Why is time management so important in the clinical setting?

With a busy schedule, it’s important to make the most of your time during the working day. Abi Rimmer talks to four experts about how to do this successfully

Laura-Jane Smith, consultant in respiratory and internal medicine at King’s College London, says, “In the clinical environment it may feel like you have little control over your time but there are things you can do. Successful prioritisation is a skill that you can develop, and batching related tasks can also help. If you need to concentrate, mute your phone and ask a colleague to hold your bleep. If you’re always leaving late, tracking your time using a diary or an app like Clockify can help you understand how you could work smarter.

“For career progression, identify what you most want to achieve and write it down. You don’t need grand aims—just set goals that are meaningful to you and be realistic about what steps are needed to achieve them. Give yourself deadlines and discuss progress with a mentor or supervisor.

“If you feel unable to manage your time, take a critical look at whether the problem is you or your environment. Colleagues or family may be asking too much of you and you may need to say no. Sometimes telling someone about your other commitments is enough. Sometimes you need to be more direct. If your boss keeps asking for more, ask which existing tasks can be deferred, in order to prioritise the new.

“Most importantly, take time for yourself. Decision fatigue has potentially serious consequences. Walk the outside route between wards to get some fresh air. Make plans outside work and keep them. Commit to spending time on things that bring you professional satisfaction and personal joy. Self care is not a luxury, it’s a responsibility.”

Trevor Bibic, learning and development consultant at Brightbloom Training, says, “Start with the basics.

“Get it out of your head—trying to juggle everything you need to do in your head will overwhelm your brain’s ability to process information, make decisions, and be creative. Whatever the source, capture the things you need to do, both personal and professional, in a system you trust.

“Prioritise prioritising—do you regularly dedicate time to prioritising for the day, week, or month ahead before you accumulate more actions? Time is one of your most precious resources. You have to choose what you will and won’t do or risk being driven by the actions that are shouting the loudest at the time.

“Automate or delegate—what tasks can you create an autopilot for? For example, paying bills by direct debit, getting a cleaner, or setting rules in your inbox to help your emails sort themselves. These actions then become something you only have to consciously interact with once in a while.

“Identify manageable actions—when you are feeling overwhelmed or something seems too challenging, identify the smallest possible next action that you feel you can do and do it. Then the next and so on. This helps create momentum.

“Email is not your to-do list—if the email contains an action then put the action in your system and don’t rely on revisiting it in your inbox.

“Finally, treat this as a learning experience, be forgiving when things don’t work, and celebrate the wins.”

Ellie Mein, medico-legal adviser at the Medical Defence Union, says, “Although time management can’t increase the hours in the day or reduce your workload, it can help you feel more in control and reduce stress. It can also help you achieve your personal and professional goals and ensure you have enough time to effectively communicate with patients and colleagues and perform administrative tasks.

“With heavy workloads, effective time management is also important for clinician wellbeing and patient safety. A study by the University of Manchester and Keele University found that burnout was associated with an increase in the likelihood of unsafe care and unprofessional behaviour, such as not following treatment guidelines and poor quality communication.1 The researchers also found that patient satisfaction was likely to be lower when doctors were physically, emotionally, and mentally exhausted.

“Good time managers take a few minutes at the start of their day to prioritise tasks and consider how much time is needed to perform them. It can help to make a list, setting priorities according to urgency. You might think it’s quicker to do everything yourself but appropriate delegation can help you to be more efficient.

“Although it can be easier said than done, try not to be distracted by non-urgent tasks and focus on your priorities. If a task seems overwhelming, break it down into smaller parts which are more achievable.

“Recognise that being a good team player doesn’t equate to never saying no. Setting boundaries in a polite but firm way can help safeguard your time, allowing you to focus on the urgent tasks that only you can do.”

Sarah Christie, executive coach, says, “With increasing workloads and fewer resources, it’s easy to fall into the habit of fire-fighting crises, while your to-do list gets longer.

“Accept that you will not get everything done on your to-do list each day, but make a list anyway, so that you can track what needs to be done.

“Rate your tasks in order of priority. Which ones must be done this week and cannot be delegated? Make sure these are ones that you rate as very important and highly urgent.

“Prepare a weekly schedule. Put in all your regular commitments such as meetings and clinics, and then look at it each day. Schedule in as many of your top priority tasks as you can.

“Be realistic about how long each task will take and allow some extra time because often things take longer than anticipated. Do not schedule back to back commitments in your day or you will slip straight back into feeling overwhelmed. Having gaps will give you the flexibility to move your planned tasks around, without causing you more stress if unexpected events occur.

