Too much to do and not enough time: How do you do it?

MIA-RN · Aug 14, 2007

Prioritization is how I stay ahead of the game. I start out with knowing what every one needs on a basic level (nursing assessment, scheduled meds etc.) Then I add on my sheet times for doing other stuff...reading chart, totalling I/O, signing the careplan etc. And then thruout the night, I recheck and re evaluate.

Priorities are like this:

What HAS to be done now

What has to be done in the next couple hours

What has to be done before I leave

Don't worry too much about it in terms of whether or not to pursue nursing, prioritization will be drummed in your head in school.

jjjoy, LPN · Aug 14, 2007

This is definitely something that you will come across and have to deal with in most nursing positions, so this position should give you some good preparation.

[i copied the rest of this post and started a new thread on "How do you define 'Prioritization'?" so as not to highjack the OP's thread]

https://allnurses.com/forums/f8/how-do-you-define-prioritization-242708.html#post2349919

Before nursing, "prioritization" to me meant figuring out what needs to be done first, second, and third with the assumption that the point was to get the most important things done first but that there would be enough time to get everything done eventually. However, in many situations, the reality is that the person CAN'T get everything done in the time allotted. Thus priorizing ensures that the MOST IMPORTANT things get done at all, not just that they get done before other things... because you might run out of time.

I say this because it sometimes bugs me to hear the advice "prioritize" when someone is asking to get more done. No matter how well you prioritize, there is still just as much to do and it will still take as much to do everything. Yes, you can learn to bunch certain tasks together for efficiency, but that's not prioritizing, that's being more efficient. You can learn to do certain things faster (assess a patient, hang an IV), but again that's not prioritizing, that's learning how to do things faster (which often comes with experience, which takes time to build up).

Prioritizing ensures that medications get given even if the linen change gets put off. Prioritizing ensures that the unstable patient gets assessed frequently even if another patient never gets the coffee they wanted. Of course, the nurse should make sure the linen gets changed and the patients' requests get taken care of, but not at the cost of patient safety. THAT to me is "prioritization."

In nursingspeak, however, "prioritization" and "time management" often seem to be the catch-all words for the speed and judgement that can only be gained through experience that allows for nurses to get more done than seems humanly possible if you break it down task by task.

JustJen, BSN, RN · Aug 14, 2007

Ask for help!

It may sound simplistic....but ask. I am a RN on a busy Med-Surg Unit. I don't mind asking for help when I need it. There is a trick to it, though. You have to be the person that is willing to help others when they are behind. It is the only way we make it on night shift.

Hang in there....

TheCommuter, BSN, RN · Aug 14, 2007

I work on a subacute/rehab unit at a large nursing home, and my workplace only gives nurses a 3-day orientation before they are cut loose to work on their own. Not surprisingly, the employee turnover rate is rather atrocious at the facility where I work.

Anyway, here is how I organize for the day. I work 16 hour shifts, from 6am to 10pm. Typically, I have about 15 patients to care for. At the beginning of the shift, I'll go through the MARs and TARs with a fine tooth comb and, as I go, I will jot down the things that must be done in my notebook. My notebook is how I organize the rest of the day, and I usually won't forget to do anything. Here is how Sunday's notebook page looked (names have been changed due to HIPAA):

8-12-2007

DIABETICS, FINGERSTICKS: Agnes (BID), Agatha (AC & HS), Bill (AC & HS), Wendy (AC & HS), Rex (BID), Jack (BID), Esther (AC & HS), Margie (0600, 1200, 1800, 2400)

NEBULIZERS: Margie, Esther, Bill, Jack, Jane

WOUND TREATMENTS: Jane, Bill, John, Jack, Lillian, Rose, Lucille

IV THERAPY: Wendy (Vancomycin), Laura (Flagyl), Rex (ProcAlamine)

COUMADINS: Agnes, Agatha, John, Lucille

INJECTIONS: Agnes (lovenox), Jane (arixtra), Rex (heparin), Bill (70/30 insulin), Esther (lantus), Mary (vitamin B12 shot)

ANTIBIOTICS: Wendy (wound), Laura (C-diff), Rex (pneumonia), Agatha (MRSA)

1200, 1300, 1400 meds: Margie, June, Rose, John, Jane, Jack

1600, 1700, 1800 meds: Rose, John, Rex, Lucille, Lillian, Laura

REMINDERS: assessments due on Agatha, Jill, and Louise; restock the cart; fill all holes in the MAR; follow up on Jane's recent fall, fax all labs to Dr. Smith before I leave, order a CBC on Rex...

MadisonsMomRN, BSN, RN · Aug 15, 2007

I prioritize, delegate when appropriate, and ask for help!!

EmmaG, RN · Aug 15, 2007

Hospital nursing is a team sport.

And remember, they're open 24/7

You'll get better at prioritizing and more efficient. Don't be so hard on yourself.

jjjoy, LPN · Aug 15, 2007

You'll get better at prioritizing and more efficient. Don't be so hard on yourself.

What if it's your supervisor and colleagues giving you a hard time?

EmmaG, RN · Aug 15, 2007

What if it's your supervisor and colleagues giving you a hard time?

Then they need a gentle reminder of what it was like when they were a new nurse

time4meRN · Aug 15, 2007

I'm not a nurse, but one day hope to be. I work at hospital as a support staff member and have been for several months. My job requires me to rotate to different positions within the department.
Tonight I had a position that I'm having a hard time with. There's just so much to do and not enough time. Honestly, I'm going non-stop from the time I get there until I leave-- I arrive 15 min early, don't take a break, and am still on the clock 45 min after when I should have left. The amount of work could easily keep someone busy, nonstop, for 6 hours, yet I'm suppose to accomplish this in 4 hours.
Tonight I spoke with my supervisor. I let them know that there are just too many tasks to get done get done and still be on-time and having done everything at an acceptable quality. The supervisor didn't agree with me. I was told next time to let them know an hour before the end of my shift where I'm at with my duties and they will summons help from the other workers in the department. As if the other workers weren't busy enough with their work. Now someone is going to have to drop what their doing to help me out and then themselves will be punching out late.
Anyhow, how do you all deal with getting everything done? I know nursing is a busy job and since I want to be a nurse I'm seconding guessing myself because of what is going on. Am I overreacting, is this just a personal problem, or do you all deal with this at some level?
Thanks for listening (reading).

Please don't give up on your nursing dreams because of this. Yes nursing is bust butt busy, but you will learn to deal with it, like many have said here , priorities are set and short cuts are learned to help. Hang in there. Nursing isn't the only busy jobs, somtimes I stand at a fast food resturaunt and think, " I wouldn't want to work like these people and get paid what they do , or for that matter be treated like they are from management".