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Kristen O'Brien, BSN, RN

freelance health writer | nurse educator

/ Basic Comfort and Care, Fundamentals

Applying Maslow’s Hierarchy of Needs to Nursing Practice

The Theory

A commonly discussed behavioral science theory, Abraham Maslow’s hierarchy of needs covers every foundation required to inspire motivation in people. 

  • The base foundation is physiological needs referring to a human’s most basic needs, such as food, water, bowel & bladder emptying, sleep, and comfort. 
  • The next tier is safety, including physically, mentally, and emotionally. 
  • The middle level describes acceptance in relationships with family and friends through love and belonging. Think of networking. 
  • Second from the top is esteem, referring to one’s own self-esteem, confidence, and feelings of valuable contribution to the world. Individual growth happens on this level. 
  • Lastly, self-actualization is the top of the pyramid and describes a sense of reaching one’s highest potential in life – doing what we’re meant to do (Hopper, 2020). 

How do we apply it to nursing?

When taking care of others, the bottom three are the ones that we can influence as nurses. We are able to meet our patient’s most basic needs and ensure that they feel safe, but also build that relationship so they feel empowered to build that confidence and move on up the pyramid of needs. 

In working at the bedside, I found that if I was able to meet everything on the first two levels (physiological needs and safety), then my patients were overall less likely to get out of bed and fall or find themselves perseverating on hunger, thirst, or risk of harm. Before I left the room, I would run through a checklist in my head of these needs to ensure that my patients were also in their best state to heal and leave the hospital.

We can use this tool to help prioritize patient care, both for individual patients and multiple patients, and their needs so we know where to focus our attention. It is also helpful for communication to relay pertinent information between the nurse and patient as well as between healthcare providers. It is a task that can be identified during the assessment phase of your care so it frequently comes up on the NCLEX as test questions.

References

Hopper, E. (2020). Maslow’s hierarchy of needs explained. http://www.christianworldmedia.com/client/docs/603_1585079540_17.pdf

/ Articles

All About Credentials

When you see a professional’s name badge, there are often a lot of extra letters and abbreviations included. There are a multitude of variations because there are so many educational programs and certifications available for a professional to take. A standardized way is essential so that it is recognized everywhere for everyone.

The American Nurses Association provides guidance on what is important to include and omit when writing your credentials. You want to include what is pertinent for your position in the nursing field.

Writing Out Credentials

Key components to include when writing out your credentials are: your first and last name, highest degree earned, current licensure, and any specialty certifications that you hold.

Highest Degree Earned

If you are working your way up the nursing ladder, you will put your highest level of education because it is a permanent fixture in your career. Currently I have an Associate’s Degree in Nursing and a Bachelor’s in Nursing so I would put BSN after my name. If you have two of similar degrees but different specialties, you should list the nursing degree first. Such as MSN, MBA.

Nursing Ladder
AD/ADN/ASN –> BS/BA/BSN/ABSN –> MS/MA/MSN/MS-MEPN –> DNP/PhD/EdD/DrPH/DNS

Current State Licensure

There are only two nursing licenses to list here: registered nurse (RN) and licensed practical nurse (LPN).

Nursing Path
CNA (no education) –> LPN/LVN (PN diploma) –> RN (ADN/ASN minimum) –> APRN (MSN/MS-MEPN minimum)

State Designation

Advanced practitioners need to include this differentiation in their credentials. This includes: advanced practice registered nurse (APRN), nurse practitioner (NP), and clinical nurse specialist (CNS).

Specialty National Certifications

Given that there are so many options for certifications, I will not list them all. A few examples of common certifications are: family nurse practitioner – board certified (FNP-BC), critical care registered nurse (CCRN), or registered nurse – board certified (RN-BC). These can be listed in no particular order, though I would opt for alphabetical or in order of when I achieved them.

Awards & Honors

An option if you have it that can be included are awards and honors earned. The Fellow of the American Academy of Nursing (FAAN) is an example of an honor.

Other Certifications

Most prominently included last, would be that of an emergency medical technician (EMT).

My Example

To put it all together, here is what my credentials would look like after I achieve all my career goals:

Kristen O’Brien, MSN-Ed, RN, CNE, CNEcl

MSN-Ed = master’s degree in nursing education

RN = registered nurse license

CNE, CNEcl = certified nurse educator & certified academic clinical nurse educator specialty certifications

How are your credentials written? Let me know below in the comments!

/ Articles

4 Ways to Empower Your Patients

A big concept in modern healthcare is the word “empowerment”, especially in relation to patients and communities. In this article, we will be discussing ways you as a healthcare provider can empower your patients. The World Health Organization (WHO) defines empowerment as:

the process by which people gain control over the factors and decisions that shape their lives.

