Effective Time Management in Nursing Leadership and Management, Exams of Advanced Education

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Effective Leadership and Management in

Nursing

4 principles of time management - planning, prioritizing, delegation, and communication barriers to time management - - job enlargement - organizational structure that can affect time demands

• flatter organizational structures - positions combined with managers having more staff to supervise
• other work enlargement conditions time wasters - - interruptions
• meetings without a clear purpose
• goals, objectives, and priorities that are not measurable
• plans without time parameters
• disorganized files or papers
• time logs, not analyzed
• tasks/activities that can be delegated
• waiting for others
• inability to say "no" methods to enhance time management: time logs - - examine your planner/appointment book to determine how to spend your time
• determine time wasters/activities which could be delegated to others or eliminated goals - provide a guide, a time frame, and a way to measure accomplishments goal categories - - professional, financial, social, entertainment, physical, lifestyle, community, spiritual Short-term goals - - within a school year

• within a professional nursing role Managing goals - - identify objectives to be achieved
• describe specific activities necessary to achieve these objectives
• estimate time required for each activity
• determine planned activities for concurrent action versus sequential
• identify activities that can be delegated losing sight of objectives - - obvious waste of time
• nurse as a leader must set and maintain outcomes to focus the course of action
• periodically review objectives to be met to use time productively Prioritize - urgent and important A patient's condition becomes life threatening and you have other patients who need your care You handle the situation by: - - delegate to other nurses to help with other patients
• life threatening is top priority, contact provider
• prioritize! important but not urgent You are the clinical preceptor for a nurse resident who needs to debrief about how he communicated with the case manager about a patient's discharge plans You handle the situation by: - - plan for a good time

• set aside a chunk of time, delegate work while off unit minimize routine work - Your employee review deadline is approaching and you maintain records of the frequency of times you cared for different types of patients. Your files and other reports need to be organized in chronological order How would you approach this routine work in the future, to save time, given your deadline?
• do little by little
• assign time everyday for it Paperwork - - Plan and schedule times for paperwork
• Sort paperwork for effective processing
• Send every communication online
• Analyze paperwork frequently
• Do not be a paper shuffler - handle paper once Self-discipline - - establish realistic commitments to effectually manage time
• explain to your superior how being overloaded with have consequences on your assignments
• communicate your own needs to others Prioritization - deciding which needs or problems require immediate action and which ones could be delayed until a later time Weigh and Evaluate - - life threatening?
• essential to staff or patient safety
• essential to plan of care 3 levels of priority setting: - 1. Airway, Breathing, Cardiac (Circulatory), and Vital Signs: ABC plus V

2. Mental status changes, untreated medical issues, acute pain, acute elimination, abnormal lab results, and risks

3. Long-term issues, health education, rest, coping, etc. Maslow - Self actualization Esteem Lov Safety Physical and survival needs
4. Which client has the most immediate need for intravenous (IV) access to deliver immediate analgesia with rapid titration? A Client who has sharp chest pain that increases with cough and shortness of breath B Client who complains of excruciating lower back pain and hematuria C Client who is having an acute myocardial infarction with severe chest pain D Client who is having a severe migraine with an elevated blood pressure - C You have received report from the off-going nurse. List the order of priority for assessing and caring for the following patients. A Patient who developed tumor lysis syndrome around 5 AM B Patient with frequent reports of breakthrough pain in the past 24 hours C Patient scheduled for exploratory laparotomy early this morning. D Patient with anticipatory nausea and vomiting for the past 24 hours. - A C B Pain??? D These orders are written for a client with Excess Fluid Volume. Your assessment reveals bounding peripheral pulses, weight gain of 2 lbs, pitting ankle edema, and moist crackles bilaterally. Which order takes priority at this time? A. Weight the client every morning B. Maintain accurate I&O records

C. Restrict fluids to 1500 ml/day D. Administer furosemide (Lasix) 40 mg IV push - D.