Magazine article American Nurse Today

How to Make the Most of Your Nursing Minutes

Magazine article American Nurse Today

How to Make the Most of Your Nursing Minutes

Article excerpt

In Through the Looking-Glass, and What Alice Found There by Lewis Carroll, the Red Queen told Alice, "Now, here ... it takes all the running you can do, to keep in the same place. If you want to get somewhere else, you must run at least twice as fast as that."

With nursing growing ever more complex and demanding, perhaps you sometimes feel like Alice, who ran as fast as she could but stayed in the same place. Nursing isn't the task-oriented profession it once was. Today's nurses must think while acting, intervene in emergencies, and advocate for patients--all while educating those around them. A typical 12-hour shift can tax the organizational skills of even the most seasoned nurse.

This article helps you make the most of your nursing minutes. It discusses common barriers to effective time management and gives advice on overcoming them.

Barrier #1: The seemingly constant med pass

Some days, you may feel as if the only thing you've done is administer medications. While polypharmacy in the elderly is well-documented, nearly all patients with acute conditions receive medications as part of their care.

Having a plan is one of the most basic skills you can use to manage your time effectively. Ever wonder why the second or third day of caring for the same patients seems more organized than the first? It's because, intentionally or not, you formulated a plan. You predicted how your shift would play out based on what you knew about the patient assignment. If you plan things right, you can achieve this same level of organization on day one.

The plan for the day should start during shift change when you receive report. As your colleague explains your patients' diagnoses, behaviors, procedures, and so on, start to formulate a plan. Then jot down the plan in concrete form. For example, you might plan to develop concept maps, checklists, or a timeline in which you assign tasks to time slots. You can then insert medication administration into any of these formats, and assign it the approximate amount of time needed. Review your patients' medication records; note not only what medications they're receiving but how many and, based on past experience, how long it will take you to prepare and administer them.

As the reporting nurse outlines specific situations and tasks awaiting resolution during your upcoming shift, give those items priority and assign them potential time slots in your plan. It helps if you prioritize the most difficult and time-consuming tasks and accomplish them as early as possible. Procrastinating the tasks you dislike may cause you subconsciously to slow your pace, which affects the efficiency of your plan. Throughout the shift, revisit your plan and make changes as needed.

Make multitasking a no-no

When it comes to medications, steer clear of multitasking. Although some people claim multitasking is the hallmark of organizational skill, current research suggests this fragmented approach can impair patient safety. Instead, designate a quiet zone around the medication preparation area, and concentrate on one task at a time when preparing and administering a drug.

At the bedside, explain to the patient and family that medication administration, especially by the I.V. route, requires your concentration. Assure them you'll be happy to answer all their questions after you've finished preparing and giving the drug. With fewer interruptions, you'll be able to complete your med pass faster and more safely while saving valuable minutes. (Keep this in mind when a colleague is preparing drugs. Don't ask her about her new promotion or her Friday dinner plans while she's concentrating on preparing or giving a medication.)

Don't leave empty handed

As one of my colleagues reminds us, never leave the "kitchen" empty-handed. (As a former waitress, she knows the benefits of planning ahead before making a move.) Before leaving the medication preparation area, ask yourself, "What else will I need? …

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