(WHO, n.d.)

So how can you help your patients achieve this state?

  • Build their confidence
    • The more that a person can do for themself, the more independent they will feel and have confidence in their own abilities. As nurses, we try to encourage independence in all aspects of their care, from ADLs to medication administration to self-monitoring after a procedure.
    • Collaborating together to formulate a plan of care is another way that a patient can feel confident in their care. It helps them feel involved and more in control of their lives when we discuss the plan with them and help guide them with options and alternatives.
    • When we collaborate and encourage independence, we’re building trust between each other. A key component for any relationship to be successful.
  • Educate, educate, educate
    • Knowledge = Power. The more you know, the more you can achieve.
    • One of the main roles that a nurse plays is an educator. It is a primary intervention technique used in the nursing process as well as in my own practice. Giving a patient the tools and the power to advocate for themselves is the main goal of education, in my opinion.
  • Promote success
    • Helping a patient understand their role in the triad of optimal health care leads to the betterment of their health and understanding of their care. Optimized patient care is a combination of recognizing social determinants of health as well as the health literacy of the patient, prioritizing the patient’s preferences and values, and, lastly, utilizing evidence-based research into the shared decision-making process (Ruth-Alma et al., 2021).
    • Utilizing local, regional, and state resources, such as Commission on Aging, the county health department, or home care programs.
  • Compliance alliance
    • The best way to assist with a patient following the plan of care is to make it as easy as possible for them. Do they prefer in person visits or virtual? Is it easier to take pills or liquid medication? This can help the patient feel involved in their care as well as make them more likely to be compliant.
    • Including a customized care plan and setting mutually agreed upon goals, the rapport is strengthened, trust is built, and you become their accountability buddy for check-ins and making improvements in their life.

Those are the four ways you can help your patient feel and be more empowered in their health care. Do you have another way you help? Did you find this article helpful? Let me know below in the comments!

References

Ruth-Alma, N., Turkson-Ocran, S., Ogunwole, S. M., Hines, A. L., & Peterson, P. N. (2021). Shared decision making in cardiovascular patient care to address cardiovascular disease disparities. Journal of the American Heart Association, 10(20). https://doi.org/10.1161/JAHA.120.018183

World Health Organization. (n.d.) Health Promotion. https://www.who.int/teams/health-promotion/enhanced-wellbeing/seventh-global-conference/community-empowerment

Empower Patients

/ Apps, Recommendations, Resources, Supplies, Tips & Tricks

The Ultimate Guide to Nursing School Preparation

As a former nursing student educator, I took note of what was necessary and heIpful for my students as they moved into their first semester of their program. It also helps that I am currently in my third round of nursing programs as I pursue my master’s degree and by this point I definitely have an idea of what I do and don’t need for my education. I compiled this list to help set you up for your most successful first semester of nursing school, no matter what program you’re beginning.

Academic Planner

  • To stay organized and adhere to the required deadlines having a planner was a MUST HAVE for me. I use it daily to make note of assignments, upcoming tests or projects, and summaries of what chapters to read that week. This is especially helpful with multiple classes going on at one time. Check out each planner to find the best one for you!
    • I’ve used the Erin Condren Academic Planner the most out of these three and love the to-do list within the weekly layouts so I could plan out tasks. There also are project pages with goals to set and actions to take to meet the deadlines. It has a coil-bound system with interchangeable covers.
      • If you’re interested in trying out the Erin Condren Academic Planner I have an affiliate link where you can get $10 off your first purchase with a new account. Don’t forget to enroll in their free rewards program because you can earn points with every purchase to get coupons for future purchases!
    • The Happy Planner Student Planner has additional pages for goal setting and intentions to take for your projects. This planner is usually an hourly spread with space below each day to make it whatever you want: a to-do list, writing out homework, goals, etc. This system is a disc-bound planner with interchangeable covers.
    • Lastly, the Passion Planner Weekly Academic is an excellent planner in its own right. It is more neutral with black and white tones and also is in an hourly layout. There’s more room on the pages for personal and work to-do lists as well as setting a focus for the week. This planner is a leather-bound, sewn book, much like a journal.

