HomeCurrent JournalProfessional prioritization

Professional prioritization

Author(s): Marla J. Weston, PhD, RN, FAAN

Remember all the good we do.  

Marla J. Weston
Marla J. Weston

Nurses repeatedly confront overwhelming workloads and the need to make extraordinarily complex choices amidst insufficient resources and competing priorities, particularly during the COVID-19 pandemic. As a result, they frequently leave work at the end of their shift feeling that no matter how much they did, they didn’t do enough.

No one can continue to be satisfied with work when they constantly feel that they haven’t done enough. For those who chose a profession that’s all about making a difference in the world, that feeling is soul shattering. No wonder burnout and resignation rates are skyrocketing.

However, when I listen to the heartbreaking stories of nurses on the frontlines of the pandemic, I hear something else under the legitimate frustrations about how untenable the situation is. In the midst of a seemingly endless pandemic with insufficient resources, I hear nurses prioritizing what’s most important. I hear stories of nurses sharing sophisticated knowledge and nuanced expertise, evolving their practice while adapting to an ever-changing situation, offering profound compassion and humanity when caring for patients and each other, and applying their practical problem-solving skills to designing and implementing innovative solutions to complex circumstances.

Each and every day, nurses apply their unique knowledge in a way that prioritizes what patients need within the constraints of existing resources. That prioritization is the cornerstone of professional practice. The term “professional” frequently is confused with expertise or having certain characteristics related to being excellent at your job. A true professional possesses unique knowledge and skills derived from research and education in a specific discipline, adheres to a code of ethics, and promotes the public good within their expert domain. Inherent in the work of a professional exists a wealth of knowledge about the range of interventions and actions that can serve clients, and the expertise to discern what is most needed, most valuable, and most impactful for the client at that moment.

As a result, professionals will almost always leave work at the end of the day aware of more that they could have done. However, rather than lamenting all that they didn’t do, they should ask themselves, “Did I prioritize the right things?”

What I hear behind the stories of this horrific pandemic, and the pressures under which nurses are practicing, is that nurses prioritize the right responsibilities in an awful situation. This doesn’t excuse the infrastructure issues that currently exist and have plagued the healthcare system and nurses for years. If anything, the pandemic has highlighted the weaknesses and the many ways in which nurses have been underappreciated and undervalued. Nurses and others need to address these issues.

However, nurses also need to recognize the amazing work they’re doing and tell the whole story of what’s happening during the pandemic. Nurses must acknowledge the professional expertise they bring to their work and take credit for the amazing job of prioritizing what’s most important—both in conversations with themselves at the end of the day and in the stories they share with others. In spite of all that nurses haven’t been able to do, we all should recognize and celebrate the professional expertise they’ve brought to their work and the good they have done. Nurses bring their professional expertise, prioritize what their patients need the most, and serve humanity during a terrible time.

Marla J. Weston is an American Nurse Journal editorial board member and chief executive officer of Weston Consulting, LLC, in Washington, DC. 

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