Time management is something I feel all new (and even some experienced) nurses struggle with! It can make or break your shift, especially when you seem to be walking into chaos before you’ve even clocked in. In this post, I’ll walk you through some of my best advice and tips for staying on top of all your job’s demands throughout a shift.
In my opinion, time management starts the moment you wake up for the day (or night 😅). Waking up late can send your shift into a downward spiral before it’s even begun. I find that if I feel rushed first thing after waking up, the rest of my shift feels rushed and that anxiety stays with me. I like to give myself enough time to fully wake up, get ready, pack my *lunch*, make something to eat, and fight traffic. Once I get to work and park, I like to set aside at least 5 minutes to relax and list to a song that pumps me up. Then I head up to my unit and gather all the things I’ll need for my shift.
The next steps in time management occur while getting bedside change of shift report from the nurse who’s going off duty. Perform a rapid assessment (ABCs) during report to prioritize which patient to see and fully assess first. Once your patients are assessed, determine if there are any immediate interventions that need to be completed because they can’t wait. Examples of such interventions include safety precautions, time sensitive medications like heart meds and antibiotics, troubleshooting ABCs, etc. Preferably, these should be completed while in the patient’s room during assessment.
Also, during report, you should get in the habit of asking the nurse about items that are pending for the patient. This can include procedures, diagnostic tests, test/lab results, electrolyte replacements, etc. You should always be reviewing the patient’s lab results with the nurse going off duty prior to assuming care of the patient. If morning electrolytes were out of range enough to require replacement, and you’re a night shift nurse, there no reason they should still be un-replaced when you come on shift. Of course you’ll replace them if they haven’t been, but the other nurse should receive education about this duty because this can put your patient at risk for dysrhythmias and other complications.
After report, I usually take time to review each of my patient’s EMARs to jot down the names and times of all medications due on my shift. You should also take a moment to review your orders for any pending tests/labs. These aspects give the best indicator of what you need to do and when it needs to be done. On this note, it’s important to know the typical times that different healthcare professionals are on your unit so you can avoid performing heavy patient care tasks at these times. Some examples to consider are morning lab draws, physician rounding, x-ray technicians, physical therapists, etc. Being conscientious of these professionals and the tasks they complete makes your shift less hectic and also respects their position by not inconveniencing them. Believe me, it will only benefit you to be on the good side of these other healthcare professionals.
I know everyone says this, but I also say it because it is THAT true… cluster your care. This is a practice of utmost importance, especially for those professionals taking care of COVID patients. Make sure you bring all items and medications with you if possible. This means ask the patient about pain, nausea/vomiting, and assess BG/temperature prior to gathering supplies. This helps you better understand what you need to collect and bring with you. Have trouble remembering? Keep a list in your pocket! If possible, try to combine med time, bed baths, linen changes, and bathroom breaks all in the same trip or at least multiple per trip. Doing so also makes sure to limit interruptions for the client, which is especially appreciated at night.
I’m always a huge advocate that charting comes secondary to patient care and medication administration. With that being said, it still needs to be done ASAP. The longer you wait to chart your assessment data, the more difficult it can be to remember details accurately, especially if you have multiple patients, a busy shift, and/or a patient who has MRT’d or coded. However, you need to find out what method works best for you. Do you assess everyone and chart all at once? Or do you assess one patient and chart as you go? You’ll learn quickly how much you can handle at a time and what method allows you to best cover your license. I like to keep a paper folded in my pocket for jotting notes about each patient along with a description and time of events that occur. You can always check out the format I use because it’s online in our Etsy shop at: https://etsy.me/373UnsL
If you’re lucky enough to have a CNA or patient care tech (PCT), delegate tasks to them and utilize their assistance. But please, don’t abuse them. Worried about a task being completed correctly? Do it once with them by walking them through it as they perform the task. If you’re comfortable with their competency and the task is within their scope of practice, allow them to help. This allows them to work to the fullest extent of their job description and scope of practice while also allowing you to do the same. ALWAYS follow up with them after a task is done, because ultimately it is still YOUR responsibility and license at risk.
Finally, learn and know where and who your best resources are! When you get in a bind, don’t guess, fake it until you make it, or avoid the situation altogether. Use the resources available to your advantage to enhance your nursing practice and clinical judgment. Example of some great resources to use while at work include more experienced RNs, the charge RN, clinical educators, physicians (don’t contact unless all other resources have been exhausted), field experts (RTs, phlebotomists, XR, dialysis nurses), unit director, databases, and clinical pharmacology (for assessing compatibilities and more).
I truly hope this article gives you inside as to how to manage time for efficiently and effectively. If there’s a major point I missed, leave me a comment below! I’d love to hear what you have to say 🤩