Nursing Leadership & Management

Patricia Kelly-Heidenthal 0-7668-2508-6

Delmar Learning
Copyright 2003 Delmar Learning, a Thomson Learning company

Chapter 18
Time Management

Delmar Learning
Copyright 2003 Delmar Learning, a Thomson Learning company

Objectives

Upon completion of this chapter, the reader should be able to:

Discuss general time management techniques. Describe strategies to plan effective use of time. Apply time management strategies to the reality of delivering effective nursing care. Apply time management strategies to enhance personal productivity.

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Achieving More with General Time Management Techniques

Time management allows the nurse to prioritize care, decide on outcomes, and perform the most important interventions first. Time management has been defined as "a set of related commonsense skills that helps you use your time in the most effective and productive way possible. Time management requires a shift from being busy to getting things done, a shift from process to outcome.
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Shift to an Outcome Orientation

Time management strategy requires a shift to an outcome orientation, not a task orientation. Determine long-term goals, then break them down into achievable outcomes that are the steps toward those goals. Long-term goals and outcomes should be written down. Goals and outcomes should be flexible and adaptable, as situations may change.
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Analyzing and Planning Use of Time

Analyze how time is currently used. Understand the value of nursing time. Consider that much of nursing time is spent performing tasks that can be conducted by nonnursing personnel. Use an activity log to record time use.

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Strategies to Plan Effective Use of Time

Understand the big picture, i.e., your time in relation to the needs of other workers. Decide on desired outcomes, separating them into optimal and reasonable outcomes. Optimal outcomes are the best possible objectives to be achieved given the resources at hand. Reasonable outcomes are objectives that can and should be achieved given less than optimal circumstances and limited resources.
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Do First Things First

Prioritize, based on outcomes desired and resources available.

First priority: a life-threatening or potentially lifethreatening occurrence Second priority: activities essential to safety Third priority: activities essential to the plan of care

Estimate how much time an activity will consume. Schedule times for activities.
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Environment

If possible, arrange the environment to provide nurses with efficient access to supplies, equipment, and patient areas.

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Shift Report

Before making a plan for the shift, use the previous shifts report to determine tasks and priorities.

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Formulate and Write the Shift Action Plan

The shift action plan is a written plan based on a shift assessment that includes a global perspective and sets the priorities for the accomplishment of outcomes that are both optimal and reasonable. Making assignments
the shift action plan should state who will perform the intervention. Assignments should be part of the planning process and should include delegation of nonnursing tasks to others, with specific reporting guidelines and deadlines for accomplishment of the tasks.
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Formulate and Write the Shift Action Plan

Timing the actions

The shift action plan should state by what time an intervention should be completed. If the time is flexible, that should be noted.

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Implement the Plan

The implementation of the shift action plan begins with the initial patient care rounds unless the nurse has participated in walking rounds. Making patient care rounds
the rapid assessment information that you gather on rounds may change your plan.

Scheduling treatments and monitoring

firm up the times for treatments and monitoring.

Planning for equipment and supply availability

make sure that nurses have appropriate equipment and supplies, so they do not waste time making multiple trips.
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Evaluation of Outcome Achievement

At the end of the shift, reexamine the shift action plan.

Did you achieve the optimal outcomes? If not, why not? Were there staffing problems or patient crises? Did you achieve the realistic outcomes? If not, why not? Were the activities necessary for outcome achievement carried out? If not, why not? What did you learn from this for future shifts?

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Shift Time Wasters

Review shift activities to identify time wasters such as procrastination, indecisiveness, nonessential interruptions, lack of delegation, and so on.

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Strategies to Enhance Personal Productivity

Time management applies not only to work, but also to the nurses personal life. Analyzing personal time
Use an activity log to document eating, resting, and socialization patterns.

Creating more personal time

Delegate activities. Eliminate chores or tasks that add no value. Get up earlier.
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Finding Personal Time for Reading, Writing, and Enjoying

Minimize time wasted waiting, or use waiting times for activities. Use traveling time for activities. Control unwanted distractions.
Use answering machine to avoid phone distractions. Do not accept unwanted or unproductive tasks. Assert need for personal time when others intrude.

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