Technology

  • What would we do for our education without technology? The science and development of technology has been so influential in the educational field and, in my opinion, has only made it better and more accessible.
    • A computer of your own is SUPER helpful to getting work done and saving everything in one place. It’s also portable because if you’re like me, you like to study in other places like the library or coffee shop. Check with your financial aid office to see if one is covered for you! Mine was 🙂
    • Headphones are perfect to listen to background music or replay your recorded lectures as you take notes. I use AirPods because they sync with my apple gear way easier but whatever headphone works best for you.
    • If you’re professor is okay with it (always ask permission first), record your lectures to listen to them again as you take notes. This helped immensely for my Associate’s degree.
    • Starting in your Associate’s program, particularly in the first semester, you will be participating in a medication calculation course in some aspect. A basic calculator (one that is not a scientific or graphing kind) is helpful for this part of your education.
    • Spotify, Pandora, Apple Music, Amazon Music or whatever you list to, are your friend. Create or find and save some study playlists. I tend to like soft piano tunes for my background music. For some reason it helps me focus more but you find what works for you.
    • Whenever I couldn’t understand a concept or I wanted to hear how something sounded, like abnormal heart or lung sounds, I would find a YouTube video on it. YouTube is like its own educational platform altogether!
    • Phone apps can be very handy, especially on the go or for clinical where you need to look things up all the time. Unfortunately, the ones that are needed require you to pay for them. The free versions just don’t allow for extended or very in-depth use.
    • Podcasts are my jam! I love to listen to podcasts cause they’re like specialized TV shows but audio style or are highly educational. I have a few favorite medical or nursing-related podcasts.

Classes

  • Note taking is A MUST for nursing school. There is soooooo much information and things to not only memorize, but recall later for application and tests. I used a lot of notebooks and pens but other items that helped are included.
    • Any notebook will do if you need to jot down anything. Back to school sales have them for as cheap as $1. Lately I’ve been prefering the Erin Condren notebooks for my Master’s degree because I love the thickness and texture of the paper and I also plan to keep my notes for a while after I graduate.
    • My absolute favorite pen to use is a Pilot G2 0.38 gel pen. It’s so smooth to write with and I can’t get enough of the thin script it produces. Makes me feel like I’m writing very neat and pretty and clean.
    • Basic neon Sharpie highlighters are awesome, cheap, and get the job done. But if you want to go extra, the highlighters I use the most to add color and organization to my notes is the Erin Condren dual tip pastel highlighters. They’re pigmented without being over the top bright and the neutral colors appeal to me. There are a lot of other color options to pick from if you want brighter or bolder.
    • The top choice that you can find anywhere is the Post-It sticky notes. For these I do like to vibrant colors because it draws my attention to it quicker and I use them for featuring key areas I need to focus my studying. I’ve been experimenting with transparent sticky notes Cloth & Paper. They’re easy to write on and you can still see the text underneath.
    • I was definitely that 90s kid that loved having a shoulder sling messenger bag. But to be honest, it killed my neck and shoulder. Nursing books are insanely heavy, not to mention all the other stuff you need to bring to class. So do your neck and back a favor. Get yourself a real backpack or, better yet, one on wheels. You’ll thank yourself later and your back will too!

Clinicals

  • There are hands-on practicums in any of the degrees you work towards for nursing so it’s best to be prepared for any level. Depending on your program and how new you are to the field, you may have some of these supplies already. But if not, here are some items you will want! Especially if you are jumping in to your first semester ever of nursing school.
    • A great quality stethoscope is a MUST HAVE! Any review, including mine, will tell you that Littmann is the gold standard of stethoscope brands. They range in price anywhere from $55 to $450 depending on the model. For new students, I recommend the Lightweight II S.E. stethoscope as it’s a great starter version that will last you all through school. Once you graduate from your Associate’s and are out in the field and know what to listen for, then upgrade if you’d like. Currently I have a Classic III but I plan to upgrade at some point to either a Master Cardiology version or a CORE Digital one.
    • To personalize your accessories further beyond your stethoscope tube color, a fancy badge reel is a cute idea. You can get one custom made on Etsy or find creative ones on Amazon. Check with your school or work place though because they may require you wear one of theirs during clinical.
    • Over the last few years I’ve seen students carrying around foldable clipboards where they can keep their notes and patient information secure in one place and easily portable. Some even have quick reference charts or cheat sheets on them so keep your eye out for those!
    • A penlight isn’t necessarily a requirement but they can help you complete your neuro checks faster by having one on hand. They’re also pretty cheap.
    • As a trauma trained nurse, a pair of high-quality scissors is immensely helpful to cut off clothes, dressings, or open medication packages. I started out with a cheap, basic pair you find in a scrub uniform store. That would work for your every day needs but if you will be cutting thicker stuff often, like clothes or dressings, get a set of Leatherman Raptor Trauma Shears. Well worth the investment and will last a long time.
    • After being on your feet for so long, compression socks are super helpful to keep swelling down in your lower legs. They promote circulatory return and even feel great as you’re walking.
    • If you’re going to invest in anything from this list, this is it. A good pair of shoes can save you a lot of pain. You’re on your feet A LOT and as a nurse you’ll learn to treat your feet well. I’ve been using Sketchers Memory Foam shoes for years and my feet never hurt by the end of the day.

