1. Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Nursing Leadership & Management Patricia Kelly-Heidenthal 0-7668-2508-6

2. Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Chapter 18 Time Management

3. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company3 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.

4. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company4 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.

5. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company5 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.

6. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company6 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.

7. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company7 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.

8. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company8 Do First Things First  Prioritize, based on outcomes desired and resources available. First priority: a life-threatening or potentially life- threatening 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.

9. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company9 Environment  If possible, arrange the environment to provide nurses with efficient access to supplies, equipment, and patient areas.

10. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company10 Shift Report  Before making a plan for the shift, use the previous shift’s report to determine tasks and priorities.

11. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company11 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.

12. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company12 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.

13. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company13 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.

14. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company14 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?

15. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company15 Shift Time Wasters  Review shift activities to identify time wasters such as procrastination, indecisiveness, nonessential interruptions, lack of delegation, and so on.

16. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company16 Strategies to Enhance Personal Productivity  Time management applies not only to work, but also to the nurse’s 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.

17. Chapter 18Copyright © 2003 Delmar Learning, a Thomson Learning company17 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.