Arrive early: Even giving yourself an extra five to 10 minutes will give you a chance to settle and take stock of the vibe on the ward for the shift. If you have more time you may be able to read through any messages, look at where you’ve been allocated and organise any tasks beforehand to prepare for your plan of care.
Keep notes: Write things down if it works for you. However or whatever form you use to write down your patients and/or activities for the shift will help guide your shift and see what needs to be done when. Some people like to write all their patients’ names down along with specific care required for each patient and when. This could include ambulatory and dietary requirements or specific patient needs or requests.
Prioritise: Use your own formula – whether you tick or allocate tasks to certain times or asterisk or highlight those activities that must be completed during the shift or at specific times, ie. a wound dressing, IV antibiotics, pre-op for surgery.
Identify the most urgent and important tasks and aim to do those first in case of any unexpected eventualities.
Factor in the unexpected: Be flexible. Sudden deteriorations, deaths, admissions – the unpredictability of nursing requires adaptability and flexibility. Allow time for the unexpected – doctors’ making rounds, relatives making inquiries, a staff member going off ill.
Be organised: Try to keep your work area or cubicles tidy; try to put equipment away after use or back in its proper place. You can’t manage your time well if you’re wasting time looking for things. It will help you to feel in control of your space and help to avoid hazards. Keep to your schedule where possible. Experience also enables nurses to anticipate their needs and save time in unnecessary trips back and forth to get equipment, for example to set up for a procedure.
Be efficient and get things right: Don’t take shortcuts and don’t guess. If you need to take an extra couple of minutes to double-check patient notes, or something you are unsure of, do it. The consequences of an adverse event may be more than extra time.
Likewise when writing notes or handing over be concise and detailed but avoid waffle or gossip. Knowing what to include and what can be left out takes practice.
Learn how to delegate: If you’re working in pairs or a team with healthcare workers or students, allocate tasks appropriate to skill level that will allow you to complete what you need to whilst also supervising. Make sure you delegate the right task to the right person. Keep communication channels open so that if for example clinical observations are performed that any irregularities are reported back to you or you check when the task has been completed or fluid balance charts are up to date.
Learn to say ‘no’: Some things have to wait. If you have the escorts waiting to take someone for a procedure and a colleague is asking to check a DD. If you know it’s not urgent, learn to say no and not feel bad. Avoid tasks that are not on your list unless they have become a priority or it’s a specific patient request or need.
Take a breath: Sometimes taking a few minutes out to reassess where you’re at and to prioritise what needs to be done next is the best thing you can do. You can’t think clearly in the midst of a muddle. Step into the treatment room and recollect your thoughts and focus on what needs to be done next and for the rest of the shift.
No matter how busy the shift is, go to the toilet and take your meal breaks. You need fuel to recharge and complete your shift effectively.
Be easy on yourself: No one likes handing over work they could have done. There will always be work left unfinished in nursing – and whether you’ve prioritised as best you can often be subjective. The emotional support you provided to a patient may have been more important than the daily wound dressing you didn’t get to. Tasks are important but remember your patient’s needs and that it’s ok to be an advocate for yourself as well as your patient.
Time management takes practice. Reflect on what worked well and what didn’t at the end of your shift and why. Sometimes things are beyond your control however you might identify areas for improvement and how you can go about it.
This article was originally published on The Australian Nursing and Midwifery Journal on https://anmj.org.au/ on 1/8/19 by Natalie Dragon.