“Most importantly of all, protect your planned schedule. Focus on your priorities and get them done.

“When your top priority tasks are complete you can then repeat the process with the next lot of tasks on your list—the ones that are also very important but not as urgent.

“Make this planning process a weekly habit and you will soon be back in control of your workload and your life.”

  • Trevor Bibic will be delivering the seminar “Getting things done” at BMJ Live on 4-5 October 2019 at the Olympia Conference Centre in London. Register for free at: https://live.bmj.com

Learn more about Marymount's online DNP-FNP program.

Time management in nursing helps nurses organize and prioritize patient care, internal administrative tasks, educational responsibilities and personal obligations. Although nursing is a demanding profession, nurses who develop techniques to better manage their time can achieve balance in the face of time limitations.

Nurses who learn how to effectively manage their time see worthwhile benefits. According to the International Journal of Caring Sciences, effective time management in nursing can result in:

  • Greater productivity
  • Reduced stress
  • Improved efficiency
  • More opportunities for professional advancement
  • Greater opportunities to achieve career and life goals

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1. Set Achievable Goals

The first step nurses must take to increase productivity is to set tangible short-term and long-term goals. According to health care researchers, a common mistake is “to allow long-term goals to be dominated by more immediate and urgent short-term time demands.”

Nurses are encouraged to set career goals that are achievable within one to three years (ex. completing higher education) as they work toward long-term goals that can be completed in five to 10 years (ex. occupying leadership positions or clinical directorships).

Working nurses or nursing students can also write down daily tasks based on their perceived priority. Daily goals are more likely to change throughout the day, but certain procedures remain constant for nurses and can be solidified with routinization.

 

2. Implement Routinization

Routinization is a tool that helps nurses maximize time efficiency. Routinization involves “repeating what works in your routine in a systematic process so that the consistency helps with time management.” Creating a consistent routine enhances time management in nursing by eliminating unnecessary planning and turning essential tasks into habits.

We engage in routinization every day when we wake up, shower and brush our teeth; the same method can be applied to a nursing profession. Routinization is designed for necessary daily responsibilities, from collecting patient health histories to performing physical exams.

A nurse should make a list of routine tasks and sequence each task based on the duration and prioritization of each item. Implementing a step-by-step process for habitual duties can save time daily.

 

3. Start Cognitive Stacking

Creating a routine to manage predictable responsibilities is a clear solution, but how can nurses manage unpredictable tasks and unforeseen changes? According to the Lippincott Nursing Center, cognitive stacking is a “workflow management process that helps nurses set priorities and manage their time.”

Time management in nursing requires dynamic change management. Working nurses can engage in cognitive stacking by determining what level of care is necessary, what care is possible and how they can best deliver necessary care with their available resources and time. Nurses are required to constantly reorganize tasks as higher priority items arise.

 

4. Take Time to Rest

Work-related burnout is a common risk among health care workers. A recent publication found that more than 15% of nurses interviewed reported feelings of burnout and 56% of nurses interviewed said their health care facility was either slightly or highly ineffective at dealing with burnout. Burnout can also result in adverse consequences, such as:

  • Reduced quality of patient care
  • Reduced quality of mental health among health care workers
  • Increase in depression, anxiety and substance abuse among health care workers
  • Higher instances of error in a hospital setting

Time management in nursing is not solely concerned with increasing productivity. It involves taking time to rest and recharge. Nurses must take regular breaks and prioritize time off to prevent work-related burnout.

 

5. Delegate Work

After optimizing time management in nursing, nurses still ask for help and rely on a network of collaborative health care workers. The American Nurses Association (ANA) released a guide on principles for delegation to help with time management in nursing.

According to the guide, delegation in nursing is “the assignment of the performance of activities or tasks related to patient care to unlicensed assistive personnel while retaining accountability for the outcome.”

The guide instructs nurses on how to make responsible decisions about delegating nursing responsibilities. The ANA says that a nurse’s decision to delegate should be based on the following:

  • The care complexity of the patient
  • The availability of the worker accepting the delegation
  • The type of supervision required
  • The intensity of supervision required

Delegation works best when health care workers have a positive work relationship, the ability to collaborate and use open communication. Delegation should not be used when nursing decisions must be made by a licensed RN. This tool for better time management in nursing can be used for administrative tasks or routine procedures rather than nursing responsibilities that rely on critical training.

