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Reflection

Topic: Patient priority setting and time management in clinical nursing practice
Description:

According to my clinical case scenario working in emergency ward during my 4th year I
was asked to select a patient for my portfolio and I was busy in my ward there were a lots of
patients. Then I was going to surgical ward so that I would select my patient I was approached
by a staff nurse who asked me to medication in male ward. As I thought this was priority as I
could select a patient at any point in the day as it was for my own learning and development and
wasn’t urgent. After I had helped the staff nurse. Staff nurse asked me that do you select a patient
for your portfolio I explained that I had gone to male ward for medication. My staff nurse then
told me that I needed to improve on my time management, as I had not selected the patient when
she asked me. She carried on explaining that when I become a Registered Nurse I would need to
select a patient for clinical portfolio and what they are used for. This situation left me
questioning which was the priority, the patient’s needs or my own professional learning and
development.

Feelings:

I automatically medication the patient as I felt that this was the priority over researching
the drug. I felt annoyed with myself for not speaking up to my staff nurse about the issue as I had
thought I had made the right decision to help the patient. I was concerned about the patients
comfort and felt I could not justify leaving the patient lying in painful condition to select a
patient. Nurses need to be able to justify the decisions they make. . This practice experience
made me feels as though I needed to learn and develop more regarding my priority. I was always
on time for my duty. This experience made me question how I was prioritizing my workload at
present.

Evaluation:

As an accountable staff nurse states that ‘you must make the care of people your first concern,
treating them as individuals and respecting their dignity’ which I did. I could understand what
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my staff nurse was explaining to me, that as a Registered Nurse I must be able to select a patient.
I must have the knowledge and skills for safe and effective practice when working without direct
supervision, recognize, and work within the limits of my competence.

I must also keep my knowledge and skills up to date throughout my working life and I
must take part in appropriate learning and practice activities that maintain and develop my
competence and performance. There will be constant demands on my time and attention and it
may be difficult to identify exactly what my priorities should be. In patient care, priorities can
change rapidly and I will need to be able to constantly re-assess situations and respond
appropriately. Priority setting is the process of establishing a preferential sequence for addressing
nursing interventions. A low-priority problem is one that arises from normal developmental
needs or that requires only minimal nursing support

Analysis:

Individuals need to control and monitor his/her personal and professional time efficiently. This
requires skills in goal setting, setting priorities, planning and organizing skills and minimizing
time wasting (Gordon & Borkan, 2014).

The commitment to change is very essential for time management. Good time management
techniques and skills are essential for functioning more effectively and to focus on results. Good
time management benefits in several ways including greater productivity, less stress, improved
efficiency, more opportunities for professional advancement and greater opportunities to achieve
career and life goals. In contrast, if the time is not managed effectively it may lead into several
consequences such as missed deadlines, poor work quality, high stress level and negative
influence on career path (Meiring, 2017).

Nursing is a profession requiring the skills in performing different tasks during the course of day
for coping with time limitations and pressure (Ancel & Yilmaz, 2016).

Nurses need to meet the expectations of patients, peers, managers, along with completing the
nursing activities in a given shift. Contingencies also arise in the schedule which need to be
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identified as high, medium and low priority and should be best fit in the shift by the nurses
(Cleary & Horsfall, 2011).

Inadequate time management has shown delay in patient care and patient safety. Whenever, time
limitations are more nurses may not be able to think critically, prioritize and tend to make more
errors. So, planning the patient care for the day, prioritization and delegation is very much
essential (Blevins & Millen, 2016).

Along with the University life, nursing students face various stressful factors. In a study
conducted at Brazil to assess the influence of stress factors and socio-demographic
characteristics on the sleep quality of nursing students showed that high stress level was
predominant for time management. Difficulties in curriculum activities conciliation with other
social, emotional and personal demands was the most common experience ( Benavente, da Silva,
Higashi, Guido, & Costa, 2014).

Conclusion:

Time management and patient priority are dynamic process and tend to go hand in hand
with good prioritizing skills. If you cannot priorities you, will waste time and be inefficient. This
can cause stress to yourself and your fellow team members, as well as causing potential harm to
your patients. An efficient way to organizing your time can be to use the nursing process as
explained in the essay to Analyze, Prioritize, Intervene and evaluate. I had thought about which
was the greater priority in this situation and I still believe that the patient was. The patient would
have been at risk from skin excoriation and would have been left uncomfortable and undignified.
I identified and minimized risk to that patient and as a Registered Nurse, I will hold a position of
responsibility and other people will rely on me. Although saying this, my priorities as a
Registered Nurse may be different to those as a student nurse and my continuing professional
development will be extremely important. I must make the care of my patients my first concern
at all times, treating them as individuals and respecting their dignity.
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References:

Gordon, C. E., & Borkan, S. C. (2014). Recapturing time: a practical approach to time

management for physicians. Postgrad Med J, 267-272.

Meiring, A. (2017). Time management: how to improve outcomes through management inputs.

Prof Nurs Today,1, 2-3.

Ancel, G., & Yilmaz, Y. (2016). Time management in Turkish nurses. Global Journal on

Humanites & Social Sciences., 205-2011.

Cleary, M., & Horsfall, J. (2011). Developing Students’ Time Management Skills in Clinical

Settings: Practical Considerations for Busy Nursing Staff. The Journal of Continuing

Education in Nursing, 248- 249.

Benavente, S. B., da Silva, R. M., Higashi, A. B., Guido, L. d., & Costa, A. L. (2014). Influence

of stress factors and socio-demographic characteristics on the sleep quality of nursing

students. Rev Esc Enferm USP, 4, 512-518.