160 unit 2 | Working Within the Organization
Any change in the distribution of time spent on
various activities can have a considerable impact on
patient care and on the organization’s bottom line.
Prescott (1991) offered the following example:
If more unit management responsibilities could be
shifted from nurses to non-nursing personnel, about
48 minutes per nurse shift could be redirected to
patient care. In a large hospital with 600 full-time
nurses, the result would be an additional 307 hours
of direct patient care per day. Calculating the results
of this time-saving strategy in another way shows
an even greater impact: the changes would con-
tribute the equivalent of the work of 48 additional
full-time nurses to direct patient care.Many health-care institutions are considering inte-
grating units with similar patient populations and
having them managed by a non-nurse manager,
someone with business and management expertise,
not necessarily nursing skills. However, as a group,
nurses respect managers who have nursing expertise
and who are able to perform as nurses. They believe
that a nurse-manager has a greater understanding of
both patient and professional staff needs. To address
these service concerns, many educational institu-
tions have developed dual graduate degrees com-
bining nursing and management.
Organizing Your Work
Setting Your Own Goals
It is difficult to decide how to spend your time
because there are so many tasks that need time. A
good first step is to take a look at the situation,
and get an overview. Then ask yourself, “What are
my goals?” Goals help clarify what you want and
give you energy, direction, and focus. Once you
know where you want to go, set priorities. This is
not an easy task. Remember Alice’s conversation
with the Cheshire Cat in Lewis Carroll’s Alice in
Wonderland:
“Would you tell me please, which way I ought to go
from here?” asked Alice.
“That depends a good deal on where you want to
go to,” said the Cat.
“I don’t care where,” said Alice.
“Then it doesn’t matter which way you go,” said
the Cat (Carroll, 1907).How can you get somewhere if you do not know
where you want to go? It is important to explore
your personal and career goals. This can help you
make decisions about the future.
This concept can be applied to daily activities as
well as help in career decisions. Ask yourself ques-
tions about what you want to accomplish over a
particular period. Personal development skills
include discipline, goal setting, time management
and organizational skills, self monitoring, and a
positive attitude toward the job (Bos & Vaughn,
1998). Many of the personal management and
organizational skills related to the workplace focus
on time management and scheduling. Most new
nurses have the skills required to perform the job
but lack the personal management skills necessary
to get the job done, specifically when it comes to
time management.
To help organize your time, set both short- and
long-term goals. Short-term goals are those that
you wish to accomplish within the near future.
Setting up your day in an organized fashion is a
short-term goal, as is scheduling a required medical
errors or domestic violence course.
Long-term goals are those you wish to complete
over a long time. Advanced education and career
goals are examples. A good question to ask yourself
is, “What do I see myself doing 5 years from now?”
Every choice you make requires a different alloca-
tion of time (Moshovitz, 1993).Alinore, a licensed practical nurse returning to
school to obtain her associate’s degree in nursing,
faced a multitude of responsibilities. A wife, a
mother of two toddlers, and a full-time staff mem-
ber at a local hospital, Alinore suddenly found
herself in a situation in which there just were not
enough hours in a day. She became convinced that
becoming a registered nurse was an unobtainable
goal. When asked where she wanted to be in 5 years,
she answered, “At this moment, I think, on an island
in Tahiti!” Several instructors helped Alinore devel-
op a time plan. First, she was asked to list what she
did each day and how much time each task required.
This list included basic child care, driving children
to and from day care, shopping, cooking meals,
cleaning, hours spent in the classroom, study hours,
work hours, and time devoted to leisure. Once this
was established, she was asked which tasks could be
allocated to someone else (e.g., her husband), which
tasks could be clustered (e.g., cooking for several days
at a time), and which tasks could be shared. Alinore’s
husband was willing to assist with car pools, grocery