Introduction
DISPLAY 9.4 Three Categories of Prioritization
A
ssume that you are the registered nurse (RN) leader of a team with one licensed vocational nurse and one nursing assistant on the 7 AM to 3 PM shift at an acute care hospital. The three of you are responsible for providing total care to 10 patients. Prioritize the following list of 10 things that you need to accomplish this morning. Use a “1” for the first thing you will do and a “10” for the last. Be prepared to provide rationale for your priorities.___ Check medication cards/sheets against the patient medication record.
___ Listen to night shift report 11:00 PM to 7:00 AM.
___ Take brief walking rounds to assess the night shift report and to introduce yourself to patients.
___ Hang four 9:00 AM IV medications.
___ Set up the schedule for breaks and lunch among your team members.
___ Give 8:45 AM preop on patient going to surgery at 9:00 AM. ___ Pass 8:30 AM breakfast trays.
___ Meet with team members to plan the schedule for the day and to clarify roles.
___ Read charts of patients who are new to you.
___ Check 6:00 AM blood glucose laboratory results for 7:30 AM insulin administration.
Priority Setting and Procrastination
Because most individuals are inundated with requests for their time and energy, the next step in time management is prioritizing, which may well be the key to good time management. Unfortunately, some individuals lack self-awareness about what is important and therefore how to spend their time.
Priority setting is perhaps the most critical skill in good time management because all actions we take have some type of relative importance.
One simple means of prioritizing what needs to be accomplished is to divide all requests into three categories:
“don’t do,” “do later,” and “do now” (Display 9.4). The don’t do items probably reflect problems that will take care of themselves, are already outdated, or are better accomplished by someone else. The individual either throws away the unnecessary information or passes it on to the appropriate person in a timely fashion.
In either case, the individual removes unneeded clutter from his or her work area.
1. “Don’t do”
2. “Do later”
3. “Do now”
Some do later items reflect trivial problems or those that do not have immediate deadlines; thus, they may be procrastinated. To procrastinate means to put off something until a future time, to postpone, or to delay needlessly. Berkman (2015) suggests that procrastination is what happens when the value of doing something else outweighs the value of doing it now.
Although procrastination may be appropriate in some cases, the reality is that more often than not, it is a barrier to effective time management. Procrastination, however, is a difficult problem to solve because it rarely results from a single cause and can involve a combination of dysfunctional attitudes, rationalizations, and resentment. The key in procrastination is to use it appropriately and selectively. Procrastination is rarely appropriate when it is done to avoid a task because it is overwhelming or unpleasant.
Before setting “do later” items aside, the leader-manager must be sure that large projects have been broken down into smaller projects and that a specific timeline and plan for implementation are in place. The plan should include short-term, intermediate, and final deadlines. Likewise, one cannot ignore items without immediate time limits forever and must make a definite time commitment in the near future to address these requests.
The do now requests most commonly reflect a unit’s day-to-day operational needs. These requests may include daily staffing needs, dealing with equipment shortages, meeting schedules, conducting hiring interviews, and giving performance appraisals. Do now requests also may represent items that had been put off earlier.
LEARNING EXERCISE
9.3
Targeting Personal Procrastination
S
pend a few moments reflecting on the last 2 weeks of your life. What are the things you put off doing?Do these things form a pattern? For instance, do you always put off writing a school paper until the last minute? Do you wait to do certain tasks at work until you cannot avoid the task any longer? What things do you do when you really do not want to do something? Do you eat? Play video games? Watch TV? Read?
A S S I G N M E N T:
Write a one-page essay on at least two things that you procrastinate and then develop two strategies for breaking each of these habits.
Making Lists
In prioritizing all the do now items, the leader-manager may find preparing a written list helpful. Remember, however, that a list is a plan, not a product, and that the creation of the list is not the final goal. The list is a planning tool.
Although the individual may use monthly or weekly lists, a list also can assist in coordinating daily
operations. This daily list, however, should not be longer than what can be realistically accomplished in 1 day;
otherwise, it demotivates instead of assists.
In addition, although the leader-manager must be cognizant of and plan for routine tasks, it is not always necessary to place them on the list because they may only distract attention from other priority tasks. Lists should allow adequate time for each task and have blocks of time built in for the unexpected. In addition, individuals who use lists to help them organize their day must be careful not to confuse importance and urgency. Not all important things are urgent, and not all urgent things are important. This is especially true
when the urgency is coming from an external source.
Not all important things are urgent, and not all urgent things are important.
In addition, the individual should periodically review lists from previous days to see what was not accomplished or completed. If a task appears on a list for several successive days, the manager must
reexamine it and assess why it was not accomplished. Sometimes, tasks just need to be removed from the list.
This occurs when a task has low priority or when it is better done by someone else. Other times, undone tasks on the list should be discarded because they are duplicative or unimportant. Halonen (2015) agrees,
suggesting that when individuals procrastinate on a task for some time, they should stop and look at the task to see why it is even on the to-do list. It could be that it’s not even necessary or relevant to do anymore.
Sometimes, however, items on the list remain unaccomplished because they are not divided into steps or tasks that can be completed. Breaking a big job down into smaller parts can make the task seem more manageable. For example, many well-meaning people begin thinking about completing their tax returns in early January but feel overwhelmed by a project that cannot be accomplished in 1 day. If preparing a tax return is not broken down into several smaller tasks with intermediate deadlines, it may be almost perpetually procrastinated.
Some projects are not accomplished because they are not broken down into manageable tasks.
Reprioritizing
The last step in time management is reprioritizing. Often, one’s priorities or list will change during a day, week, or longer because new information is received. If the individual does not take time to reprioritize after each major task is accomplished, other priorities set earlier may no longer be accurate. In addition, despite outstanding planning, an occasional crisis may erupt.
No amount of planning can prevent an occasional crisis.
LEARNING EXERCISE
9.4
Creating Planning Lists
D
o you make a daily plan to organize what needs to be done? Mentally or on paper, develop a list of five items that must be accomplished today. Prioritize that list. Now make a list of five items that must be done this week. Prioritize that list as well.If a crisis does occur, the individual may need to set aside the original priorities for the day and reorganize, communicate, and delegate a new plan reflecting the new priorities associated with the unexpected event causing the crisis.
Dealing With Interruptions
All managers experience interruptions, but lower level managers typically experience the most. This occurs in part because first- and middle-level managers are more involved in daily planning than higher level managers and thus directly interact with a greater number of subordinates. In addition, many lower level managers do not have a quiet workspace or clerical help to filter interruptions. Frequent work interruptions result in situational stress and lowered job satisfaction. Managers need to develop skill in preventing interruptions that threaten effective time management.
Lower level managers experience more interruptions than higher level managers.
Dealing with interruptions also requires leadership skills. Leaders role model flexibility and the ability to regroup when new information or tasks emerge as priorities. Followers often look to see how their leaders are coping with change and even crisis and their reactions often mirror those of their leaders. That is often why a staff nurse who feels harried or out of control typically finds these same feelings reflected in the individuals he or she is assigned to work with.
Time Wasters
There are many time wasters, and the time wasters that are used most often vary by the individual. Four time wasters warrant special attention here (Display 9.5). The first of these surprisingly is technology, which generally has been promoted as a time saver for most people. Indeed, technology can and does save time. E- mail now makes instantaneous, asynchronous communication to multiple parties possible simultaneously, and the Internet provides virtually unlimited access to emerging, state of the science knowledge globally. In addition, social networks such as Facebook, Pinterest, and Twitter have created new opportunities for communicating in real time to vast networks of users.