 

6. Enroll in a Flexible Online Doctor of Nursing Practice Program

Nurses learn how to manage competing responsibilities when they balance their academic, personal and professional lives. Online Doctor of Nursing Practice - Family Nurse Practitioner (DNP-FNP) programs teach students time management in nursing tips while allowing students the flexibility to complete the program on their terms.

Marymount University’s DNP-FNP program is offered on a part-time basis so working nurses can complete an advanced nursing degree while continuing to work full-time. Earning an advanced nursing degree is a tangible way to develop time management in nursing skills in courses like “Innovative Models of Care Delivery,” which teaches students how to balance productivity with quality of care.

 

7. Use Clinical Placement Services

Finding the right clinical placement can be challenging and time-consuming for nursing students. Nursing students can save time by enrolling in a school that offers a placement upfront.

Marymount University has a team of Clinical Placement Coordinators that work to secure every student a well-suited clinical placement by using a connected network of healthcare professionals and resources. Students can focus on immersing themselves in their placement rather than investing their own time to seek one out.

Engaging in a clinical placement during nursing school also teaches nursing students how to start applying theoretical concepts from courses like “Leadership, Quality, and Ethics in Health Care” to real-world settings.

 

8. Build a Support System

Time management in nursing is an issue that working nurses have dealt with for decades. It’s beneficial for nursing students to connect with their peers, instructors and fellow working nurses to share different time management in nursing strategies and build a solid support system.

The importance of mentorship in nursing cannot be overstated. In one case study, researchers found that a healthy mentor-mentee nursing partnership resulted in the following benefits:

  • Improved nursing staff retention
  • Reduced isolation
  • Increased opportunity for promotion
  • Less transition time for learning
  • Improved teaching effectiveness

Nursing students who have less transition time for learning and experience improved teaching effectiveness can start applying learnings to their practice. Joining a community of nursing experts and instructors enables this success and reduces wasted time.

 

9. Stop Multitasking

As a working nurse or a nursing student, you likely have several items on your to-do list, however, you must tackle the list one item at a time. New research finds that not only is multitasking ineffective, but it can be damaging to our brains. Multitasking reduces your ability to comprehend what you’re seeing and hearing by flooding the brain with competing information. The study concluded that multitasking makes you:

  • Less effective while multitasking
  • Less effective after multitasking
  • Less effective at prioritizing goals
  • Less effective in the presence of other multitaskers

Nurses should reduce multitasking by prioritizing one task at a time. Delegating certain tasks, prioritizing responsibilities and removing distractions can all help curb multitasking.

 

10. Remove Distractions

The modern world is full of tempting distractions, from social media feeds on smartphones to talkative coworkers in open-concept workspaces. If you want to succeed at better time management in nursing you need to remove common distractions.

Common interruptions and distractions in a healthcare setting include phone calls, coworkers, questions from patients or patients’ relatives. Distractions are especially dangerous in the administration of medication and can lead to higher instances of error.

One study found that nurses can engage in “interruption handling strategies” to maintain patient safety during medication administration to mitigate errors. Nursing students can also remove distractions during their studies by setting a timer and focusing on one task at a time.

 

Optimize Time Management in Nursing in a DNP-FNP Program

Working nurses interested in pursuing a Doctor of Nursing Practice - Family Nurse Practitioner (DNP-FNP) program must learn time management in nursing skills to effectively balance their coursework with their clinical placement. The ability to cultivate school and work balance can later translate to creating a better work-life balance, during and after school.

Marymount University’s DNP-FNP program offers nursing students a flexible online program, free-of-charge clinical placement services, a network of highly experienced nursing experts and the resources needed to optimize time management in nursing.

A DNP-FNP program is designed to set up nursing students for success in all areas, including time management. Nurses with advanced degrees are in high demand. According to the Bureau of Labor Statistics (BLS), overall employment of nurse anesthetists, nurse midwives and nurse practitioners is projected to grow 45 percent from 2019 to 2029. As a result, nurses are earning an average salary of $115,800 per year.

If you’re interested in transitioning into a leadership position in health care, an online DNP-FNP degree at Marymount University can pave the way by providing you with the following:

  • Clinical placement services at no extra cost
  • A flexible, part-time, online format
  • Access to a network of peers, instructors and professional alumni
  • No GMAT/GRE requirement
  • High passing rates on AANP and ANCC FNP certification exams

With the support of Marymount University’s Enrollment Advisors, Student Success Advisors, Clinical Placement Services team and engaged faculty members, you will succeed in earning your DNP-FNP degree online and excel in your nursing career.

Ready to Take the Next Step?

Explore your nurse practitioner career options by reading more about the DNP-FNP program at Marymount University.

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