Time management suggestions

nurseprnRN, BSN, RN · Mar 13, 2014

Go to the top of the page to the Search box and type in, "Esme brains." You'll find a plethora (!) of useful resources and one or more is bound to look useful to you.

allnurses Guide · Mar 13, 2014

Brain sheet and learning to delegate to the CNAs - top two keys to time mgmt

dudette10, MSN, RN · Mar 13, 2014

Something you already know: You will be pulled in many different directions, the key is knowing what is a priority and what is not.

You must develop a brain sheet. Everyone's will be different, but you must have one. Even experienced nurses get a pained look on their faces when they've misplaced it, or (Horror of Horrors) accidently dropped it into the privacy shredder! Tip: if you are working multiple days in a row, don't throw out your brain sheet at the end of the day. Use it for your next days assignment because you may have the same patients.

Set eyes on every patient at the beginning of your shift with the offgoing nurse in tow. Takes five minutes. Address distress situations with the offgoing nurse who has had the patient for 8 or 12 hours because you can't be expected to address these issues effectively when you've had the patient for all of 5 minutes! If patients request something (water, another blanket, etc.) tell them you will bring it after report (usually stated like, "...after I get information on all my patients from the nurses going home.") I know, I know, not patient-centered according to management, but really...screw 'em. Setting patient expectations goes a long way in avoiding dissatisfaction, even if you aren't jumping to the request immediately.

If family wants to talk to you in person or over the phone, but you are in the middle of prepping for a, let's say, dressing change or Foley insertion or hanging a new antibiotic that was just ordered on someone with no IVF running, tell them you will be happy to talk to them in x number of minutes. Then KEEP your promise. Why is this better than dropping everything to talk to them right then? First, you are able to complete the priority task and get it off your mind. Second, you will be more relaxed and engaged when you do talk to the family, thereby eliminating their initial irritation at having to wait.

If you are elbow deep in poo in a CDiff room, do not answer your phone or get anxious about it. Finish your task. If it's important, they'll call back. The most important thing about choosing to not answer the phone is if you have the rep for ALWAYS answering your phone. I do have that rep, and if someone can't reach me, the assumption is always that I'm in the middle of a procedure or my phone isn't working! Managers, unit secretaries, charges, and other nurses have the backs of nurses that always answer their phones, and they've helped us out by taking messages or addressing concerns that don't require the assigned nurse. If you don't answer your phone consistently, people get ticked when they can't reach you, assume the worst, and just keep bouncing the calls back to your phone or track you down to answer it.

You must multi-task when it is safe to do so. Make necessary calls and chart at the same time. The ideal is chart as you go, but if you can't, CARVE OUT time after first assessment and med pass to chart, if even on just one patient. No rule says that you have to get all your charting done in one sitting...because you won't most days!

When gathering supplies for a procedure, mentally walk through the procedure and gather everything. Even better, during your first assessment, survey the room, check line and PIV dates, etc., then grab everything on your first med pass, even if you aren't going to do the tasks at that time. At least the supplies will be in the room when you are ready. As for sharps and and some flushes that I've counted out (like CVL blood draws) and wound meds that shouldn't be at the bedside, I put them in a Baggie and drop them into the patient specific bin when I pull first meds of the day.

Do not skip chart reviews! As you get better at time management, with the computer system, and at nursing in general, you'll know where to go in the chart and which notes you must read. Sometimes it will save you time! Example: was given report that a patient's discharge home was concerning and that the MD and SW needed to be involved. Before making calls, I dug into the chart and found that the concern passed on to me was no longer a concern (I'm purposely leaving out details). Saved me a bunch of time, and most likely saved a confrontation with an irritated MD and SW.

Another time saver: if your assessment reveals something not given to you in report, skim MD notes prior to making a call. See if they are already aware and what is being done. If they are, and the condition is improving with medical and nursing interventions, you don't need to call. If it is getting worse, even with the current medical interventions you've reviewed, mention to the MD that you know she knows, but there is continued deterioration. Expect new orders from the conversation and work that into your priorities.

