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chapter 11 | Time Management 159 CikguOnline
expected to follow precisely set schedules and meet institutions need to change their thinking on how to
deadlines for almost everything, from distributing manage work. Most are looking toward technology
medications to completing reports on time. Many to help cope with staffing shortages (Baldwin,2002).
agencies produce vast quantities of computer- For example:
generated data that can be analyzed to determine
A new graduate worked in a medical intensive care
the amount of time spent on various activities.
unit from 7 a.m. to 3 p.m. and rotated every third
Several fallacies exist regarding time manage-
week to 11 p.m. to 7 a.m., working 7 days straight
ment. One of the foremost is that time can be man-
before getting 2 days off. It was not difficult to
aged like other resources. Time is finite. There are
remain awake during the entire shift the first night
only 24 hours in a day, so the amount of time avail-
on duty, but each night thereafter staying awake
able cannot be controlled, only how it is used
became increasingly difficult. After taking and
(Brumm, 2004). Individual personality, culture,
recording the 2 a.m. vital signs, the new graduate
and environment interact to influence human
inevitably fell asleep at the nurses’ station. He was so
perceptions of time (Matejka & Dunsing, 1988).
tired that he had to check and recheck patient med-
Everybody has an internal tempo (Chappel, 1970).
ications and other procedures for fear of making a
Some internal tempos are quicker than others.
fatal error. He became so anxious over the possibility
Environment also affects the way people respond to
of injuring someone that sleep during the day became
time.A fast-paced environment influences most peo-
impossible. Because of his obsession with rechecking
ple to work at a faster pace, despite their internal
his work, he had difficulty completing tasks and
tempo. For individuals with a slower tempo, this
was always behind at the end of the shift (of course,
pace can cause discomfort. If you are high-
napping did not help his time management).
achievement–oriented, you are likely to have already
set some career goals for yourself and to have a men- A number of studies have examined how nurses use
tal schedule of deadlines for reaching these goals (“go their time, especially nurses in acute care. For exam-
on to complete my bachelor of science in nursing in ple, a study by Arthur Andersen found that only
4 years; a master of science in nursing in 6 years”). 35% of nursing time is spent in direct patient care
Many health-care professionals are linear, fast- (including care planning, assessment teaching, and
tempo, achievement-oriented people. Simply technical activities). Lundgren and Segesten (2001)
working at a fast pace, however, is not necessarily found that this increases to 50% when an all-RN
equivalent to achieving a great deal. Much energy staff is involved in patient care delivery, as the nurses
can be wasted in rushing around and stirring things spent less time supervising non-nursing personnel.
up but actually accomplishing very little. This Documentation accounts for another 20% of
chapter looks at ways in which you can use your nursing time. The remainder of time is spent on
time and energy wisely to accomplish your goals. transporting patients, processing transactions,
performing administrative responsibilities, and
How Do Nurses Spend Their Time? undertaking hotel services (Brider, 1992).
Categories may change from study to study, but
Nurses are the largest group of health-care profes- the amount of time spent on direct patient care is
sionals. Because of the number of nurses needed and usually less than half the workday. As hospitals
the shift variations, attention concerning the effi- continue to reevaluate the way they deliver health
ciency and effectiveness of their time management is care, nurses are finding themselves more involved
needed. Efficient nurses deliver care in an organized with tasks that are not directly patient-related,
manner that makes best use of time, resources, and such as determining quality improvement, devel-
effort. Effective care improves a situation. oping critical pathways, and so forth. These are
Today’s labor market for skilled health-care pro- added to their already existing patient care func-
fessionals remains tight. Institutions face new chal- tions. The critical nursing shortage compounds
lenges, not of “trimming the fat, but compensate this problem. The result is that, in some cases,
[sic] for loss of muscle” (Baldwin, 2002, p. 1). nurses are able to meet only the highest-priority
Current shortages of nurses, radiology technicians, patient needs, particularly in certain clinical set-
pharmacists, and other health-care specialists show tings such as short-stay units or ambulatory care
all the signs of a long-term problem. Health-care centers (Curry, 2002).