self-actualization.
• Actual vs. potential problems: Actual problems are current, confirmed patient issues, while potential problems are risks that may develop if not addressed. 

How Emergency Rooms Prioritize Patient Care

Emergency rooms prioritize patients based on different levels. 

Level 1: Immediate, life-threatening conditions.

Level 2: High-risk patients.

Level 3: Stable, but needs multiple resources.

Level 4–5: Low acuity, requires one resource or none.

How Nurses Prioritize Patient Care on the Floor

Triage is a skill; thus, nurses must use their best clinical judgment when evaluating patients.

1. Airway or breathing: Patients with airway obstruction, labored breathing, or no breathing need emergency care ASAP.
2. Circulation issues: Address patients with cyanosis, poor perfusion, delayed capillary refill and/or decreased level of consciousness.
3. New or worsening symptoms: Patients who develop new symptoms or whose symptoms worsen need aid.
4. Abnormal vital signs: Low blood pressure, high heart rate, or abnormal body temperature require urgent attention.
5. Unstable vs. stable: Patients who are responsive, breathing normally, and do not present any life-threatening conditions are stable.
6. Time-sensitive medications or procedures: Untreated medical issues can lead to quick deterioration. 
7. Pain: A patient’s pain level can determine whether they need immediate care. Severe pain should be prioritized when it is acute, sudden, or associated with concerning symptoms such as chest pain or neurologic changes.

High-Yield Prioritization Mnemonics

ABCs (airway-breathing-circulation)

Assess the airway, breathing, and circulation first, AKA the ABCs of nursing! 

Actual vs. Potential Problems

Address confirmed, active patient problems before potential or anticipated issues. This concept is reinforced across prioritization-focused Picmonics, including How to Use Prioritization in Exam Questions, which explains how exam writers expect students to weigh current versus possible risks.

SUDDEN CHANGE always wins

A sudden change in condition, such as acute pain, altered level of consciousness, or new symptoms, signals an immediate priority. Both the Guidelines for Prioritizing and Triage Picmonics emphasize recognizing abrupt changes as higher priority than stable conditions.

UNEXPECTED = see first

Unexpected reactions are a no-go! See this patient immediately.

FAVORS ACUTE over chronic

Acute problems pose a greater risk than chronic ones.

Prioritizing Patient Care: Real Examples

Put your knowledge into practice with a few examples of prioritizing patient care.

1. One patient is unresponsive, while the other presents with a high fever. Which patient should you treat first?

   1. The unresponsive patient. An altered level of consciousness is a high-priority-level patient safety concern.

2. A patient has abnormal bleeding post-op, while another needs their scheduled insulin shot. Which patient should you address first?

   1. Unexpected post-op bleeding should be prioritized first. Excessive blood loss leads to shock.

3. A patient is expressing feeling chest pain, while another’s lab results show high blood pressure. Which patient should you prioritize first?

   1. Chest pain is the more pressing circulatory issue if the patient with high blood pressure isn’t expressing discomfort.

4. A patient is having an anaphylaxis reaction, while another is experiencing severe nausea. Which patient should be seen first?

   1. Anaphylaxis is deadly and can block the patient’s airway. See this patient first.

Common Mistakes Students Make When Prioritizing Patients

Learning how to identify when care is urgent vs. nonurgent is key, but it takes time. Avoid the common pitfalls below, such as: 

• Choosing stable patients first: While it may seem easy to treat their symptoms, stable patients can wait. 
• High pain: Avoid distractions from a patient with high pain. Pain can be tolerated UNLESS it is acute. 
• Ignoring the ABCs: Remember, the ABCs are the first priority.
• Chronic conditions: Not all chronic conditions are emergencies. 
• Missing the details: Some patients appear stable, but subtle symptoms can still be dangerous. Be thorough in your evaluation.

Prioritization gets easier with practice, so don’t get discouraged if you don’t nail it right away. Use mnemonics to recall the basics, and study up! 

Make patient prioritization easy with Picmonic’s visual mnemonics for ABCs, triage, and high-yield clinical red flags.