Time management

[Serotonin2]

I work as a triage nurse in a clinic once a week. I started this position about 6 mo ago and have been triaging on my own for the last 3 months. As viral season has picked up, I am getting out later and later. My supervisor spoke with me and said that the doctors and my coworkers are stating that I am "too thorough" and finish late because of this. I feel frustrated because I have been told that I struggle with OCD, perfectionism, or being slow since I was a young child, bybtrachers and peers in school and at any job including my nursing jobs that I have held. I can see that I am slower than others but I do not know how to fix it.  Trying to "be fast" has lead to errors in the past. I know my thought process and workflow must be different than others but I do not know what the difference is. I know the problem exists but I can not see clearly enough to fix it. I want to change but do not know how. The anxiety about losing my job only worsens the situation. 

[DavidFR, BSN, MSN, RN]

Is this really the job for you? 

Could you think about a less pressured area? Doing triage all the time is I imagine, very high maintenance. You've been there 9 months. Can you stick it out for at least a year - not long to go. That's a respectable length of time to say, great experience, time to move on thank you.

Have you talked through your perfectionism issues with a therapist?

[FolksBtrippin, BSN, RN]

 "Too thorough" does not help you improve or give you any real information  at all. 

"Too slow" is something you could work on, if it's truly the problem.  Is that the problem?

You can always get better at something if you understand and agree as to what the problem is, especially as a perfectionist. If you don't agree as to the nature of the problem, you can't get better. 
 

So, what do you think is your real issue? What makes you leave late? Is it  the charting? The amount of time you spend on the phone with patients? What do your coworkers and docs say is more detailed than it needs to be, aka "too thorough"? 
If you feel that the job is impossible to do faster, then leaving is a good option. If you agree that you could do it faster by learning what to edit out of your process then staying and figuring this out would be in your best interest. Let us know what you think. We may have tips for speeding it up, if you agree that you need to speed up.

[Nurse Meg, BSN, RN]

Hi, I commend you for taking the time to reflect on your own actions after receiving this feedback. However,  were you provided with specific, measurable goals to help improve your performance ? In my experience as a Nurse Manager in a busy clinic, where we also had triage, timing is important but accuracy is just as crucial.    

Nursing, as we all know, is a team sport, and triage requires ongoing communication with providers. I would usually work with the providers (or other clinical staff) to pinpoint the most critical information needed for common symptoms or issues that came through triage. From there,  meet with staff to discuss their comfort level with gathering patient history, vitals, exams, and exercising clinical judgment in those moments, ensuring everyone was on the same page with expectations. 

My advice would be to have a candid conversation with your supervisor. Let them know you're eager to improve and learn, but you need more specific guidance. Being told you're "too thorough" is vague and doesn't offer clear direction. I'd recommend asking them to help you develop SMART (Specific, Measurable, Achievable, Relevant, Time-bound) goals to better focus your efforts and give you tangible steps for improvement.  Also - be sure to follow up your meeting by email (get documentation of your conversation).

You're clearly dedicated to doing your job well, and I hope your supervisor will support you to improve.  If they do not agree to work with you on this, then I would NOT stick around much longer.

Best of luck !

 

[JKL33]

Quote

My supervisor spoke with me and said that the doctors and my coworkers are stating that I am "too thorough" and finish late because of this.

This is interesting because, well, being "too thorough" is a thing. There's a time and place (or situation) for it, and there are times that it is a hindrance/can be inappropriate.  On the other hand, thorough people are why things get recorded properly, metrics get met, rooms are stocked, providers have accurate med lists to work with and many, many other things that otherwise don't get done when everyone is perpetually in get-'er-done mode. It wouldn't surprise me one bit to find out that some of the people complaining about your work are some of the same who do med reconciliation by stating, "any changes to your med list" or don't even ask at all. Or those who get minimal information when triaging on phones so the message has to go back and forth 3 times before it can be answered by provider. So being thorough certainly it isn't all bad.

All that to say, I strongly agree with the poster above me. They need to get more specific. The supervisor who brought these concerns to you needs to provide examples and then give direction on what can be omitted or done more efficiently. It might be simple things, for example if the whole place is inundated with influenza patients and respiratory illness, that isn't the time to note that someone hasn't had GAD-7 screening yet this year. It isn't the time for you to listen to a 10 minute story about how their back has hurt since 1982 and they'd like that looked at while they're here.

I hope you are provided with more useful feedback from your supervisor.

 

[Nurse Beth, MSN]

Trying to change your performance (speeding up) will likely frustrate you immensely. You are battling your nature and the way you are wired.

Therapy and a better job fit for you are key.

Some employers might disregard your pace due to your overall performance, while others may not be so forgiving. If you believe your position is in jeopardy, it's wise to begin searching for a new job.

A better fit may be a different environment, such as surgery, hospice, pre-admission, quality, informatics, and case review.

[lmichelle25, BSN, RN]

My coworkers say I have OCD too. I've never seen anyone to get a diagnosis, but had suspicions a long time ago that I might have it.
My last position was so chaotic and fast paced and my old coworkers were out on time and would talk about how they don't do the required charting or tasks they thought were a waste of time. And then there I was feeling like I was drowning because my brain won't let me casually not chart something I've been told is required, or not do something that I feel is my responsibility. So I was missing lunch and leaving late 75% of the time. Thankfully, I was never punished or made to feel inadequate because of this (I felt inadequate enough on my own). Looking back, I'm glad I'm thorough because I was able to recognize early signs of deterioration or changes that the less observant nurses might have missed. And the fact that I charted any changes and the communications with the doctors, (even when they were rounding I would put a note in if I thought it was even slightly important) is one of the reasons I have good outcomes, haven't lost a patient (thankfully called rapids early enough), and have never been written up or accused of giving bad care. 
Sorry this is so long,  but I just want you to know I've literally been through the same thing. I transferred to acute inpatient rehab, which is amazing for my mental health. My "quirks" that I thought made me a subpar, slow nurse are actually seen as good qualities and I'm consistently getting positive feedback from my managers. 
You might also need a change so that your skills can shine. You sound like you'd be great in ICU or somewhere you can focus on the things you need to do instead of feeling rushed and then reprimanded.