Study Time

  • You’ll be spending the bulk of your education with your nose in a book, and likely not the fun reads but a textbook. There is so much information to learn as a nurse that you will need all the help you can get. If you’re like me, it took lots of different study methods to retain the information in order to apply it.
    • Getting an NCLEX prep book is very helpful as you move through your studies. They have sample questions so you can learn the style of questions and how best to analyze them to answer them correctly. I’d recommend waiting until you’re nearing graduation because the edition may update after you buy it. I used Saunders and found it easy to study from and narrow down what to focus on. I’ll link to the most up to date version at the publishing of this post but make sure you are getting the current edition if you’re buying this in 2023 or later!
    • Cheat sheets from NurseInTheMaking on Etsy. Condensed, colorful notes on essential topics that include tips, graphics, and key points to remember.
    • Flashcards can be very useful as a visual representation of the information you need to learn. They’re not for everyone if it’s not your learning style but it can be helpful to write them out yourself or buy or make a condensed version of the content.

Extras

  • There are some things that will be helpful in your educational journey that don’t quite fit into any category, so here they are.
    • A coffee maker is a MUST for nursing school! You can brew fresh coffee in the mornings or hot water for your tea if that’s what you like. They’re fairly cheap and you can brew different sizes depending on your cup.
    • Staying hydrated is necessary for anyone, but especially a busy nursing student. I prefer the Yeti Rambler because they keep water and ice super cold which helps me drink it more frequently. Plus they don’t break the budget.
    • For classes, but especially for clinical, you’ll likely need to pack a lunch so having a decent sized lunchbox will come in handy. Fit + Fresh makes some that come with storage containers and matching water bottles too which is cool! They also have a lot of sizes and patterns to pick from.
    • Not a necessity, but a helpful tool is a smartwatch. It can sync with your phone so you can see your messages or notifications without having your phone on you, which is required by most schools for clinical. They also have features such as a clock with a second hand for counting vitals, a timer and/or alarm clock to set to help remember tasks, a pedometer if you’re interested in monitoring your health, and the date or a calendar to help you stay organized and for reference during charting. I love my Apple Watch! I’ve also used a FitBit before and that is another great option.

There is the comprehensive list that makes up my Ultimate Guide to Nursing School Preparation. Did you find it useful? Tell me your must haves for your nursing school journey!

/ Emergency

Performing an Emergency Trauma Primary Survey

Imagine a patient walks in to your exam room with a chief complaint of mouth and throat prickling with hives and itchy skin after eating peanuts. You know this I’m allergic reaction. What would you first be thinking of?

Another example would be a patient comes into your trauma room after a car accident going approximately 55 miles per hour, unrestrained with airbag deployment. They are unconscious, have an obvious broken femur, multiple oozing lacerations, are intubated from the field with unequal pupils. What’s your first priority?

In emergency medicine, there’s an easy checklist to run through in your head in order of prioritization. With experience and practice, many are done simultaneously. They’re called the ABCs Trauma Primary Survey.

ABCDEFGHI


• A is for airway – without this patent the person will not last long. Your looking at their alertness level (Alert, Verbal, Painful, Unresponsive), maintaining cervical spine precautions, and keeping their airway open.

• B is for breathing – cause again the person will not do well without this. Are they breathing effectively? Is they’re rate and rhythm enough to sustain them without assistance?

• C is for circulation – have bleeding controlled and palpable pulses. Also inspect the skin color, temperature, and moisture. The skin can be the first indicator something is wrong!

• D is for disability – pupils and any deformities. Assess for PERRLA and perform a Glasgow Coma Scale.

• E is for examine – expose your patient and check for missed injuries, apply warm blankets. Keep the environment warm.

• F is for full set of vitals – check your patient’s vitals in whatever capacity you can, they can tell you a lot about how your patient is doing. This is usually done earlier or simultaneously with other tasks but it’s included so it’s not forgotten. Also encourage the family to be present during this phase.

• G is for get monitoring – connect them to a monitor, vitals can tell you so much about how your patient is doing. This includes LMNOP: labs, monitor, naso or orogastric tube, oxygen (wean down if able) and capnography (EtCO2), and pain management.

The H and I portions are part of the secondary survey to be completed once your patient is stable.

• H is for head-to-toe assessment – now we listen, palpate, and inspect the whole body. Roll and remove the backboard if present and your patient’s spine has been cleared. A complete history is also done at this time.

• I is for interventions – perform any ordered interventions, get pictures done, and empty the bladder.

Always remember to reassess after any interventions are done to see if it’s helped or not!

This information I pulled from the Emergency Nurses Association (ENA) Trauma Nursing Core Course (TNCC) that I took and is also available online.

Did you find this helpful? Have you used the Primary Survey in practice?