Maslow’s Hierarchy of Needs: How does it find relevance in nursing?

The nusring profession is a challenging one! Nurses often face complicated situations where they have to take decisions and sometimes address multiple issues at a time. Their job is not limited to providing help that heals a patient physically but sometimes they also have to pacify the perturbed minds of the patients as well as their families. When you have lots of jobs at hand, how should you be handling them? The answer in in setting priorities and accomplishing the most important first and so on and so forth.

Now, the question arises as to how a nurse should be setting priorities? Maslow’s Hierarchy of Needs, lays down the human needs in manner where it becomes easy to understand what should come first and what last! 

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Psychologist Abraham Maslow defined basic human needs as a hierarchy showing how human needs progress from the most basic needs to complex ones!

The Maslow’s Hierarchy of needs is depicted in the form of a pyramid as given below where he has shown the base of the pyramid holds the most important and crucial needs of physiological well being which require food, air, water, sleep etc. Progressing upwards in the pyramid, the degree of importance of the needs keeps decreasing. After the physiological need we have needs for safety and security which include shelter. Henceforth are social needs, esteem needs and self actualisation needs.

A need is defined as that which, in its absence breeds illness, when present prevents illness and if restored, cures illness. Maslow also felt that the need is inactive, at a low ebb, or functionally absent in a healthy person. But, needs exist in a hierarchy and so when one need is satisfied the person becomes aware of another need. For example, the basic physiological needs have a greater priority over those higher on the pyramid. They must be met before the person can move on to higher level needs. In other words, a person who is starving will not be concentrating on building his self-esteem. A patient in severe pain will not be concerned with improving his interpersonal relationships.

Maslows hierarchy of needs jpgWhy is Maslow’s hierarchy of needs important in nursing?

With the perspective of the nursing profession nurses and clinical care that is extended to patients, Maslow’s theory holds great importance. It helps nurses to prioritise client’s needs. Whenever they will face a situation that demands them to prioritise they will easily be able to decide that physiological needs hold the most importance and need to be fulfilled first, then the others may be taken care of.

A research paper published by NCBI: Improving Patient Care Through the Prism of Psychology: application of Maslow’s Hierarchy to Sedation, Delirium and Early Mobility in the ICU establishes the importance of this theory in the Nursing Profession. 

With respect to client care let’s see what the needs are and what any efficient nurse can to render the right kind of help!

1. PHYSIOLOGICAL NEEDS: They include basic concerns by family members if sometimes patients are unaware of their condition. This is mostly extended and  well taken care of by hospitals. It may include providing support for failing organs, pain and symptom management, taking care of nutrition etc.

2. SAFETY NEEDS: Concerns about emotional well-being in the context of frequent nightmares and delusions as well as with whether the ICU team can prevent their conditions from worsening. This can be taken care of by preventing errors, delirium management and monitoring, taking care of hospital acquired infections etc.

3. SOCIAL NEEDS (LOVE/BELONGING): Concerns about how much support they will receive if their critical illness persists (e.g. will people continue to visit or will they forget about me) and well as whether they will “fit in” to old communities now that they have “newly acquired” disabilities that may limit them.Hospitals should allow open visitation of family and friends and post ICU support should be given by nurses.

4. ESTEEM NEEDS: Concerns about whether they can reach recovery-related goals – e.g. return to vigorous activities or to work as soon as they had hope.Can be fulfilled by recognition of dignity/value in each patient, optimising pre illness cognition and physical function through rehabilitation.

5. SELF ACTUALISATION: Concerns about ability to reconcile pre-morbid identity with “new normal” and to embrace a potentially new identity.For re establishing this need, incorporation of spiritual values into patient acre, acceptance of new limitations, reconciliation of new identity etc can be of some help.

How it actually helps!

  • It has been affirmed that especially for patients who have long been in the ICU, ‘aftercare’ is very important. Maslow’s Hierarchy of Needs, provides the framework and spark that are needed to enhance translation of care with a patient-centered emphasis on the physical and psychological complaints experienced by survivors. The poor quality of survivorship and dismantled lives of many patients emerging from ICU care remain an under-recognized public health problem that is not being addressed rapidly. 
  • For nurses working in ICUs this theory lays down relevant guidelines which help them to work efficiently while even understanding their patient’s need well! Since the prime duty of any nurse is ‘Client Care’!
  • Nurses will also be able to adjust their behaviour towards patients when they understand their needs well. They can develop a good bond with them leading to an amicable environment and speedy recovery.
  • Apart from the practical aspect, when it comes to the Licensure examination, the NCLEX this will also be of great help. Having correct knowledge about this will help you understand needs and answer tricky NCLEX questions that require you to prioritise and take decisions!

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