Ideas for Effective Time Management at Work/Juggling Tasks

alilar · Mar 16, 2010

I first introduce myself to all my patients while checking on their individual needs. Next I do my chart checks hopefully without interruptions since I have addressed and assisted all my patients. Then I start to make my assessment rounds with meds and chart as I go. This is how it is suppose to go as we all know things change quickly in nursing, but if all goes well I am finished with all this by 2130 at the latest. Now it should be mentioned that I work on a cardiac intervention floor and most of our patients are walkie talkie. :yeah:

sistasoul · Mar 16, 2010

How can people chart right after an assessment and meds? There are so many things pulling at your time. No time to chart most days until after shift is over. I would like some suggestions also.

monicanurse · Mar 16, 2010

I have the same problem as the above thread. I find that I can do assessments and meds ( meds sometimes takes me almost 3 hours with all the interruptions in between) that I dont have time for charting until close to 1 pm. Then I get pulled away by a patient needing pain meds, ...ect...ect...Sometimes I stay 1.5 to 2 hours past my time at work just to finish all this paperwork.

cherrybreeze, ADN, RN · Mar 16, 2010

I find that charting as I go, when possible, makes things much easier. We have stations outside the patient rooms where they PCR's are kept, so when I finish an assessment in that room, I step outside the door and quick chart it. I try to chart meds every few hours, too. Now, no, this isn't always possible. Some days are like that. I used to wait and sit and chart all of my assessments at the same time (especially when I worked nights), and found that I didn't have time to do that until the end of the shift, and then it snowballed. It gets easier to "chart as you go" the more you do it. I used to think it wasn't possible, either.

I am also VERY particular about my shift sheet and how I organize my paperwork. I still get comments on how organized my sheet is. :) I can tell instantly what has been done and not done, and what's been charted on. I keep a separate short list of the different things that require computer charting, too (IV site observations, ADL's, foleys) and the simple routine tasks (checking off orders and updating profiles). If I have few minutes, I'll get on the computer and quick chart all of my IV site observations. Then I can cross them all off and know they're all done for the night.

barlowjb · Mar 16, 2010

I literally force myself to chart (99% of the time) right after each patient unless there is a definite emergency that I have to attend to right away. As a matter of fact, I go into each pt's room with their medications, my computer and my assessment screen ready to chart as I chat with them. Most of the time, my assessment is charted before I even exit the pt's room. That helped me the other day, because we towards the end of the shift we had downtime and our computers were not working. I had already charted on all 5 of my patients so I did not have to do any backup paper charting. Unfortunately the other nurses who had not been charting right away were scrambling to do paper charting.

It can be difficult when you feel pulled in ten different directions, but you have to practice prioritizing. Many times pts will ask to speak to the nurse and when you leave what you are doing to attend to them you may get questions/comments such as: when are my meds due?; can i get a cup of water? its my bed time I need to get back to bed etc. So you have to figure out is it important for me to do all that stuff or finish what you are doing first.

After you assess one pt for example if you feel pressured to go see another pt, go see that pt to see what's going on, and if its nothing that requires your immediate attention, go outside the pt's room and finish your charting for the previous pt. etc. It truly comes with practice.

Another thing you could do is do the most difficult or stressful or time consuming tasks first. For example, if you go to work and you are given 5 patients right off the bat and one of them needs IV access in order to get well needed fluids, do that first, then any dressing changes etc., so that after that you will only be left with assessing pts and passing meds.

I do 8 hr shifts, but sometimes I am floated to another floor after 4 hrs, therefore I treat my work time as two 4 hour shifts, and approach it as if I have to finish one shift before starting another.

If you go into work and have only three pts for example, work quickly to complete assessments and med passes, because more likely than not, you may end up with 2-3 new admits.

Try not to procrastinate, if you need to call the Dr. about something, just do it and get it over and done with.

One last very important thing is practice delegating responsibilities to the CNAs if there are any working on your floor, that will free up your time to complete other tasks.

