Time Management and Critical Thinking Flashcards
What are the benefits of time management in nursing
prioritization
focus
perfecting skills
clinical thinking and clinical reasoning skills are used
real time documentation coverage
gives more time with patients
holistic care
focuses goals of care
allows intervention implenmentation
limits procrastinations
protects your license
work life balance
rest and restore
What are the 3 steps of the cycle of time management
- Allow time for planning and establish priorities
- Complete the highest priority task whenever possible and finish one task before beginning another (also delegate)
- Reprioritize based on the remaining tasks and on new information that may have been received
Repeat
What are the 4 types of tasks
I: Important and Urgent
II: Important and Not Urgent
III: Not Important and Urgent
IV: Not Important and Not Urgent
Examples of Type I Tasks (I,U)
crises
pressing problems
deadline driven projects, meetings, preparations
Examples of Type II Tasks (I, NU)
Preparations
presentations
values clarification
planning
relationship building
true recreation
empowerment
Examples of Type III Tasks (NI, U)
interruptions, some phone calls
some mail, some reports, some meetings
many proximate pressing matters
many popular activities
Examples of Type IV Tasks (NI, NU)
trivia, busy work
junk mail
some phone calls
time wasters
“escape” activities
What are some strategies for time management for Staff Nurses
Organization is Key - stay on top of tasks, don’t procrastinate, use tools, use resources, ask for help as needed
Group Activities - take room inventory, gather supplies, prep tasks/meds together, assist aides in tasks during assessment
Estimate time gaps - time in between tasks/meds, patient off floor, lunch/breaks, staff help
Document in Real Time
Use tools - report sheets, time grids, EMR grids, timers, color coded/other for learning styles
Complete work on time
Work time is work time - avoid distractions and socializing and media
Time Management Strategies for Nurse Leaders
unit and personal priorities of the day
identify goals
know the staff - strengths and needs, nursing v assistive personnel
evaluate changes and needs of the unit both long term and short term
keep a planner or calendar up to date for meetings
prepare meetings with agenda items in advance
allow time for unexpected issues, check in points through the day
anticipate changes and needed adjustments often
plan in breaks
leave on time
4 Major ways to Prioritize Time
- Deal with Interruptions (find quiet places to chart and for planning spaces, close a door, block out time as able)
- Avoid Procrastination
- Be mindful of personal time - avoid burn out
- Set limits - dont let others, tasks, and personal issues creep into work time
The more organized a person…
the less stressed they are
Leadership and communication are ____
interdependent
What should a leader be doing in order to promote time management and prevent stress
help others with managing time
role model behaviors and values
fiscal responsibility is tied with productivity
assists as needed on unit goals and tasks
balances work and life
Brans’ 12 Habits to Master for Personal Time Managemetn
12 habits to help prevent stress and promote productivity
- Strive to be authentic. be honest with yourself
- favor trusting relationships
- maintain a lifestyle that will give you maximum energy
- listen to your biorhythms and organize your day accordingly
- set very few priorities and stick to them
- turn down things that are inconsistent with your priorities
- set aside time for focused effort
- always look for ways of doing things better and faster
- build solid processes
- spot trouble ahead and solve problems immediately
- break your goals into small units of work and think only about one unit at a time
- finish what is important and stop doing what is no longer worthwhile.
___% of nurses feel burnout in their work
15
Time Management Tips
Prioritize Tasks
Set a Manageable Routine
Learn to Say No
Build a support system
dont be afraid to delegate
make sure you communicate
give yourself breaks
Decision Making
making a choice with a given set of options
Problem Solving
goes one step further than decision making
finding reason and asking why questions
requires critical thinking skills
Decision Making Process
- Define and analyze the problem
- Develop alternative solutions
- Evaluate the alternative solutions
- Select the best solution
- Implement your decisions
- follow up
repeat
Critical Thinking
Using the nursing process to obtain information and formulate a plan based on this knowledge
thinking through a situation to make sound judgment and apply the necessary interventions for the situation to reach a successful end goal.
