166 unit 2 | Working Within the Organization
interruptions every 5 minutes. Patient-care managers—
nurses—seem to be interrupted every minute.
Interruptions need to be kept to a minimum or elim-
inated, if possible. Closing the door to a patient’s
room may reduce interruptions. You may have to ask
visitors to wait a few minutes before you can answer
their questions, although you must remain sensitive
to their needs and return to them as soon as possible.
There is nothing wrong about asking a col-
league who wants your assistance to wait a few
minutes if you are engaged in another activity.
Interruptions that occur when you are trying to
pour medications or make calculations can cause
errors. Physicians and other professionals often
request nursing attention when nurses are involved
with patient-care tasks. Find out if an unlicensed
person may help. If not, ask the physician to wait,
stating that you will be more than glad to help as
soon as you complete what you are doing. Be cour-
teous, but be firm; you are busy also.
Categorizing Activities
Clustering certain activities helps eliminate the
feeling of bouncing from one unrelated task to
another. It also makes your caregiving more holis-
tic. You may, for example, find that documentation
takes less time if you do it while you are still with
the patient or immediately after seeing a patient.
The information is still fresh in your mind, and you
do not have to rely on notes or recall. Many health-
care institutions have switched to computerized
charting, with the computers placed at the bedside.
This setup assists in documenting care and inter-
ventions while the nurse is still with the patient.
Also, try to follow a task through to completion
before beginning another.
Finding the Fastest Way
Many time-consuming tasks can be done more effi-
ciently by automation. Narcotic delivery systems that
deliver the correct dose and electronically record the
dose, the name of the patient, and the name of the
health-care personnel removing the medication are
being used in many institutions. This system saves
staff time in documentation and in performing a
narcotic count at the end of each shift. Bar coding is
another method used by health-care institutions. Bar
coding allows for scanning certain types of patient
data, decreasing the number of paper chart entries
(Baldwin, 2002; Meyer, 1992).
Efficient systems do not have to be complex.
Using a preprinted color-coded sticker system
helps identify patients who must be without food
or fluids (NPO) for tests or surgery, those who
require 24-hour urine collections, or those who
require special cultures. The information need not
be written or entered repeatedly if stickers are used.
Everyone talks about the amount of time wasted
by physicians, nurses, and other clinicians in looking
for such things as patient charts, equipment, and
even patients. Erica Drazen, vice president of First
Consulting Group in Lexington, Massachusetts,
suggested using more sophisticated wireless tech-
nology, similar to the car tracking systems used by
law enforcement. Tiny transmitters can be activated
from a central point to locate the items or individ-
uals. Using electronic medical record systems
decreases the amount of time spent looking for
patient records. By using approved access codes,
health-care personnel can obtain information from
anywhere within the institution. This also mini-
mizes time spent on paper charting.Automating Repetitive Tasks
Developing techniques for repetitive tasks is simi-
lar to finding the fastest method, but it focuses on
specific tasks that are repeated again and again,
such as patient teaching.
Many patients come to the hospital or ambula-
tory center for surgery or invasive diagnostic tests
for same-day treatment. This does not give nurses
much teaching time. Using videotapes and pam-
phlets as teaching aids can reduce the time needed
to share the information, allowing the nurse to be
available to answer individual questions and create
individual adaptations. Many facilities are using
these techniques for cardiac rehabilitation, preoper-
ative teaching, and infant care instruction.
Computer-generated teaching and instruction
guides permit patients to take the information
home with them. This can decrease the number of
phone calls requiring repetition of information.The Rhythm Model for Time Management
Navuluri (2001) looked at time management in
terms of a Rhythm Model—a PQRST pattern:
Prioritize, Question, Recheck, Self-reliance, Treat.
By prioritizing, you can accomplish the most
important tasks first. Questioning permits you to
look at events and tasks in terms of effectiveness,
efficiency, and efficacy. Rechecking unfinished
tasks quickly helps you to manage your time
efficiently. Self-reliance allows you to know the
difference between events that are within your