I am very rarely behind. I work in the ER most often and I dont really talk to my patients, I get in and get out. I dont ask about their day, chat about kids ect. Give meds, assess, vitals and leave the room. This saves me a lot of time.
I also cluster care. I'm not going into the room 6 times. I am sure to ask if they need anything before I go get meds for them for example. This way I can give them their blanket, give meds, and then leave. Eliminates running back and forth.
I use my downtime to help the other nurses around me. If they don't need me then I sit at the nurses' station and eat saltines LOL