Nursing Time Management Strategies for Patient Care

Introduction: Time Management in Nursing

By its very nature, the profession of nursing requires effective time management. Nurses are constantly asked to balance the needs of patients alongside the demands of administrators as they provide care and attend to the bureaucratic aspects of their duties. The nursing shortage has made the need for time management particularly acute. Nurses are often overburdened with the care of many patients, whom they must attend to simultaneously while working long shifts. They must budget their time yet still deliver high-quality care. With this in mind, the article by Nelson (2010) entitled "Helping New Nurses Set Priorities" argues that time management skills must be a component of the training of all new nurses. During the first critical years of practice, nurses develop the habits and assumptions that will govern how they manage their time.

In general, "orientees' time-management skills improve as they develop routines and get familiar with the facility's policies, procedures, and supply locations" (Nelson, 2010). However, proper training can do much to speed this process. Nursing students must transition from a classroom environment — where one health issue can be examined at a time — to the real, everyday world of practice, where they are confronted by many urgent needs at once. This transition is emotional as well as logistical, as nurses must learn to handle stress while simultaneously learning to categorize tasks as urgent, important, routine, or less pressing.

Priority-Setting for New Nurses

It must be stressed early on that "safety over speed" is the priority (Nelson, 2010). One analogy offered to new nurses is that their pacing must resemble a beating heart: the heart maintains a steady rhythm, and even though it speeds up to deal with an urgent situation, it must slow down again afterward. Nurses cannot operate in a constant state of fight-or-flight, or they will burn out very quickly. Ironically, high rates of burnout are one reason the nursing profession suffers a shortage today — poor prioritization and the feeling of being overwhelmed thus become a vicious cycle. The more quickly nurses burn out and leave the profession, the more oppressed existing nurses feel regarding the demands made upon their time.

Questions which nurses must ask themselves in order to engage in effective time management include: "What are you going to do first? Why?", "Which is more important? Why?", "What could happen if you don't do this now?", and "What is most important to the patient?" (Nelson, 2010). Asking focused questions about the prioritization of duties enables nurses to engage in effective scheduling and to approach their workloads with greater clarity and confidence.

Another source of stress in nursing is rooted in the very high expectations nurses face regarding patient-centered care. According to Jones (2010): "as providers of care, nurses are expected to allocate their time to establish and maintain therapeutic nurse-patient relationships and implement the nursing process to maximize patient outcomes (Foster & Hawkins, 2005; Hagerty & Patusky, 2003). The emphasis is on individualized patient-centered care and time is a resource used to produce care. Nurses and patients want more time devoted to patient care." However, finding such time during daily rounds can be extremely challenging.