Patricia Reid Ponte, DNSc, RN, FAAN, NEA-BC and Genevieve J. Conlin, DNP, MEd, MS/MBA, RN, NEA-BC After studying this chapter, the reader will be able to: 1. Understand the unique demands of complex health care environments in today’s fast-paced world of high technology and communication transfer and its effects on personal time management. 2. Describe the relationship between personal performance and time management. 3. Articulate one’s own time management preferences and style. 4. Create an action plan to manage procrastination, distraction, and anxiety. 5. Describe how individual learning and communication styles interact with the ability to manage time effectively. 6. Adopt into daily practice a time management strategy plan unique to one’s own style to ensure high-level personal performance in work and home life. Ensuring that the right amount of effort matches the right task to optimize an outcome while gauging the amount of personal energy expended or taxed to achieve the desired result. A tangible, measurable, and attainable act in a specific period of time. It has broad-term results, experiences, or achievements toward which someone is willing to work. The physical or social setting in which something occurs or develops. Five stages of proficiency in the development of skill acquisition and performance within the domain of clinical nursing practice that frames a transition from reliance on abstract principles of the new learner to becoming an involved performer who is engaged in a situation—the expert performer (Benner, 2001). An identifiable, measurable act that implements one’s goal and is typically short-term. The act of deciding what should be done first and what activities should follow sequentially; establishing an ordered list or ranked items based on importance or urgency; method used to determine what actions need to be accomplished ahead of others; represents the execution of ranked items. The act of intentionally and/or habitually putting off doing something that should be done. Application of information systems and equipment to enhance work and life activities to maximal benefit. The development of processes and tools that increase efficiency and productivity within the set standard of time. Additional resources are available online at: http://evolve.elsevier.com/Cherry/ Vignette Ten minutes later, Susan resumed her trek to the workstation. Just as she arrived, the phone rang, and Susan answered it. A patient was seeking information about her appointment time. It took Susan quite a while to open up the computer screen, log in, and find the information, which she communicated to the patient. By now many of her colleagues were on-site, already starting to work on their assignments. Susan looked at her assignment and realized that in addition to her other assigned patients, one of her patients would be receiving the first treatment of a new chemotherapy protocol. She knew that given the time necessary to work with the patient and family, triple-check orders with her physician and pharmacist colleagues, and administer the premedications and chemotherapy, all while monitoring this very ill patient, she would be very busy all day. Meanwhile, Maura Callahan, a staff RN who had been working on the inpatient oncology floor for just less than a year, was passing out 10 am medications when she received a call from Susan to take report before accepting the patient later in the day when a room became available. Maura was already behind in passing medications because of the new barcoding system now in use for medication administration. Despite the fact that this system would be safer and more efficient, using the new application took more time in the first few weeks. The training was great, but nonetheless, medication administration took longer. Maura asked the charge nurse if she could take report for her, but the charge nurse said she was in the midst of transferring another patient to the medical intensive care unit. Both Susan and Maura were working frantically to ensure that patients’ needs were met in a timely way, but it seemed impossible to both of them before they decided to call their respective managers and seek assistance. Questions to Consider While Reading This Chapter: 1. When Susan arrived on duty, what are some strategies she could have used to be sure she made the most of her early arrival? 2. What factors should Susan and Maura consider when deciding how to prioritize their patient care assignment? 4. What are some strategies that Maura and Susan can use to ensure balance between their work and personal lives? The previous scenarios are typical of what happens daily in the lives of busy professionals. Managing multiple priorities during a particular workday and integrating personal and work-related demands is the constant dilemma of so many men and women today. Additionally, performing well in both arenas is a goal of most working professionals. To accomplish the important goals in life, it is necessary to understand your own preferred style of managing priorities, recognize your typical distractions, identify a personal performance approach, and consistently use strategies and tools to make the most of every minute. This chapter is designed to assist students and busy professionals in implementing self-management strategies to better use their time and energy to ensure a highly productive, focused life. As health care continues to evolve and the nation is focused on major health care reform to improve access and quality and reduce costs, efficiency has become a critical component when considering the cost and quality of health care delivery (Larkin, 2009). Managing time, organizing care, and maintaining personal health and balance between work and home settings become much more demanding—and essential. Therefore, it becomes critical for each professional working in these dynamic settings to receive education and coaching in managing time, energy, balance, and focus to ensure high performance. Florence Nightingale’s words resonate: “Knowing how you manage when you are there [at work]…impacts how your work should be done when you are not there” (1969, p. 35). In her book, Time Management from the Inside Out, Julie Morgenstern (2004) presents “10 psychological obstacles” that influence one’s ability to create and sustain focused and productive work habits. As the following 10 obstacles are reviewed, carefully consider how they might affect your own ability to develop productive, energetic work habits. 