St John of God Subiaco Hospital - Time Management: Graduate presentation

1. Graduate Presentation
Michelle McKivett SDC

2. Learning Outcomes
• Be able to determine patient care planning
priorities.
• Knowledge of the ABCD system.
• Transfer knowledge from session to work
place.

3. PRIORITISING & REPRIORITISING
• Essential skill for nurses
• Strategy to accommodate and adjust to
interruptions
• Establish and maintain a routine
• Allows you to alter routine while meeting
demands of job
• Complicated tasks may need to wait until
there is more time

4. ABCD System
• A : Absolutely must be done
• Tasks that must be done at a certain time
• You will be interrupted to do a particular task if it is
not done soon
• Others need it done to do their job
• Waiting will cause a patient or his/her family distress
• A risk of hazard is present
• Most documentation and paperwork

5. ABCD System
• B: Better sooner than later
• Can wait but not too long
• Must be done today or on this shift
• Will save time and resources if done soon

6. ABCD System
•C: Can wait until later
•Things that do not have
any time frame attached
•Getting things that will be needed
later in the day
•Some paper work

7. ABCD System
• D: Do not worry about it
• These are tasks that are beneficial, but if left
undone will not affect patients or their care
• These things should get done, but no one will
be hurt if they are not

8. STRESSED OUT
• Learning to say no to requests from others if
they seem inappropriate or impossible.
• Meal breaks are essential and should always
be taken.
• At the end of each shift try not to take any
work or worries home with you.

9. TIME WASTERS
Doing too much
Perfectionism
Disorganisation: Work area, systems
Inability to say ‘NO’
Complaining

10. TIME WASTERS
• Procrastination – Can be a habit – Confront it
Ask yourself why and be honest
- Am I finding it hard to just get started?
- Am I sure I know how to do it?
- Is it my job to do it?
- Am I afraid to do it?
- Does the task seem to huge or overwhelming?
- Am I afraid of the outcome – (Fear, Success or
finishing)

11. INTERRUPTIONS
• Patient and Pain
• Doctors
• Fellow workers
• Phone Calls & relatives
• Admissions
• Manager
• Students
• Other Health Professionals

12. WHAT CAN YOUR SHIFT
COORDINATOR DO FOR YOU
• Help – need to ask
• Make calls
• Contact Drs
• Chase medication charts
• Check drugs

13. WHEN THE UNEXPECTED HAPPENS
• Don’t panic
• Talk to your team member or shift coordinator
• Assess all your workload
• Reassess patient care priorities
• Report & discuss situation with senior colleague
• Maintain a positive mental attitude
• Encourage & support colleagues
• Review situation regularly
• Review shift – put reflective practice into place - could
anything have been done differently?

14. TEAM WORK
• Teams are made up of people with
complementary skills, committed to a
common purpose and performance goals.
• Most teams can outperform individuals it is
the "people issues” that cause most of the
problems.

15. GUIDELINES TO CONSIDER WHEN
WORKING IN A TEAM
• Establish clear, achievable goals
• Set a clear plan at the beginning of the day
• Define each person’s role in the team clearly
• Insist on clear communication
• Encourage team behaviours

16. GUIDELINES TO CONSIDER WHEN
WORKING IN A TEAM
• Agree on decision-making procedures
• Increase awareness of group process
• Expect participation
• Establish ground rules
• COMMUNICATE, COMMUNICATE

17. SCENERIO 1
• You are working on a medical ward.
• You are on an early shift with 6 other nurses.
• It is 07:30. You have been allocated to care for the following patients:
Diabetic patient who has insulin before breakfast.
Anaemic patient who needs to have a blood transfusion.
A new patient who has just arrived on the ward,
A patient who is going home after treatment for a leg ulcer.
• Before you see any of your patients, another RN asks you to check a
Schedule 8 drug with her. You see the breakfast trolley arrive on the ward.
One of your patients has rung the bell.

18. SCENERIO 2
• You are working on an early shift and are looking after 4
patients. After your tea break you discover that consultants
have been in to see 2 patients and have left these
instructions:
Patient 1 may go home after you have removed her sutures,
Patient 2 (1st
day post-hernia repair) may have his IV & IDC
removed & can then get up to shower.
Patient 3 is ready to be collected from theatre,
Patient 4 rings the bell and would like assistance to shower and
have her bed made.
• Outline your plan of care.

19. SCENERIO 3
• You are working on a late shift. One of your patients
is Day 3 post laparotomy and has the following; IV
Therapy, abdominal dressing, IDC, Varivac drain. The
patient is allowed to have free fluids. His PCA has
been removed and he is having IMI Pethidine 4
hourly.
• At 13:50 the patient rings the bell and tells you that
he is in pain. Pethidine was last given at 09:30.
• Outline your plan of care.

20. COMMANDMENTS FOR REDUCING
STRESS
• Thou shalt not be perfect, nor even try to be
• Thou shalt not try to be all things to all people
• Thou shalt leave things undone that ought to be undone
• Thou shalt not spread thyself too thin
• Thou shalt learn to say ‘No’
• Thou shalt schedule time for thyself & thy supportive network
• Thou shalt be boring, untidy, inelegant & unattractive at
times
• Thou shalt not even feel guilty
• Especially, thou shalt not be thine own worst enemy, but be
thy best friend