164 unit 2 | Working Within the Organization
You may create additional work for yourself without
realizing it. How often do you walk back down the
hall to obtain equipment when it all could have
been gathered at one time? How many times do you
walk to a patient’s room instead of using the inter-
com, only to find that you need to go back to where
you were to get what the patient needs? Is the staff
providing personal care to patients who are well
enough to meet some of these needs themselves?
Streamlining Your Work
Many tasks cannot be eliminated or delegated,
but they can be done more efficiently. There are
many sayings in time management that reflect the
principle of streamlining work. “Work smarter, not
harder” is a favorite one that should appeal to
nurses facing increasing demands on time. “Never
handle a piece of paper more than once” is a more
specific one, reflecting the need to avoid procrasti-
nation in your work. “A stitch in time saves nine”
reflects the extent to which preventive action saves
time in the long run.
Avoiding Crisis Management
Crisis management occurs when people procrasti-
nate or do not pay attention to their intuitions. The
key to avoiding crises is to anticipate possible prob-
lems and intervene before they become overwhelm-
ing. As a new nurse, it may be difficult to anticipate
everything; however, there are some things that you
can do by organizing your day. Several methods of
working smarter and not harder are:
■Gather materials, such as bed linen, for all of
your patients at one time. As you go to each
room, leave the linen so that it will be there
when you need it.
■While giving a bed bath or providing other per-
sonal care, perform some of the aspects of the
physical assessment, such as taking vital signs,
skin assessment, and parts of the neurological
and musculoskeletal assessment. Prevention is
always a good idea.
■If a patient does not “look right,” do not ignore
your intuition. The patient is probably having a
problem.
■If you are not sure about a treatment or medica-
tion, ask before you proceed. It is usually less
time-consuming to prevent a problem than it is
to resolve one.
■When you set aside time to do a specific task
that has a high priority, stick to your schedule,
and complete it.
■Do not allow interruptions while you are com-
pleting paperwork, such as transcribing orders.What else can you do to streamline your work? A
few general suggestions follow, but the first one, a
time log, can assist you in developing others unique
to your particular job. If you complete the log cor-
rectly, a few surprises about how you really spend
your time are almost guaranteed.Keeping a Time Log
Perception of time is elastic. People do not accurate-
ly estimate the time they spend on any particular
task; people cannot rely on their memories for accu-
rate information about how they spend their time.
The time log is an objective source of information.
Most people spend a much smaller amount of their
time on productive activities than they estimate.
Once you see how large amounts of your time are
spent, you will be able to eliminate or reduce the
time spent on nonproductive or minimally produc-
tive activities (Drucker, 1967; Robichaud, 1986).
For example, many nurses spend a great deal of
time searching for or waiting for missing medications,
equipment, or supplies. Before beginning patient care,
assemble all the equipment and supplies you will
need, and check the patient’s medication drawer
against the medication administration record so you
can order anything that is missing before you begin.
Figure 11.1 is an example of a time log in which
you enter your activities every half hour. This
means that you will have to pay careful attention to
what you are doing so that you can record it accu-
rately. Do not postpone record-keeping; do it every
30 minutes. A 3-day sample may be enough for you
to see a pattern emerging. It is suggested that you
repeat the process again in 6 months, both because
work situations change and to see if you have made
any long-lasting changes in your use of time.Reducing Interruptions
Everyone experiences interruptions. Some of these
are welcome and necessary, but too many interfere
with your work. A phone call from the laboratory
with a critical value is a necessary interruption.
Hobbs (1987) stated that necessary interruptions are
not time wasters. Middle-level managers are inter-
rupted every 8 minutes, and senior managers suffer