Critical Reasoning
one step beyond critical thinking
bigger thinking - if I do this what will the outcome be and why
various levels of knowledge application
applies EBP
nursing dx and care plans come to fruition based on several aspects of the patient’s assessment, nurse’s knowledge and skill, and holistic interpretation of needs.
ASKING WHY IS THIS HAPPENING - WHY WOULD THE OUTCOME BE LIKE THIS
Nursing process
Assessment –> Nursing Dx–> Planning –> Implementation –> Evaluation –> REPEAT
Nurses must become ___ thinkers and use ___ ___
critical thinkers and use critical reasoning
Ways to Develop Clinical Reasoning Skills as New Nurses
Trust intuition
Assess early in shift
Notice subtle changes in status
Be thinking about the next best action due to change or “What if”
SBAR thinking (Situation background action response)
Evaluate how the patient responded to the intervention and if further action is needed
Learn your resources
Reflect on the outcome and how to improve next time
Seek help from seasoned peers
When in doubt always question
How can leaders enhance team clinical reasoning
provide education, discussion, reflect
work groups
practice counsels
evaluate the literature for EBP
support new nurses in training
know resources
apply the nursing process
communicate with your teams
offer support from seasoned nurses for mentorship
How to support others in decision making
recognize/celebrate difference and diversity (gender roles/views, past experiences/knowledge, personal choices, learning and thinking styles)
Do not rush the process, be patient
Results of Rushing Decisions
“Skydiving without a parachute” - lacking data prior to calling the provider or not having equipment ready
Assumptions overtake real data- prejudices of disease
Overconfidence can be detrimental, always ask - you are responsible for lives
not considering others POVs
shooting from the hip with no data to support
doing the first thing that comes to mind because you PANIC
Novices nurses are focused on what
tasks - ex: assess pain, give medicine, check lists to complete
Expert nurses focus on what
seek reasoning beyond the task, prevent situations, refine goals based on outcomes
Novice have what qualities
linear thinking, black and white, no gray
react quickly, lack data for rationale
need clear instructions and guidelines
task oriented
learning to delegate and prioritize
internships and preceptor models well received
Experts have what qualities
organize data well
assess early, put all the pieces together then act, prioritize
know when and how to get things done
timely
confident, leadership qualities
pays close attention to patient responses
vast knowledge, great preceptor/mentor
What elements make up critical thinking
decision making
problem solving
professional judgment
creativity
Decision Making
complex, cognitive process defines as choosing a particular course of action
Problem Solving
part of decision making
systematic process focusing on analyzing a difficult situation
always include a decision making step
What is the small but important difference decision making and problem solving
Although decision making is the last step in the problem solving process, it is possible for decision making to occur without the full analysis required in problem solving
Critical Thinking
also called Reflective thinking
evaluation - broader scope of thought than decision making and problem solving
more complex than problem solving or decision making requiring higher order reasoning and evaluation and has both cognitive and affective components
Clinical Reasoning
use of both knowledge and experience to make decisions at the point of care - using various types of knowledge
Elastic thinking
bottom up process
non linear and creative way of thinking allowing overcoming of barriers
Case Studies
stories that impart learning
Simulation
provides learners opportunities for problem solving that have little or no risk to patients or to organizational performance
Problem Based Learning (PBL)
provides opportunities for individuals to address and learn from authentic problems vicariously (small groups meet and analyze real life problems)
Marquis Huston Critical Thinking teaching Model
4 overlapping spheres each as a component of teaching leadership and management
Didactic Theory, Personalized Learning, Problem Solving, Group Process
Traditional Problem Solving Process
- Identify the problem.
- Gather data to analyze the causes and consequences of the problem.
- Explore alternative solutions.
- Evaluate the alternatives.
- Select the appropriate solution.
