04.01 Maslow’s Hierarchy of Needs

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All right. We're going to talk about Maslow's hierarchy of needs. Now, this is something that's really important, but I feel like is often glossed over in nursing school, or we don't understand exactly how to use it or how important it is.

First of all, what is the hierarchy of needs? Well, this was developed by Abraham Maslow. It's really a psychological theory based on our human needs. It's based on the priority of our human needs. So not just what we need as human but in what order we need those things. First of all, it focuses on physiological needs. Then it's going to focus on safety, love belonging, esteem and self-actualization.

We're going to dive into this a bit more. But each of these builds on each other. We don't worry about love and belonging until safety is met. We don't worry about self-esteem until our physiological needs are met. What are the physiological needs that we have? Now, these take priority before anything else. Remember, this is the very bottom of that pyramid. These are the most important things that we must have met before anything else. Examples of these would be oxygenation. We have to be able to breathe. Things like fluids and nutrition, shelter, and the ability to eliminate.

These things must happen before anything else. The best way to think of this is with our ABCs, our airway, breathing, circulation. Until our ABCs are met we don't worry about anything else. We focus on our As before our Bs, focus on our Bs before our Cs. This is the very bottom of our pyramid in Maslow's hierarchy of needs. Now, the next one is safety. Once our physiological needs are met, once our ABCs are met, we can then start looking at safety. This is the second level need. We have down here our physiological needs. Right above that is safety. Okay. Once all of our physiological needs are met we can start focusing on our patient's safety.

Now, there's psychological safety where people attempt to seek safety before meeting any other needs. For example, when a patient's in the hospital, they're going to want to be sure that their home is safe. They want to make sure that they're safe in the hospital. Examples of this would be like law and order, shelter, employment, and health. They want to make sure all those psychological safety needs are met. Then, we also have physical safety. Patients need to feel physically safe. Now, with this we have infection, biological safety and then we also have physical environmental safety. That's going to be lights, extension cords, things like that with our patients who maybe have dementia. Then, we also want to have our bed rails up and all those types of things. So we have our physical safety and our psychological safety.

The next one we're going to focus on in our third level of our pyramid once we have our safety met, is we can focus on our love and belonging needs. This is our third level. Now, all of our patients have a need for social relationships. They need to feel connected to other humans. Now, some examples of this would be like relationship with family members. It might be friendships. It might be social relationships. It might be intimate relationships. As a nurse, we can also sit there, talk with our patients, give them that social connection, give them that sense of love and belonging.

Then there's esteem. It's the fourth level need. Now, this becomes very important once all of our other needs are met, once our physiological needs are met, our safety needs are met, our love and belonging. Then we can start worrying about esteem. Okay. We focus on outer esteem first then we focus on ... our outer acceptance first and then we focus on esteem. First, focus on being accepted then focus on building up esteem. Patients want to feel useful. They have a need for feeling of accomplishment or a need for self-confidence and self-worth. Some examples of this might be they need to have recognition. They need to feel status. They need to feel respect. As a nurse, some things we can do is recognize our patients when they do make accomplishments or when they are working harder, when they are progressing. It's really important that people feel this.

Then our next level need, our fifth level need is going to be self-actualization. We must meet this need once every other need has been met. People want to feel like they've actualized their full potential, or they've achieved their full self. We can focus on coping here. We can encourage problem solving capabilities. This is really kind of like being your best self. This is when we've achieved that sense of being our best self. Some examples of ways that this can happen is we can be pursuing talents. We can be pursuing personal growth. We have the ability to be creative.

Now, Maslow's and nursing. How does this all apply to nursing? Nurses really need to prioritize the care of their patients based on this model. We must meet the physiological needs of our patients before we do anything else. If we're talking to a patient, and a patient becomes winded we need to stop the conversation. That's a love and belonging need where we really need to start focusing on their O2 status, which is a physiological need. O2 comes before love and belonging. We must encourage safety needs. We must make sure the patient's room is safe. We must encourage the patient to engage in safe behavior also.

Then love and belonging, we can build rapport. We can go in there and introduce ourselves, encourage family support if the patient has family support or encourage friend support as long as that is healthy and a positive influence on the patient. Of course, there's going to be situations where we might not want the family there because they're not a positive influence on our patient. Then we can start meeting self-esteem needs. We meet this through therapy, through encouraging success, through recognizing successes that the patient's having. Then we can start looking at self-actualization needs. We can start looking at long-term goals. This is where we start getting into those planning phases with our patient of where are we going to be? What's our long long-term goals for recovery? We can start looking at rehabilitation and returning to home.

I really want you, as you're working as a nurse and as you're practicing as a nurse and you're on a floor, really think about this pyramid. Don't just see this as something that you must memorize for a test. But really think about this pyramid and especially focus on these first couple rungs right here, that we're meeting these physiological needs of our patient, we're meeting the safety needs of our patient. Then we can start dealing with these other issues and these other things. In our test-taking course we do talk about this as well and how to answer questions on tests and how to prioritize care. We're going to talk about this more and more as we go on in this fundamentals course.

How do you prioritize the care of multiple patients? You can use Maslow's hierarchy of needs to determine which patient should come first. Physiological needs come before self-actualization needs. If you have a patient who has an ABC need, you deal with that first before you deal with a patient who maybe has an education need. You even deal with an ABC need before you deal with a safety need. This is how you can prioritize care and put this Maslow's hierarchy of needs into practice in your nursing care. You must meet your patient's needs. Patients often come to the hospital with many, many, many unmet needs. We need to identify those needs through our assessment.

That's the whole importance of doing a holistic and a complete assessment on our patient is we can start to identify, okay, yeah, the ABCs are all met. The patient's safe. Now we can start looking at these other ones, love and belonging, esteem, self-actualization. We can start looking at these other needs and start addressing those in order, making sure that, boom, that's all taken care of. That's all taken care of, and start really working up this pyramid to make sure that the patient's needs are first. Again, addressing our physiological needs first, then safety, then love. That's really the importance of our assessment. And then categorizing our patient's needs and prioritizing our care as such.

Now, some of the nursing concepts you're going to see with this are prioritization, of course. We've got to prioritize our patient's care and we've got to prioritize our patients as we're taking care of multiple patients. Then, clinical judgment would be another nursing concept you're going to see here because this really comes into play on how you use your judgment and your critical thinking in nursing care.
Let's talk really quick to wrap up on the key points of Maslow's hierarchy of needs. There's five levels in Maslow's hierarchy of needs. There is a cheat sheet on this and there's other resources on this. But the first one is physiological needs. We must meet those ABCs of our patient before we address anything else. Then we can really focus on safety. Encourage a safe environment and safe habits and safe practices by our patient. Make sure there's a culture of safety. Make sure they understand how to be safe. Make sure that they understand things that they can adjust in their lives to continue to be safe.

Then we can focus on love and belonging. Reinforce the building and maintenance of strong social relationships. Then we can focus on esteem, where we encourage our patient, we reinforce with our patient and we help our patient feel that esteem. Then there's self-actualization. We help the patient set goals and we help them along that path of both short-term and long-term goals.

All right, guys. That's the basics of Maslow's hierarchy of needs. Make sure you check out all the other resources, the quiz questions, the cheat sheets that go along with this lesson. Now go out and be your best selves today. As always, happy nursing.
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