Nursing Priority: The Mental Concept Internalised by Nurses and Nursing Students. A Qualitative Study

Abstract

BACKGROUND: Setting priorities is a fundamental aspect of nursing practice; however, both nurses and students often struggle to define and apply this concept. Existing literature tends to focus on urgency, relevance, or missed care, overlooking the cognitive processes involved in prioritisation.

METHODS: This qualitative study analysed open-ended survey responses from 104 participants -68 nursing students and 36 nurses- from two universities and three hospitals in Northern Italy. A combined deductive and inductive content analysis was used to explore how nursing priority is internalised and defined, which elements are considered in its identification, and what challenges are perceived in its application. This study adhered to the COREQ guidelines.

FINDINGS: Approximately half of the participants were unable to accurately define nursing priorities. Among those who could, nurses most frequently referred to urgency, while students emphasised relevance. Both groups identified patient needs and autonomy, observation, and communication as key elements in prioritising patient care. Reported challenges included patient complexity, simultaneous emergencies, and communication difficulties. Few participants applied comprehensive frameworks, suggesting a gap between theoretical instruction and clinical practice.

CONCLUSIONS: The study highlights a widespread difficulty in conceptualising and operationalising nursing priorities, consistent with international findings. Educational and organisational interventions are needed to support nurses and students in managing complexity and improving decision-making. Enhancing conceptual clarity and reasoning skills in nursing curricula can reduce missed care, improve patient outcomes, and mitigate nurse burnout. These findings underscore the importance of updating educational models and clinical tools to better reflect the realities of nursing practice.