Time Management Strategies

Specialties Emergency

Published

ok, so i'm a new nurse in the er. i am in my 5th week after finishing a 12 wk emergency nurse internship program which consisted of classroom time and clinicals. yesterday, my preceptor and i met with our nurse educator. the good news was that she told me she is hearing good things about me (phew)! she asked me where i felt i was in my training. i told her i felt my weakness was time management. my preceptor agreed, telling her that i am very smart, that i have good judgment, and that i am very focused, however, sometimes i focus too much on my more critical patients and spend too little time with my other patients (although i kind of feel if you're not acute, you can wait--i'll glance at you and make sure you're pwd, and then i'm more worried about the guy who can die within the next 5 minutes). i guess part of the reason is that i prefer the more challenging cases as opposed to the otherwise healthy 20 yr olds who have the sniffles yet feel that merits a trip to the er, but i know they come with the deal too. anyhow, my nurse educator asked me to come up with a document listing some strategies to improve my time management skills. i have no clue--if i knew, i would do them! do any of you more experienced nurses have some strategies i could use? i did a search through the threads, but i'm looking for more specific strategies. what makes it worse is that we're one of those hospitals with a 30 minute promise (which i dislike, because i think it encourages non-emergent patients to come to the er), so i always feel rushed, rushed, rushed. the good news is that my preceptor said no one expected me to be as fast as a more experienced nurse. she says it will come with time and experience. also, i don't know if this will affect the advice you have, but i work the night shift.

i think one thing i could suggest is that my preceptor stop trying to assist me with my assignments. she should supervise, review my charts, but otherwise back off unless i am absolutely drowning. although she doesn't say it, i know she gets impatient because i am not as fast as the others so she jumps in, but if the patients are not critical and we don't have a waiting room full of people or ambulances backed up (we're a relatively small er, so we do have our down time), she should just let me do things at my own pace because it's the only way i'll learn to become faster--practice. what do you think?

(and please, no offense, but no lectures about me needing med-surg experience first. i know a lot of nurses feel that way, but it just motivates me to work harder to prove them wrong. the reality is that i'm here and i'm not going anywhere. i know it's not the same thing, but i was a tech in the same er prior to becoming a nurse, so i am familiar with the pace. all i need is some help to get up to speed and i would really appreciate any advice that you have. thank you so much!!)

Specializes in Emergency Only.
I did do a med/surg job for about 6 months prior to entering the ED last month and I can't say it really helped me. I am happy I had the time there and learned what I did, but I am not a believer of that's the only way in to the ED or any specialty field, neither is the hospital I work at. There are benefits to everything... so who knows really.

....

!

Five on it

Specializes in Emergency Only.
Hello,

Currently I'm a Nursing Student

Management when you start

Even though I'm only in my first semester

and personal life.

After awhile you learn techniques.

I know you priortize certain patients because of their urgency but

using great customer service will really go a long way. Well, I wish

"U" (added that "U" to your quoted post, took some words out too...) - "U" ... .. Have Fun with it.:yeah:

A really good nurse is probly born that way, but the education is still required, right?

Nothing...

I graduated in May 2008 and I've been working in my ED for about 5 months. I absolutely love my job and would do it for free!

I had a 3 month orientation and when I came off orientation, time management was still an issue for me.. being on my own was when I became much more productive.

A few time management tips I've picked up:

Walk by the room on the way out to get a pt and snap up a gown, grab a sheet, ready the room.

Get the patient, get urine from just about everyone, if ambulatory I'll jokingly tell them "the bathroom is just down the hall, think you can take a walk and give me a urine sample before you get in this lovely, revealing gown?" I joke a little with my patients, it makes the experience better for them, and they are more cooperative for me!

I instruct them to bring the urine cup back to their room and change into the gown. I'll go put the chart in the doc rack.. come back and grab vitals on them (knowing I won't need to revitalize for another hour).

Another big thing is just getting experience.. following protocols and anticipating orders.. if someone comes in for a toothache I'm not grabbing pee and blood but if someone comes in for abdominal pain I get pee, and I start their IV, send blood to the lab. A fever and I've got the labs and 2 sets of blood cultures in the lab, plus NS running before the doc sets foot in the room... we have a few freedoms in my ED and I take advantage of them. But this comes with experience and paying attention.. I'm still new but I go by protocols and know my 'for sure' NS bolus complaints, I know which babies are getting a rectal temp and Tylenol or Motrin as soon as they hit my room. Get it OUT of the way.

Waiting for the doc to order labs, then the tech to enter them, THEN going in to draw blood and send it to the lab.. big time suck. Waiting 40 minutes for a doc to hit the room on a febrile toddler and then order Tylenol, then wait for it to work.. time suck.

I used to feel *bad* for starting anything bigger than a 20g IV on anyone, now I do 18s on just about everyone as the fluids go in quicker, they feel better faster, and get out quicker.. which is what they (and I) want.

My ED requires hourly VS on each patient. I keep an eye on my chart rack, when I'm getting a patient via ambulance I'll grab vitals on my current patients and update them as I wait on EMS.

Never go anywhere empty handed.. I try to keep moving.. cleaning a room after a discharge is not beneath me, emptying a laundry bag is not beneath me, I'll grab a blanket if I anticipate a patient needing one, look over discharge instructions on your way to a room so you can anticipate and answer any questions.

My biggest time management tip is really just being kind and respectful to the patients. There are always some patients who are uncooperative and painful but if I'm nice to my patients, keep them informed, and empathize with even their ridiculous complaints and they are just so much more cooperative and they leave a lot happier.

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