Thats all I can think of for now. :)

swansonplace · Mar 13, 2014

Thank you for the info. Such a great help. :)

swansonplace · Mar 13, 2014

Thank You.

swansonplace · Mar 13, 2014

Something you already know: You will be pulled in many different directions, the key is knowing what is a priority and what is not.
You must develop a brain sheet. Everyone's will be different, but you must have one. Even experienced nurses get a pained look on their faces when they've misplaced it, or (Horror of Horrors) accidently dropped it into the privacy shredder! Tip: if you are working multiple days in a row, don't throw out your brain sheet at the end of the day. Use it for your next days assignment because you may have the same patients.
Set eyes on every patient at the beginning of your shift with the offgoing nurse in tow. Takes five minutes. Address distress situations with the offgoing nurse who has had the patient for 8 or 12 hours because you can't be expected to address these issues effectively when you've had the patient for all of 5 minutes! If patients request something (water, another blanket, etc.) tell them you will bring it after report (usually stated like, "...after I get information on all my patients from the nurses going home.") I know, I know, not patient-centered according to management, but really...screw 'em. Setting patient expectations goes a long way in avoiding dissatisfaction, even if you aren't jumping to the request immediately.
If family wants to talk to you in person or over the phone, but you are in the middle of prepping for a, let's say, dressing change or Foley insertion or hanging a new antibiotic that was just ordered on someone with no IVF running, tell them you will be happy to talk to them in x number of minutes. Then KEEP your promise. Why is this better than dropping everything to talk to them right then? First, you are able to complete the priority task and get it off your mind. Second, you will be more relaxed and engaged when you do talk to the family, thereby eliminating their initial irritation at having to wait.
If you are elbow deep in poo in a CDiff room, do not answer your phone or get anxious about it. Finish your task. If it's important, they'll call back. The most important thing about choosing to not answer the phone is if you have the rep for ALWAYS answering your phone. I do have that rep, and if someone can't reach me, the assumption is always that I'm in the middle of a procedure or my phone isn't working! Managers, unit secretaries, charges, and other nurses have the backs of nurses that always answer their phones, and they've helped us out by taking messages or addressing concerns that don't require the assigned nurse. If you don't answer your phone consistently, people get ticked when they can't reach you, assume the worst, and just keep bouncing the calls back to your phone or track you down to answer it.
You must multi-task when it is safe to do so. Make necessary calls and chart at the same time. The ideal is chart as you go, but if you can't, CARVE OUT time after first assessment and med pass to chart, if even on just one patient. No rule says that you have to get all your charting done in one sitting...because you won't most days!
When gathering supplies for a procedure, mentally walk through the procedure and gather everything. Even better, during your first assessment, survey the room, check line and PIV dates, etc., then grab everything on your first med pass, even if you aren't going to do the tasks at that time. At least the supplies will be in the room when you are ready. As for sharps and and some flushes that I've counted out (like CVL blood draws) and wound meds that shouldn't be at the bedside, I put them in a Baggie and drop them into the patient specific bin when I pull first meds of the day.
Do not skip chart reviews! As you get better at time management, with the computer system, and at nursing in general, you'll know where to go in the chart and which notes you must read. Sometimes it will save you time! Example: was given report that a patient's discharge home was concerning and that the MD and SW needed to be involved. Before making calls, I dug into the chart and found that the concern passed on to me was no longer a concern (I'm purposely leaving out details). Saved me a bunch of time, and most likely saved a confrontation with an irritated MD and SW.
Another time saver: if your assessment reveals something not given to you in report, skim MD notes prior to making a call. See if they are already aware and what is being done. If they are, and the condition is improving with medical and nursing interventions, you don't need to call. If it is getting worse, even with the current medical interventions you've reviewed, mention to the MD that you know she knows, but there is continued deterioration. Expect new orders from the conversation and work that into your priorities.
Thats all I can think of for now. :)

Thank you.