Nursing Time Management

Time Management is the process of doing required tasks efficiently and effectively.

Introduction

  • Nursing is changeable and variable therefore difficult to plan and manage
  • There is not a great deal of literature aimed at time management in nursing; usually aimed at office and factory work.
  • Bad time management can lead to frustration, failing, significant events.
  • Is time management an oxymoron?

Time Response

  • When it is busy the sheer volume of work makes it hard to set priorities.
  • Reactive time is responding to demand - which is sometimes necessary.
  • Proactive time is deciding what work is beneficial (preventing)
  • DO NOT get caught up in the Activity trap  / Merry Go Round syndrome – lots of movement but little direction. Do not mount 6 horses and gallop in 6 different direction. A person who tries to catch 2 rabbits will not catch any!
  • DO NOT Implement half –baked plans as short cuts can become long cuts
  • DO: plan the day, estimate times, list your demands for Dr`s, get questions answered and plan on Dr`s round.
  • DO: Build in reflection time. What is the best use of my time?
  • DO: Quality vs. Quantity
  • KISS –keep it short and simple.
  • DO: Role model a Nurse who manages well

Pareto`s Principle

  • The Principle is that 80% value comes from 20% of the work.
  • The ABC Principle is:
  • A – if it is not done today/ this duty there will be negative consequences.
  • B- if it is not done soon there may be negative consequences
  • C- can be put off without negative consequences

Stressors

  • Stressors will effect one`s ability to work
  • Stress when managed becomes eustress which a lot of people enjoy
  • Nature of work; dying, role conflict, conditions, load, equipment.
  • Important to be positive especially role models feel good/ work good, conversely anxiety spreads
  • People who are stressed often act like the White Rabbit (A I W) – agitated, clock watching, aimlessly wandering portraying an air of being busy so that no-one will approach them or delegate them more work.

Delegation

  • Described as ‘making the most of your time by involving others’
  • IT is NOT a way of getting rid of ‘crappy jobs’
  • Routine jobs to other HCP`s, Pharmacist to explain meds to pt, Physio to mobilize pt, Dietician to explain / organize diet.
  • Problem solving can be delegated to people of greater or relevant experience
  • When delegating always take into account experience, confidence, training and education.
  • A mismatch between a person's possible and actual skills has potential for inefficient and ineffective care / work.
  • Often as a manager; it is not what happens when you are there but what happens when you are not there that counts

Ergonomics

  • Organise your environment to assist your work. Prior Planning Prevents Poor Performance
  • Pre procedure think about a career move:
  • Check policy/procedure/charts
  • Assess the patient/environment/equipment
  • Review the procedure with the patient
  • Execute the procedure
  • Evaluate
  • Record and report
  • Get to know your ward / unit
  • Cupboards, drug trolley, orderly service,
  • Use IT-telephone, fax, computer—learn it!
  • Do not replicate work- obs in Nurse kardex
  • Do not struggle alone on a 2/3 man job. May take longer but is safer. Family help e.g. feeding win/ win situation
  • Procrastination
  • From Latin meaning ‘tomorrow’
  • Probably the major cause of poor time management. Present with unpleasant, large, high risk of failure, or need of feeling pressure tasks.
  • Do Not confuse it with planning time.
  • “ don't just do something – sit there!”
  • Ask oneself “why am I putting this job off”
  • Carpe Diem-seize the day, Graspum Stingum-grasp the nettle.
  • Nike –just do it attitude often helps.
  • For many it is knowing where to start, proactive NOT reactive time is helpful here
  • Chunk big workloads into groups
  • Take breaks on time someone else wants theirs

 

Memory

  • “One on the eye is worth two in the ear”
  • Write things down as soon as possible you will forget about 50% of what you hear or read in < 1minute.
  • Communicate messages as soon as possible
    • Good documentation is not only an aid to communication but a legal requirement.
    • Most problems arise from bad communication

Interruptions

  • Phone, visitors, MDT, fellow Nurses are the major interrupters.
  • Try to prevent those not vital.
  • Learn to say NO!
  • condense conversations, brief to the point
  • Don’t let others steal your time-dropper inners, idle chat –learn cut offs: I need to settle this quickly, I will get right onto it, well it's been good talking to you.
  • Meetings are a big time thief, don’t go to meetings you don’t have to, if do- get them started, to end close folder, stand up
  • Meetings can be interrupted, hand over time is always spoiled. The social side of handover is important but should be after the biz is done and then kept short.
  • Handover-factual, concise, written, taped, bedside, verbal, office, whatever works best for the area.

 

Staff Suggestions

  • Recognize that what you are doing is important and you can`t always drop everything to accommodate others
  • Prioritize-not every task has to be done on your shift
  • Know that your priorities may be different from the patient, MDT and other Nurses, so sometimes prioritize your priorities.

Scenario

  • Handover-LISTEN-ask Q`s before staff leave, take 5 minutes to make plan, time -/+ task chart, highlight must do`s.
  • Bedside check, arrange work space. Things differ from what you are told. Sooner discrepancies found less damage done. YOU are accountable.
  • Sequence care weigh, toilet, chair, meds, procedures, hygiene etc.
  • Some Do`s are flexible some are MUST
  • Use team members e.g. ward clerk, escort Nurse, orderlies.

Thoughts

  • Learn by practice-Martha Graham
  • Stop a moment, cease your work, and look around you- Thomas Carlyle
  • When it is dark enough, you can see the stars – Charles Beard
  • If you wait for the moment when everything, absolutely everything is ready, we shall never begin-Ivan Tugena
  • Procrastination is the thief of time-Edward Young
  • Procrastination is the art of keeping up with yesterday-Don Marquis
  • Procrastination is opportunities natural assassin-Victor Kiam
  • My evil genius Procrastination has whispered to me to tarry `til a more convenient season- Mary Todd Lincoln

 

Questions

  • What is time management?
  • Why is time management difficult for Nurses?
  • When would reactive time apply?
  • Name some stressors?
  • What is delegation?
  • Procrastinate- what does it mean?
  • How much do you forget in 1 minute?