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chapter 11 | Time Management 163 CikguOnline
folders is often helpful. Each color holds docu- Some people have difficulty saying no.
ments that are related to one another. For example, Ambition keeps some people from declining any
all continuing education credits might be placed in opportunity, no matter how overloaded they are.
a blue folder, anything pertaining to licensure in a Many individuals are afraid of displeasing others
yellow folder, and so on. and therefore feel obligated to take on continuous-
ly all types of additional assignments. Still others
Setting Limits have such a great need to be needed that they con-
tinually give of themselves, not only to patients but
To set limits, it is necessary to identify your objec- also to their coworkers and supervisors.They fail to
tives and then arrange the actions needed to meet stop and replenish themselves, and then they
them in order of their priority (Haynes, 1991; become exhausted. Remember, no one can be all
Navuluri, 2001). The focus of time management things to all people at all times without creating
exists on two levels: temporal and spatial. Nurses serious guilt, anger, bitterness, and disillusionment.
need to focus on patient care needs during the shift “Anyone who says it’s possible has never tried it”
(temporal) or within the boundaries of the working (Turkington, 1996, p. 9).
environment (spatial).
Eliminating Unnecessary Work
Saying No
Some work has become so deeply embedded in
Saying no to low-priority demands on your time is one’s routines that it appears essential, although it
an important but difficult part of setting limits. is really unnecessary. Some nursing routines fall
Assertiveness and determination are necessary for into this category. Taking vital signs, giving baths,
effective time management. Learn to say no tact- changing linens, changing dressings, performing
fully at least once a day (Hammerschmidt & irrigations, and doing similar basic tasks are more
Meador, 1993). Patient care is a team effort. often done according to schedule rather than
Effective time management requires you to look at according to patient need, which may be much
other members of the team who may be able to more or much less often than the routine specifies.
take on the task. Some of these tasks may appropriately be delegated
The wisdom of time management is that you to others:
may have to let others help you while never giving
up ownership of your time. In other words, ■ If patients are ambulatory, bed linens may not
although supervisors and managers tell you what to need to be changed daily. Incontinent and
do, how you accomplish this remains up to you diaphoretic patients need to have fresh linens
(Navuluri, 2001). Is it possible to say no to your more frequently. Not all patients need a com-
supervisor or manager? It may not seem so at first, plete bed bath every day. Elderly patients have
but many requests are negotiable. Requests some- dry, fragile skin; giving them good mouth, facial,
times are in conflict with career goals. Rather than and perineal care may be all that is required on
sit on a committee in which you have no interest, certain days. This should be included in the
respectfully decline, and volunteer for one that patient’s care plan.
holds promise for you as well as meets the needs of ■ Much paperwork is duplicative, and some is alto-
your unit. gether unnecessary. For example, is it necessary
Can you refuse an assignment? Your manager to chart nursing interventions in two or three
may ask you to work overtime or to come in on places on the patient record? Charting by excep-
your scheduled day off, but you can decline. You tion, flow sheets, and computerized records are
may not refuse to care for a group of patients or to attempts to eliminate some of these problems.
take a report because you think the assignment is ■ Socialization in the workplace is an important
too difficult or unsafe. You may, however, discuss aspect in maintaining interpersonal relation-
the situation with your supervisor and, together, ships. When there is a social component to
work out alternatives. You can also confront the interactions in a group, the result is usually
issue of understaffing by filing an unsafe staffing positive. However, too much socialization can
complaint. Failure to accept an assignment may reduce productivity. Use judgment in deciding
result in accusations of abandonment. when socializing is interfering with work.