I usually start by trying to make sure that I have everything I know I will need done ahead of time to make things go smoothly as possible. I'll give you the general gist of my shift this past Friday evening. I had 18/21 patients of this unit and am familiar with all of them.
2:25p: Arrive on unit. Patient wants me to call doctor to get her a pass for Sunday. Promised I'd do it the day before but I was too busy so took care of this immediately. Finished doing that by 2:30p
2:30p: Get keys from nurse I'm relieving, he's too busy to help me count so I count while he sat at the desk and it was good so I kept the keys.
2:35p: I go around to all my g-tube feeding patients and remove their old g-tubes and throw them in the soiled linen/trash room.
2:40p: Grab some folded scrap paper and a prescription refill order sheet
2:40p: I know I have 8 heparin injections I have to give on my shift so I pull them all up ahead of time and leave them in the top of the cart (Keep your cart locked when you're not by it, if state comes in the building discard the syringes immediately)
2:55p: gather alcohol pads, glucose strips, finger prickers (bleh forgot what they're called), and alcohol wipes
3:00p: Get the blood sugars for my 4pm accuchecks, record them in the MAR, and flag any insulin doses I'll have to give during my med pass.
3:20p: Run to supply room on the other side of the building where we keep our feedings. Shove 2 diabetic boosts in one pocket, 6 feeding tubes in my other pocket, have 1 Diabetasource feedings under each arms and 2 in each hand. Balance my way back to my unit.
3:25p: Place feedings on cart and look at the desk to see Admissions left me an re-admission. Yay! (ugh)
3:25p: Fill out the necessary paper work for my CNA for the admit, get my short report sheet filled out with as much info as I've been given so far so Im' ready when the nurse calls and leave it at the desk
3:40p: Label all my g-tube feedings with patients names,dates, rates prime them and hang them in each room so they're ready to be connected. 6 of them so it takes me about 20 minutes.
4:05p: Start my med pass. I finished around 5:45p which was about the time the admission came and also got 2 more accuchecks for 6pm. And I got report from the hospital she came from in between then.
6pm - 8pm: Trying to reach doctor, working on admission paperwork, assessing admit, calling the pharmacy, DCing foley, getting ABT from convience box, stopping another patients feeding at 6, giving dilantin at 7, restarting the feeding at 8pm
8pm: Start my 9pm med pass.
9:15pm: Finish 9pm med pass
9:15pm - 10:30p: Get RN to hang PICC (LPN's can't hang PICCs in IL) for a patient's ABT's, finish admits paperwork.
10:40p: Night nurse arrives to relieve me and I give report.
If you mentally run through some of the things you know you'll need to do, even if it's something thrown at you last minute you'll find your much better equipped to manage your time when you get things out of the way ahead of time. Pulling up those syringes, getting my accuchecks, and hanging all those feedings probably saved me another 30 - 40 minutes on my med pass. Not to mention the time I would have lost to work on my admission.
Good luck with your management skills. It's a process developing them but you will:)