1. Unclear Goals and Priorities. Within a particular work shift or within your life as a whole, if you lack clarity about purpose and expected outcomes, the ability to manage time to meet your desires becomes a futile task. 2. Conquistador of Chaos. If you are constantly overburdened with tasks, events, urgent requests, and last-minute cancellations, you are a better crisis manager than manager of time. 3. Fear of Downtime. Some individuals fear the possibility of standing still too long. They feel guilty with timeouts or time off. Often this is a result of not wanting to address the larger issues in life. Staying too busy to think keeps long-term planning and personal introspection at bay. 4. Need to be a Caretaker. In professions such as nursing, the need to be a caretaker is a common devotion and can be very gratifying. However, when this need becomes unbalanced, it can cause you to feel resentful, unappreciated, and overwhelmed. 5. Fear of Failure. When you are unable to get to the things that are important to you and are unable to meet your personal goals, it may mean you are afraid of failure. It can be very upsetting to go after your dreams and find out you cannot reach them. Sometimes it is easier to avoid making the effort. Take time to understand what your fears are and to openly address them. 6. Fear of Success. You may have been given a message somewhere in your life that you do not deserve to be a success. Therefore, it can be anxiety provoking to garner success and stand apart from others who may distance themselves from you. Take time to think through whether or not this is playing out in your life. 7. Fear of Disrupting the Status Quo. Not pursuing your goals for fear of the reactions of those around you is very common. Your family, coworkers, or supervisors may be critical of what you want to pursue. Gradually approaching changes gives you and those around you time to acclimate. 8. Fear of Completion. If you are afraid of completing a project that is creative and fun because you are fearful that another similar project will not find its way to you or the project may no longer be important to you, take the time to understand why you are not completing a routine task or a major project that has been with you for some time. 9. Need for Perfection. If you are a perfectionist and feel that everything should be completed with the same level of excellence, you are not keeping things in perspective. If you demand extremely high standards for every single task you undertake, you simply will not get everything done. 10. Fear of Losing Creativity. Many creative people think that by creating an organized time management structure or approach to life their creative natures or tendencies will be squelched. However, creating a framework to manage priorities will allow more freedom and time to enhance one’s creative juices. Following are some of the benefits that will result if you take the time to uncover your own tendencies, fears, strengths, and weaknesses (Childre, 2008; Federwisch, 2009; Reid Ponte, 2008): • Improved patient outcomes by implementing a collaborative structure in the work environment • Increased satisfaction with your work accomplishments as a result of applying something new in your setting • Improved interpersonal relations because of your ability to be fully present and engaged to do your best work • Better future direction because there is more attentiveness to proactively managing and engaging in the environment • Improved personal health because of decreased anxiety and a restoration of emotional balance According to Loehr and Schwartz (2003), “Energy, not time, is the fundamental currency of high performance” (p. 4). Striving to be more efficient and more organized or to manage time and priorities better is all in the interest of becoming a better performer either in one’s work or personal life. Loehr and Schwartz (2003) also state that only when we are fully engaged do we perform our best. This requires drawing on four separate but related sources of energy: (1) physical, (2) mental, (3) spiritual, and (4) emotional. Peter Senge (2006) has identified “personal mastery” as the discipline of continually clarifying and deepening one’s personal vision, focusing one’s energies, developing patience, and seeing reality objectively. People with a high level of personal mastery live in a continual learning mode, uncovering their personal growth areas. Physical, mental, and spiritual energy provide fuel for building our emotional capacity. Managing emotions skillfully in the service of high positive energy and full engagement is called emotional intelligence. Goleman (2006) suggests that self-confidence, self-control, and interpersonal effectiveness are all key to emotional intelligence. Striving to increase one’s emotional capacity—which includes improving one’s self-confidence, self-control, self-regulation, social skills, interpersonal effectiveness, empathy, patience, openness, trust, and enjoyment—will result in a more positive, invigorating work experience and personal life. We are all subject to distractions in our work and personal lives that may influence our propensity to procrastinate or not reach our goals. It is important to recognize and understand the distractions that inhibit our ability to complete tasks and to meet our objectives and goals. Box 25-1 lists many common internal and external time distractions and energy distractions that each of us may experience in a typical day. It is critical to be aware of the time distractions that affect us. The following section provides specific examples of how to strategically avoid these common time distractions. It is easy to apply the perspectives-on-time concept to nurses because many nurses have type A personalities, which means they are oriented toward high achievement. As a result, they are more likely to encounter stress when they mismanage themselves and do not use time appropriately. The reason for this phenomenon becomes clear when some of the common characteristics of high achievers are examined. Nurses tend to go above and beyond for their patients, colleagues, and families, and they set a high bar of achievement for themselves and strive for a positive experience for their patients and families (Lee, 2004).
Managing Time
The Path to High Self-Performance
Chapter Overview
Health Care Today
Perspectives on Time
Energy Management
Spiritual Energy
Emotional Energy
Time Distractions and Energy Distractions
Time-Management Strategies
Managing Time: The Path to High Self-Performance