- Implement the solution.
- Evaluate the results.
Managerial Decision Making Model
- Determine the decision and the desired outcome (set objectives).
- Research and identify options.
- Compare and contrast these options and their consequences.
- Make a decision.
- Implement an action plan.
- Evaluate results.
Ethical Problem Solving Model
- DETERMINE whether there is an ethical issue or/and dilemma.
- IDENTIFY the key values and principles involved.
- RANK the values or ethical principles which—in your professional judgment—are most relevant to the issue or dilemma.
- DEVELOP an action plan that is consistent with the ethical priorities that have been determined as central to the dilemma.
- IMPLEMENT your plan, utilizing the most appropriate practice skills and competencies.
- REFLECT on the outcome of this ethical decision-making process.
Recognition Primed Decision Model
intuitive decision making model
people are primed to act with intuition or gut feelings
Critical elements of Decision making
- Define objectives clearly.
- Gather data carefully.
- Take the time necessary.
- Generate many alternatives.
- Think logically.
- Choose and act decisively.
Confirmation bias
tendency to search for and favor information that confirms our beliefs while simultaneously ignoring or devaluing information that contradicts our beliefs
One alternative in each decision should be…
to not do anything
3 Ways People think Illogically
Overgeneralizing
Affirming the Consequences
Arguing from Analogy
Overgeneralizing
This type of “crooked” thinking occurs when one believes that because A has a particular characteristic, every other A also has the same characteristic. This kind of thinking is exemplified when stereotypical statements are used to justify arguments and decisions.
Affirming the Consequences
In this type of illogical thinking, one decides that if B is good and he or she is doing A, then A must not be good. For example, if a new method is heralded as the best way to perform a nursing procedure and the nurses on your unit are not using that technique, it is illogical to assume that the technique currently used in your unit is wrong or bad.
Arguing from Analogy
This thinking applies a component that is present in two separate concepts and then states that because A is present in B, then A and B are alike in all respects. An example of this would be to argue that because intuition plays a part in clinical and managerial nursing, then any characteristic present in a good clinical nurse also should be present in a good nurse-manager. However, this is not necessarily true; a skilled nurse-manager does not necessarily possess all the same skills as a skilled nurse-clinician.
Simon’s 2 Types of Management Decision Makers
Economic Man
Administrative Man
Economic Man
rational decision maker
has complete knowledge of the problem or decision situation
has a complete list of possible alternatives
has a rational system of ordering preference of alternatives
selects the daily decision that will maximize utility
Administrative Man
makes decisions that are good enough
because complete knowledge is not possible, knowledge is always fragmented
because consequences of alternatives occur in the future, they are impossible to predict accurately
usually chooses from among a few alternatives. not all possible ones
the final choice is satisficing rather than maximizing
Satisficing
term describing decisions that may not be ideal but result in solutions with adequate outcomes
Decision Grid
visual representation of the alternatives and comparing them based on criteria that are the same among them
Examples of Decision Making Tools
Decision Grids
Payoff Tables
Decisions Trees
Consequence Tables
Logic Models
Program Evaluation and Review technique (PERT)
PERT
program evaluation and review technique
a flow chart that predicts when events and activities must take place if a final even is to occur
Logic Models
schematic or picture of how programs are intended to operate
Short Term Plans
period of 1 hour to 3 years
usually less complex than strategic or long range plans
Time Management
the optimal use of available time
Prioritizing things can be in 3 categories
dont do
do later
do now
Decision Relayed Action Orientation
Theory that those who tend to hesitate or procrastinate show higher amygdala volume providing a neural signature called an “amygdala hijack:
Major Time Wasters
Technology
Socializing
Paperwork Overload
Poor filing system
Interruptions
All 12 of Brans Habits for time Management are directed at what
being self aware regarding what is important to accomplish in one’s life, staying focused on things that matter, taking care of oneself, and following through in a timely and consistent manner.
