How to Prioritize Nursing Care With Maslow's Hierarchy of Needs

Maslow’s hierarchy of needs was developed in 1943 by psychologist Abraham Maslow to describe and categorize things people need to experience self-actualization. In simpler terms, he created this psychological theory to describe how individuals’ needs change throughout life as they work toward meeting their full potential.

In the nursing world, this hierarchy of needs can help you prioritize how to best care for patients. You’ll initially encounter this theory on the NCLEX-RN exam, where you’ll use it to show that you can adequately prioritize the appropriate actions to take with a hypothetical patient.

Curious to know more about Maslow’s hierarchy of needs, how it relates to health care, and what you can do to prepare for your NCLEX-RN exam? We are here to help.

The 5 levels of Maslow’s hierarchy of needs

As discussed earlier, Abraham Maslow developed his hierarchy of needs around the idea of self-actualization, but what does this mean? The term self-actualization refers to an innate drive within individuals to realize their full potential and move closer to an ideal state of being. To get to this state, Maslow believes individuals work through five levels of a pyramid — each one describing a different level of human needs.

The five levels of the pyramid — from lowest to highest — include:

• Physiological needs
• Safety and security
• Love and belonging
• Self-esteem
• Self-actualization

A person needs to find fulfillment at the lowest level of the pyramid before they can properly move on to the next level. Individuals can move up to the next level once their needs are met; they reach peak self-actualization needs once they get to the top.

As a nursing student, it is important to understand what these five levels of needs are and what is generally experienced at each level. This allows you to offer the best care for future patients. Let’s look at each level and what your patients will need to move from one level to the next.

Physiological needs

At the lowest level, you will find a person’s physiological needs. This category includes basic human needs required to stay alive. For example, a person on this level requires enough food to eat and clean water to drink. The individual’s respiration, digestion, and cardiovascular health must also be adequate, in addition to other basic bodily functioning systems. Assisting in meeting these core needs must be the top priority in patient care before you, as a nurse, can effectively move forward.

Nursing example: As you take your patient’s vitals, note if any interventions would make them more comfortable (e.g., if a patient seems to have trouble breathing, work with their doctor to figure out a way to help the patient get more oxygen).

Safety and security

Once a person’s physiological needs are met, the next level in the hierarchy refers to an individual’s overall sense of safety and security. Feeling safe and secure can come in various forms, including both mental and physical safety. An individual can have their needs met at this stage with emotional security, financial stability, and good mental health.

In the nursing profession, providing patients the resources to feel safe both physically and psychologically is key for individuals at this level.

Nursing example: Ensure your patient’s room has proper safety precautions in place (e.g., railings up on their bed to avoid falling).

Love and belonging

The next level of the pyramid includes feelings of love and belonging. At our core, we want to feel loved and cherished by others. We learn feelings of empathy and compassion through experience, and individuals at this stage must be encouraged to build trusting relationships with those around them.

In the nursing world, building rapport and laying the foundation for a professional relationship of trust and care with your patients is a huge step toward achieving this level’s needs.

Nursing example: Ask your patient about their own life outside of the hospital: Do they have any family members nearby? What hobbies do they enjoy?

Self-esteem

Self-esteem refers to a person’s overall sense of self-worth. Individuals in this stage long to gain the respect and appreciation of others in their community. At this level, individuals want to feel a sense of accomplishment and be recognized for it.

As a nurse, you can empower patients to help themselves as much as possible by taking an active role in improving their health.

Nursing example: If you’re tending to a patient recovering from surgery, help them celebrate when they reach one of their goals (e.g., being able to take a few steps on their own).

Self-actualization

The highest level of Maslow’s pyramid is self-actualization. This describes someone’s ability to realize their full potential. People can only reach this step when the needs of other levels have successfully been fulfilled and maintained. At this stage, people are content and focus on continued personal growth. They look toward the future with hope and a positive attitude.

As a nurse, you can help patients get to this state by ensuring that they are physically and emotionally prepared to leave the hospital.

Nursing example: When you’re putting together a patient’s discharge paperwork, review how far they’ve come and remind them that they are leaving in a healthier state.

