This document discusses time management and delegation strategies for nurses. It emphasizes the importance of prioritization and creating a to-do list based on urgency of tasks. Non-urgent tasks can be delegated to other medical staff. The document outlines levels of prioritization from urgent to non-urgent and discusses guidelines for proper delegation, including assigning the right task to the right person and providing supervision. It also addresses potential obstacles to effective delegation such as fear of loss of control or lack of confidence in other staff. Proper time management requires organization, avoiding procrastination, and eliminating unnecessary tasks.

1. TIME MANAGEMENT
& DELEGATION
DR. JAMES M. ALO, RN,MAN,MAP,PHD

2. ORGANIZATION
Being organized is the key to
effective Time Management!
DRJAMESMALO

3. STEPS TO ORGANIZATION
Prioritization
Delegation
(Assignment & Supervision)
DRJAMESMALO

4. PRIORITIZATION
“Prioritization is defined as deciding
which needs or problems require
immediate action and which ones could
be delayed until a later time because
they are not urgent.”
(LaCharity, Kumagai, & Bartz, 2006, p. 4)
DRJAMESMALO

5. PRIORITIZATION
Prioritize the tasks in order of importance
 Is it life threatening or potentially life threatening if the task is
not done?
 Would another patient be endangered if I do this now or leave
this task for later?
 Is this task or process essential to patient or staff safety
 Is this task or process essential to the medical or nursing plan
of care?
How much time will each task require?
 Try to leave tasks that are not urgent, but take more time for
last
Tickler List
 Check Boxes of tasks
 To-Do List
DRJAMESMALO

6. LEVELS OF PRIORITIZATION
First Level
 “ABC’s plus V”:
airway, breathing, cardi
ac/circulation, vital
signs
(LaCharity, Kumagai, & Bartz, 2006, p. 5)
DRJAMESMALO

7. LEVELS OF PRIORITIZATION
Second Level
 Immediately subsequent
to the 1st level
 Mental status
changes, untreated
medical issues, acute
pain, acute elimination
problems, abnormal lab
results, and risks
(LaCharity, Kumagai, & Bartz, 2006, p. 5)
DRJAMESMALO

8. LEVELS OF PRIORITIZATION
Third Level
 Health problems
other than the first
two levels
 Long-term issues in
health
education, rest, copi
ng, and so on
(LaCharity, Kumagai, & Bartz, 2006, p. 5)
DRJAMESMALO

9. DELEGATION
“ According to the ANA Code of Ethics for
Nurses with Interpretive Statement, (ANA
2001) the nurse is responsible and
accountable for individual nursing practice
and determines the appropriate delegation of
tasks consistent with the nurses’s obligation
to provide optimum patient care.”
(Kelly-Heidenthal & Marthaler, 2005, p. 2)
DRJAMESMALO

10. DELEGATION
“Delegation is defined as the transfer of
responsibility for the performance of an
activity from one individual to another
while retaining accountability for the
outcome.”
(Kelly-Heidenthal & Marthaler, 2005, p. 6)
a.k.a. “Assignment”
DRJAMESMALO

11. DELEGATION
“Delegation is needed because of the
advent of cost containment, the
shortage of nurses, increases in patient
acuity levels, an elderly chronic
population, and advances in healthcare
technology.”
(Kelly-Heidenthal & Marthaler, 2005, p. 3)
DRJAMESMALO

12. DELEGATION
After creating your prioritized “To
Do” list, decide which tasks can be
delegated
This can be a written or mental list
Charge Nurse, PCA’s, physical therapists, respiratory therapist, etc…
What are some tasks that can be delegated???
DRJAMESMALO

13. FLORENCE NIGHTINGALE
“But then again to look to all these things
yourself does not mean to do them
yourself…But can you insure that it is
done when not done by yourself?”
(Nightingale, 1859, p. 17)
DRJAMESMALO

14. THE 4 RIGHTS OF DELEGATION
Right Circumstances
 Rules & regulations of your area of practice
 Patient condition & preferred patient outcomes
Right Task Assigned to the Right Person
 Licensure, certification, & role description
 Strengths & weaknesses
Right Direction/Communication
 Clear & concise communication
Right Supervision
DRJAMESMALO

