How do you prioritize and manage your time?

JustaGypsy · May 9, 2011

Truly depends on where you work. I am in the ER so any plan is subject to change.

EmergencyNrse · May 9, 2011

I really don't "do" anything anymore. All my time is spent filling out forms.

Joint commission forms, national safety goal forms, hospital forms, customer survey forms, sepsis screen, stroke screen, domestic violence screen, braden screen, personal belongings form.... I'm no longer a nurse, I'm a clerk.

Sure, I give meds from time to time but it's only the ones that are life-saving.

I have no time for the other stuff... Certainly no patient teaching.

I'm too busy kissing @$$ to make them "feel better" about their visit. They have to be "mostly satisfied" while they are there or I haven't done my job. Health be damned.

Good luck figuring out your method. The system is broke and nobody cares...

(Just about the Press Ganey)

carolmaccas66, BSN, RN · May 9, 2011

Hi Jewl. There are many threads on this, if you use the search box right hand top, you will find lots of info.

Time management is one key to good nursing. You need to get a cheat sheet b4 u start ur shift, write down all the patients names and room numbers on the left hand side, then up the top write each hour starting from beginning to end of shift. Grab ur patient's files after handover and flick thru them to see what needs doing, and write all these on ur cheat sheet at the time they are due, ie: IV med's, ABs, dressings, etc. I write meds in red, other things in blue, some in green (any patient notes for handover I write in blue). With ABs I put a star next to it so I don't forget. We also used to grab a little trolley to put our IV paraphernalia and dressing stuff on, then we weren't running into the drug room all the time. And we taped our cheat sheet on the top of the trolley (though check your facilities' policy with this as it can breach confidentiality). I always used to fold mine so up so visitors wouldn't see, & we kept the trolleys in little 'bays' so people don't bump into them when not being used.

Always start your IVs or drugs half an hour b4 hand - preparing and checking drugs takes quite a while - you need to think of the time taken for each drug, ie: IV ABs take longer than giving a pill usually.

It depends on the ward as to what routine you get into as well. Surgical you have to take patients down to OT, and pick them up so you have to factor that in as well. It takes time and patience! so don't be too hard on yourself. But always keep ur cheat sheet in ur pocket to remind you what u have to do, and try to keep ahead of time - it's very hard sometimes though.

With hourly obs, say for post op patients, you may find ur doing obs all night - you start one lot, then it's time to do the next! If you get behind, try to start again on the ones that are behind on the next hour, then go from there. It's difficult. Ask patients what they need whilst in the room, try to group all your care together.

Wear good, supportive shoes with arch supports - ur gonna need them mate!

Like I said, the search function up top may give u more info.

Good luck.

AgentBeast, BSN, RN · May 9, 2011

"The best laid plans of mice and men often go astray."

joanna73, BSN, RN · May 9, 2011

Sickest, most unstable come first. Make sure my meds are given. Then chart. However, there are many nights when my plans are shot to hell.

Jewl · May 9, 2011

Thank you everyone for your input!

eriksoln, BSN, RN · May 9, 2011

just priotitise is all:

1st assess all your patients. wiat, hold on, meds need passed. they sent out an email saying the "window" for passing meds was being reduced.

1st, pass your meds. [gasp] i forgot, in the last employee meeting, they said all orders should be taken off the chart and put into action withni 30min. of being written, and there are five charts on the nurse server with new orders on them.

1st, initiate new orders case manager want's to know why tom abdpain isn't discharged yet. what!!? we need to have a meeting about this.

1st, attend meeting with unit manger and social service/case management to discuss tx/discarge planning. as soon as the meeting is over, miss. ineedattention want's tea (cause breakfast comes in 15min. and that is too long to wait), and we are supposed to be customer service oriented now right?

1st, attend to pt. needs (hopefully at the same time assess them, and maybe get those orders done, its been 45min. now) tom abdpain has his call light on. go to answer it, "can i help you?". answer is, of course, "i want dilaudid right now :flmngmd:". and "pain" is now considered one of the vitals right along with hr and bp now, right? alrighty then mr. sunshinecomesouttamybuttwhenipoop, i'll get it for you right away.

1st, attend to pain issues, then other pt. needs charge nurse can't help but point out to you the "window" for passing am meds is 5min. away from being over, but oh......sorry, can't help you do anything so you can pass meds, and you will get written up if any meds are late.

1st, pass meds then attend to pain issues, then other pt. needs then..............

ah, to heck with it. n/m.

Jewl · May 9, 2011

just priotitise is all:
1st assess all your patients. wiat, hold on, meds need passed. they sent out an email saying the "window" for passing meds was being reduced.
1st, pass your meds. [gasp] i forgot, in the last employee meeting, they said all orders should be taken off the chart and put into action withni 30min. of being written, and there are five charts on the nurse server with new orders on them.
1st, initiate new orders case manager want's to know why tom abdpain isn't discharged yet. what!!? we need to have a meeting about this.
1st, attend meeting with unit manger and social service/case management to discuss tx/discarge planning. as soon as the meeting is over, miss. ineedattention want's tea (cause breakfast comes in 15min. and that is too long to wait), and we are supposed to be customer service oriented now right?
1st, attend to pt. needs (hopefully at the same time assess them, and maybe get those orders done, its been 45min. now) tom abdpain has his call light on. go to answer it, "can i help you?". answer is, of course, "i want dilaudid right now :flmngmd:". and "pain" is now considered one of the vitals right along with hr and bp now, right? alrighty then mr. sunshinecomesouttamybuttwhenipoop, i'll get it for you right away.
1st, attend to pain issues, then other pt. needs charge nurse can't help but point out to you the "window" for passing am meds is 5min. away from being over, but oh......sorry, can't help you do anything so you can pass meds, and you will get written up if any meds are late.
1st, pass meds then attend to pain issues, then other pt. needs then..............
ah, to heck with it. n/m.

dear brass monkey,

i am waking up right now, still half asleep, but i just read your post and i can't help but laugh (in a good way). yea, that sounds like a typical morning. i would love to hear more from you, feel free to write me anytime.

have a great week,

jewl

tokmom, BSN, RN · May 9, 2011

That's the thing with nursing. How you prioritize changes on an hourly basis. No day is ever the same. It's a 'fly by the seat of your pant's' for the most part.