Its not easy, but it can be done. I am only 5 months on the job and I had to learn all these things very fast. If you don't chart as you go, it will become too overwhelming.

Best Wishes

meadow85 · Mar 16, 2010

I try to prioritize at the beginning of my shift, delegate tasks and accept help where I can get it (i.e. family members, volunteers). I like to get all my work done and then chart at the end of the day which often means I go home late, but charting is SO important. Or if its a particularly slow day I will chart as things come up. Computer charting that is. Now with paper charting you have to find the time to sit and chart as things are happening unless there is an emergency then you can always go back and make a late entry.

Dorito, ASN, RN · Mar 16, 2010

Here's a few tips that I present on a course to new nursing staff on Time Mangement:

Cross off tasks completed

Delegate tasks

Do not accept assignments that you cannot complete

Control interruptions (yeah right)

Avoid perfection

Identify tasks, obligations, & activities

Write them down

Identify which need to be completed in a specific time- Prioritize according to importance

Work on most important first

Obviously these dont all work all the time. At the start of the shift write the tasks that you would like completed under one of 3 categories: "Must Do", "Should Do", & "Nice to Do". Hope this helps. Time management is one of the hardest things to balance and it takes time.

monicanurse · Mar 16, 2010

Many of you say to delegate....unfortunately, I work on a floor where we have one nursing assistant on the floor for 30 something patients....Everyone is stressed. Even the charge nurse ( who doesnt take patients but takes care of all the orders) is swamped sometimes. She has helped with IV sticks , which I am not so great at. In the hospital where I work, we have no IV team, we often have to transport our patients outside when they get discharged, we sometimes have to do accuchecks, give baths...depeding on whether we have an NA for the weekends ( sometimes we dont). IT is literally impossible for me to do all this tasks.....That is why I thought maybe some of you have innovative ways of accomplishing things. THanks for all the advice. All I can do is my best.

onetiredmomma · Mar 17, 2010

After walking rounds, where we are introduced to our pts, I look at labs, check MARS and try to plan my day. If anyone asks for pain meds and it is close to 8am, they are gonna get pain meds, 8 and 9am meds and an assessment all at once. If someone has gone back to sleep, I put them at the end of the list for meds and assessments. Sometimes I chart as I go, other times I just can't. Don't over chart. If you do a check list type charting that covers everything, don't add a note that repeats what the flow sheet says. I do try to always have my "morning" charting don before I go to lunch but sometimes even that doesn't happen. That said, I do go to lunch. I need to get away and regroup especially on really busy days. I find I think better when I come back from eating. Ask your coworkers for suggestions since they might see what you are doing that can be changed. I learned not to do daily dressing changes too early in the shift cause the doc always seemed to come in and want to look at the wound..."you need a new dressing in there" (grr) Time management is hard to teach, but you will get there. Good luck!

iluvnoodles · Mar 17, 2010

is there anyway you can post a link to your organized sheet? i'm a new nurse and i made my own sheet, but i would like to see how yours is if you don't mind.

tcvnurse, BSN, RN · Jan 2, 2014

When I worked the acute care floors, I would do a quick assessment on all patients, give AM meds and then chart them. When I moved to step-down, I did my assessment and the charted it immediately. I continue to do that to this day.

Oh and I give all me meds 8,9, and 10's at the same time--9am. ***Caveat--Be cautious about giving ALL the cardiac drugs at once.

I feel like time management is partly about having a good memory. I used to forget which patient needed what i.e.--rm 8 needed pain pills, rm 10 needed pottying, rm 7 wanted to talk to MD, etc etc. I keep a blank piece of paper on top of my clipboard (it's good for HIPPA too!) and I keep a running to do list.

Here's the thing. You will find at some point in your career, heck maybe tomorrow-- that you have so much to do you can't decide what to do FIRST. IF nobody is about to die (and I am serious about that) then just pick something and do it. Cross it off the list and do the next thing. Cross it off--and so on and so forth. Just keep moving. It really does get better.