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Beware of monkeys on your back by managing your time


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by Debra Nussdorfer, MS, RN, PMHCNS-BC

Do you feel like everyone and everything is vying for your attention? Is your to-do list growing, calendar bulging, and deadlines looming? In today's healthcare environment, complexity, time compression, information overload, and change are the norm.

An excellent time management article, "Management Time: Who's Got the Monkey?" published in Harvard Business Review, uses a monkey on the back metaphor to describe the pressure, stress, and heaviness managers, and staff members, can feel from all the demands on their time. While you cannot increase the number of hours in your day, you can increase the energy and mental performance you put into those hours and the quality of life you get out of them. Ensure you (and your staff) make the most out of each and every day by practicing the following tips:

  1. Examine your perspective of time. Good time managers possess a heightened sense of time and recognize time has boundaries. You have the power to make deliberate decisions even if the choice is acceptance vs. resistance. Recognize these choices.
  2. Nursing is a process, not a set of tasks or a simple checklist. However, the nursing process provides a useful structure. Establish goals, make a list of actions to complete those goals, and create a timetable. Focus on outcomes, then analyze your list of actions and delete any nonessential steps. Give your brain a chance to come up with new and efficient solutions. Routines can be beneficial for straightforward and repetitive tasks, but they can thwart creativity and resourcefulness. 
  3. Use a scheduling tool that supports your schedule with reminders and recurring appointments. Enter designated time blocks to work on specific projects. Concentration and productivity is easily lost when unfinished tasks circulate in your mind. The simple step of putting projects on your schedule will allow you to focus on the task at hand. If some new, unplanned task comes up, add it to the list and prioritize among your other tasks.
  4. Expect the unexpected. Be flexible and allow for the reality of surprises. Procrastinating or planning every minute of your day are recipes for frustration. 
  5. Use your strengths. Is it possible to trade tasks with a peer? Identify a mentor for professional development.
  6. Promote expertise and professional development. Consider the "monkey." When someone asks a question or makes a request, decide if accepting this "monkey" is constructive. It may seem easier to say yes, but saying no and being a coach can keep your workload down while simultaneously promoting the professional development, confidence, and competence of colleagues. 
  7. Simple words can change energy and attitudes that surround you. Imagine the effect of saying, "I have time" while making eye contact with another staff member. Eliminate "so busy" from your vocabulary.
  8. Limit perfectionism, clutter, distractions, and lack of purpose. Do not forward or reply to an e-mail unless it is absolutely necessary. Reduce redundancy and meeting times.
  9. Focus, focus, focus. Thirty focused seconds is usually more meaningful for both parties than five multitasked minutes.
  10. Leave work with a sense of accomplishment. Reflect on each work day to identify at least one way you made a difference. Make notes of your thoughts and free your mind. Keep a pad of paper and a pen in the car in case a thought arises on the ride home.

There is never enough time to do all of the things required and desired. Everyone struggles to balance work and personal activities. Be deliberate and choose how to use each moment. When reflecting on the work day, take a moment to feel a sense of accomplishment and professional pride, and know that what is done each day makes a difference.

Editor's note: Nussdorfer is the coordinator for the ANCC Magnet Recognition Program® at Penrose St. Francis Health Systems in Colorado Springs, CO.