Maslow’s hierarchy is designed to organize basic life priorities, helping people understand how to address physical, mental, psychological, and emotional needs. Failure to meet one’s needs at the lower levels of the pyramid will disrupt the ability to build later capabilities, such as improving their self-esteem. Incorporating this process into nursing can help you find the best way to care for others and create a common understanding among those involved in your patient’s care.

Additional ways Maslow’s hierarchy of needs can be used in nursing

In nursing, the focus is on improving the overall well-being of each patient. Looking at the hierarchy of needs and using it to evaluate the patient’s condition can help you with decision-making and determining priorities for treatment. A patient cannot gain self-esteem, for example, when they still need to have basic physiological needs met.

As a nurse, you can use the hierarchy to categorize patients’ needs and determine the best treatment priorities. As you conduct your nursing assessment, note the different needs and where your patient falls on the hierarchy. You can then make the best use of your time by focusing on the most critical issues first.

This ability to determine the highest priority for a patient, particularly in a critical care setting, will benefit you and your patients alike. This process can help you address problems efficiently and orderly without sacrificing the quality of your care or adding stress to your environment. This process also helps everyone on your care team have common goals related to best-practice patient care.

Using this hierarchy can also help you prioritize between patients. As a nurse, you can expect to have multiple patients who need your attention at one time. Using this hierarchy can help you understand who needs the most urgent attention, ensuring all patients receive the quality care they need.

Maslow’s hierarchy of needs on the NCLEX exam

Nursing places considerable value on Maslow’s hierarchy of needs because of its capacity to guide treatment priorities. It can improve communication between nursing staff and result in better care for the patients.

Given the importance of the hierarchy in the nursing field, nursing students should expect to see questions related to this system on the NCLEX exam. Even if the nursing exam doesn’t ask about the hierarchy directly, test-takers might have to use it to determine treatment priorities for hypothetical patients.

Here is a sample question that relates to Maslow’s hierarchy of needs:

NCLEX sample question

Question #31:

Which is the most appropriate nursing diagnosis for a mechanically ventilated patient who is constantly exposed to the loud noises associated with being in an intensive care unit?

1. Acute pain
2. Delirium
3. Disturbed sleep pattern
4. Risk for anxiety

Rationales:

(Choice 1)

Disrupted sleep can cause a lower pain threshold so adequate sleep should be the priority for the nurse.

(Choice 2)

Disturbed Sleep Pattern is a documented cause of delirium, so this needs to be addressed first.

(Choice 3) CORRECT

Disturbed Sleep Pattern is the most appropriate because this can potentially lead to other health problems such as anxiety and delirium.

(Choice 4)

Disturbed sleep patterns can increase patient anxiety so this nursing diagnosis should be addressed first.

Overview: Sleep deprivation in the ICU can be exacerbated by factors inherent to critical illness. Pain, a very common symptom in critically ill patients, contributes to awakenings during sleep. Anxiety and stress due to unfamiliarity with the ICU environment, inability to speak, or illness can also contribute to sleep loss.

Learning Outcomes: Multiple environmental factors can disrupt the sleep pattern of an ICU patient including excessive noise. Disturbed sleep patterns can lead to additional negative effects such as delirium, anxiety, acute confusion, decreased REM sleep, and increased heart rate. The nursing diagnosis of Disturbed Sleep Pattern is the most appropriate to avoid potential adverse events. Nursing intervention should focus on consolidating and minimizing potential sleep disturbing activities.

NCLEX Test Taking Tip:

Maslow’s hierarchy of needs– Physiological needs (pain, food, sleep) are addressed before safety and security and psychosocial problems. This is typically used in complex patients with multiple problems.

The best NCLEX study resources are available on SimpleNursing

When it comes time to prepare for the NCLEX exam and become certified in your dream profession, it’s important to study well. You want to work with someone that understands the test and can offer you substantial guidance as you prepare.

You can access several NCLEX resources at SimpleNursing. Our NCLEX prep course offers valuable insight, including practice using the hierarchy of needs outlined above. We recommend getting started now so you can go into your NCLEX exam confidently, feeling prepared to effectively treat patients with the right priorities in mind.