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
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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
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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
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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
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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
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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
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Estimate how much time an activity will consume.
Schedule times for activities.
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Environment
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If possible, arrange the environment to provide nurses
with efficient access to supplies, equipment, and
patient areas.
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Shift Report
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Before making a plan for the shift, use the previous
shift’s report to determine tasks and priorities.
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Formulate and Write the Shift Action
Plan
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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
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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
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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.
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Scheduling treatments and monitoring
• firm up the times for treatments and monitoring.
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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
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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
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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
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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.
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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
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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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