Time Management or Personal Boundaries?

UM Review RN, ASN, RN · Jun 21, 2009

The root of the problem lies with the fact that nurses are responsible for just about everything. From admission orders to meal trays to pre-op prep, verifying that the doc's orders are correct, to discharge teaching and patient education, the nurse is "it."

It's enough to make the average person's head explode.Mine would've exploded years ago, but that would've just meant more paperwork for me to complete.

caliotter3 · Jun 21, 2009

Yes, there is too much to be responsible for and too much to do. Supervisors use the "time management" onus to criticize employees who can't get it all done because it is impossible to get it all done. Most nurses do not have justifiable problems with poor time management.

gonzo1, ASN, RN · Jun 21, 2009

Work is a constant interuption. I'll be giving an IV med and someone will stick their head in the room and say room 10 needs a catheter. I'll be charting and a doc will go by and say he wants room 6 to have cardizem right away. I'll be changing a diaper and hear someone yell code blue, 2 rooms down.

And then management wonders why we forget to chart, why we can't get it all done.

More and more patients and procedures, fewer techs and support help. And yes, we RNs are responsible for everything related to our patients, from eating, to pooping to drugs, to family education.

More and more work piled on with fewer resources. And then it is our fault when we don't "finish" on time.

I quit feeling quilty a long time ago.

At the start of each shift I think about which of my patients is the sickest and most likely to die on me. They get the most attention, and everyone else a little less.

I do what I can and leave the rest for the next shift. If management doesn't like the job I do they can replace me with someone they like. Most of us are doing the best we can, the fastest we can.

Management plays games with us all the time, trying to guilt us into working harder and faster, but I am pretty much at my max most of the time.

Nurse_Hagatha · Jun 22, 2009

Sometimes I get the feeling from my co-workers that I don't have time management down, because I'm usually running behind. This is usually from nurses who have all of their charting and MAR checks done by 10 max, and are heading down to the cafeteria by 11 for lunch. Management loves them and sees them as leaders, because they have time to get involved in everyone else's business and are such great helps to the charge nurses. They know their patients' histories inside and out, because they have time to sit and research labs, tests, and H&P's.

Meanwhile I am wondering what my big fat problem is and am beating myself up in my head for not being efficient. I work hard. I'm definitely not lazy or a slacker. I am starting to HATE nursing, because I feel so horrible about not being able to do it all and having certain co-workers looking down their noses at me. I feel like snapping at them sometimes when they are bragging about what awesome nurses they are, and I know their incontinent patients only get changed once or twice in 12 hours, and only get turned that often as well.

I seriously need a break from floor nursing.

Batman24 · Jun 22, 2009

It's easy to be a "good" nurse if you don't do your job, Nurse Hagatha. You however are providing the quality care to your patients that takes time. Don't feel bad. You would have time to help others and the CN if you neglected your duties.

And I agree with the others. This isn't a time management issue but a lack of aprropriate nursing and ancillary staff.

Miss Mab · Jun 22, 2009

So, in answer to your question, No.

No, it's not a matter of the nurses having the self confidence/assertiveness/personal gumption or even strong 'boundaries' to be able to stay on task and not experience the myriad time pressures that come w/the job.

It's generally not an internal problem, but one that results from all of the external demands.

Sadly, there are no boundaries to that which the RN will be held ultimately responsible for.

That was cute..

BrnEyedGirl, BSN, MSN, RN, APRN · Jun 22, 2009

It is somtimes really hard to get out of some rooms. I hate it when you have a really sweet pt/family that has legitimate questions/concerns and you spend 30 minutes explaining (teaching) and then you are soooo far behind. It is difficult to get out of those conversations without coming off as rude or uncaring. Again, if we had more staff, this wouldn't be such an issue.

keithjones · Jun 22, 2009

My original question was really concerning the difference between nurses who are regularly "behind" and those who have "free time" but I think that got answered a bit.

seems more of a question of speedy care vs quality care.

Once I start clinicals I'll keep my eyes open for nurses who finish early and those who fall behind... see what level of care each is providing.

Scrubby · Jun 22, 2009

I'm not going to argue that time management isn't important because it is. We shouldn't stuff around taking half an hour to do something that should only take 10 minutes. But one of the problems I see a lot of (and are guilty of myself at times)is nurses becoming too focused on accomplishing everything on time, that they become too task orientated.

Time management was shoved down my throat in nursing school, and is still something I hear way too much of. I think it's more important to use critical thinking skills and not become too stressed out if we're behind in our tasks. I think time management is also a method some managers use to justify not easing the workload...'well if you can't do this on time then the problem is YOU not the fact that we're giving you too much to do in too little time'. I think the whole time management thing is way out of proportion.

Anyway to answer the OP if your doing your med round then yes you should set yourself an achievable and efficient time limit. However, who is to say that during this med pass a patient/relative gives you information that may be of some importance to their health condition? If your too focused on the task and trying to finish it in a certain amount of time, you may miss out on important info and subsequently a patient may suffer.

I hope this makes sense.

sicushells, RN · Jun 22, 2009

Once I start clinicals I'll keep my eyes open for nurses who finish early and those who fall behind... see what level of care each is providing.

Hopefully you'll be too busy in clinicals taking care of your patient(s) to be ... well, let's call it "evaluating"... more experienced nurses. Just because a nurse is "done" early (and, really, it ain't over till you're in your car on the way home) doesn't mean they haven't worked hard or are neglecting their patients. :twocents: Maybe see what's going on a little bit in the bedside nursing world before you start... evaluating... what level of care experienced nurses are providing.

bosnanurse · Jun 22, 2009

Once in my nursing lifetime :)) I worked at the facility with 26 patients who needed EVERYTHING!!Total care unit. I was alone with two aids and one LPN if she was available. Job was from respiratory care, tube feedings, turning and positioning, vitals, temps and on top of that checking charts, answering phone, doing triage over phone for other community units, responding to emergencies in the building.. all together was total mess. I complained did not work.. so I sat down and wrote every single thing I needed to do and calculated the least possible time to do it... THE FASTEST possible to do it without break and without emergencies... I came down to 14,5 hours.:)) Well, I was paid 7.5 hours. So, I said that I will start calling some agencies responsible for accreditation and by miracle my overload became somewhere around 9 hours.. still too much for me but I did not have others who would do "project" of counting with me. So , I decided to move from there. It was my "personal boundaries" to deal with THEIR "time management".:deadhorse .

God bless all nurses.