15. THE 4 RIGHTS OF DELEGATION
Right Supervision
 Ask for the team member’s input first
 Give credit for all that has been
accomplished
 Offer observations and concerns
 Ask for the delegate’s ideas on how to
resolve the problem
 Agree on a course of action and plan for
the future
DRJAMESMALO

16. OBSTACLES TO DELEGATION
What should you do when a delegate refuses to complete a task?
DRJAMESMALO

17. UNDERDELEGATION
New nurses often underdelegate
 Fear of older staff resentment
 Seek to demonstrate capabilities
 Perfectionism or “Control Freaks”
Avoid underdelegation
 Overwhelmed & frustration
 “Burnout” of assistive staff
DRJAMESMALO

18. OVERDELEGATION
Overdelegation may place patient at risk
 Uncomfortable performing unfamiliar duties;
dependence
 Disorganization
 Inclined to avoid responsibility or immerse
themselves in trivia
Avoid overdelegation
 Leads to asking staff, such as PCAs &
LPNs, to perform duties that are not within
their scope of practice
 “Burnout” of assistive staff
DRJAMESMALO

19. OBSTACLES TO DELEGATION
Fear of being disliked
Inability to give up control
Inability to determine what to delegate and
to whom
Past experience with delegation that did
not turn out well
Lack of confidence to move beyond being
a novice nurse
DRJAMESMALO

20. OBSTACLES TO DELEGATION
Tendency to isolate oneself and choosing
to complete tasks all alone
Lack of confidence in delegating to staff
that were previously one’s peers
Inability to prioritize using Maslow’s
Hierarchy of Needs and the Nursing
Process
DRJAMESMALO

21. OBSTACLES TO DELEGATION
Thinking of oneself as the only one who can
complete the task the way it is supposed to
be done
Inability to communicate effectively
Inability to develop working relationships with
other team members
Lack of knowledge of the capabilities of staff
including competency, skill, experience,
level of education, job description, and so
on.
DRJAMESMALO

22. OBSTACLES TO DELEGATION
What should you do when a delegate
refuses to complete a task?
DRJAMESMALO

23. ORGANIZATION: MORE TIPS
Make a Schedule:
Create deadlines for tasks to be accomplished
Create reasonable deadlines as a guideline to
accomplish tasks in a timely manner
Don’t procrastinate
Prevent Fires instead of Fighting Fires all day!!!
DRJAMESMALO

24. SAYING “NO”
“Heavy Patient Assignment”
Can I refuse a patient assignment?
What should I do?
DRJAMESMALO

25. ELIMINATE UNNECESSARY
WORK
Duplicate documentation – charting by
exception
Social Talk in Hallways, nurses’
lounge, cafeterias, etc…
Avoid re-writing report or lab values, etc.
DRJAMESMALO

26. TIME ALLOCATION
Idle
5% 0%
Transaction Documentation
Processing 20%
15%
Transportation
6%
Administration
7%
Direct Patient Care
Hotel Services 35%
12%
DRJAMESMALO

27. TIME MANAGEMENT ISSUES???
Keep a Time Log or Time Allocation Diary
Assists with tracking daily routines and
identification of tasks that can be
delegated or eliminated
Follow each task to completion
DRJAMESMALO

28. DOCUMENTATION:
DEALING WITH INTERRUPTIONS
Delegate tasks…
Close door…
Visitors will need to wait…
Ask HUC to hold non-urgent calls…
Document while in patient’s room…
DRJAMESMALO

29. REFERENCES
Kelly-Heidenthal, P., & Marthaler, M. T. (2005). Delegation of
nursing care. Clifton Park, NY: Thomson Delmar
Learning.
LaCharity, L. A., Kumagai, C. K., & Bartz, B. (2006).
Prioritization, delegation, and assignment: Practice
exercises for medical-surgical nursing. St. Louis, MO:
Mosby Elsevier.
Nightingale, F. (1859). Notes on nursing: What it is and what
it is not. London, England: Harrison & Sons.
DRJAMESMALO