Definitions of Self-Management, Time and Stress for Nurses

Those of us who graduated from nursing school and started their first job were full of dreams, aspirations, and had every intention of making a difference. Now fast forward five years; these same nurses have been on their feet for 16 hours and have not had time to eat or use the bathroom since leaving their homes this morning. The call lights will not stop going off long enough for them to give report to the oncoming nurses and once again they are late for their children’s dance recitals or soccer games. They can forget about trying to squeeze a yoga class in this week. I understand what it is like to rush to your car feeling as if some important task was forgotten; was Mr. Smith’s tube feed restarted, did room 8 receive their pain medication? Nurses all over the world are experiencing “burnout”. To avoid burnout, nurses must properly care for themselves by separating work from personal life, knowing when to say no, and making time for enjoyable activities to manage stress, because we cannot provide quality patient care if we are neglecting ourselves.

Staff nurses have great responsibilities in caring for patients. Often, these nurses experience heavy workload. Heavy patient load and stress contributes to burnout. Why is burnout important to discuss in relation to nurses? Burnout affects the performance of the nurse and the quality of care he or she provides to the patient. Therefore, it is imperative that staff nurses decrease the possibility of burnout and increase or maintain excitement and enjoyment in the field of nursing. If nurses do so, they will find joy in their work and quality of patient care will be increased. Contributors to burnout and

You are 20 minutes into your 12-hour shift, do you know how the rest of your day is going to go already? Ask yourself these simple questions: Do you know about your patients? Have you reviewed all of your orders and your “to-do” list? Have you already planned how to prioritize and delegate your tasks for the day? In Today’s world of nursing, a nurse must multitask, intervene when necessary, and advocate for the patients – all while educating and promoting safety. Time management is an often overlooked task by many nurses, but is essential to maintaining a stress free shift while accomplishing patient-centered care. According to Oxford’s Dictionary, time management is defined as “the ability to use one’s time effectively or productively, especially at work.” ("Time Management - Definition of Time Management In English | Oxford Dictionaries") To appropriately manage time, a nurse must use prioritization, efficiency, and communication to complete obstacles that may come their way.

Workload was described to be heavy, stressful, increase in intensity and overtime hours. As a result 25.8% consider resigning, 20.2% consider retiring and 25.6% consider leaving profession. Another problem that was observed at individual level was poor commitment to care. One of the factors that often limited nurses to provide therapeutic care was the change in nurse to patient ratio. As nurses assignments increase with the increase in the number of patients (i.e. 1 nurse to 6-8 patients) the quality of care provided decreases. Nurses’ ability to maintain safe environment became challenging. As part of caring, nurses also showed decreased amount of time spent with their patient. This eventually led to nurses being less satisfied with their current job. Self – efficacy was often low. Nurses felt that they did not have enough knowledge and skills required for professional practice (Newhouse, Hoffman, & Hairston, 2007). This often led into stressful transition and the ability to care for a patient even harder. New graduate nurses often had difficulty maintaining leadership role. They often felt that they did not have the ability to self advocate and raise their voice to be heard by others. They often feared that they would be over heard and that no one would listen to them (Mooney, 2007).

According to Chater and Litchfield's study done on new graduate nurses who work in a neonatal unit at an Australian hospital, five themes: "knowing, planning, support, fulfilment, adapting and being flexible" can be utilized to help student nurses and new graduate nurses to better manage their clinical time (Chater & Litchfield, 2007).

Nursing students must learn to manage their time effectively to be able to handle the heavy load of coursework, and clinical requirements that they have and they will continue to use those skills once they are practicing as a nurse. Eliminating distractions, setting boundaries, and scheduling are key to time management (Kaplan, n.d.). Time management requires prioritizing tasks, removing distractions, and planning. Using both a master and weekly calendar as well as setting clear boundaries with family and friends are integral to time management.

Nurses work long hours and deal with high levels of stress during the workday which leads to nurse burnout. Nurse burnout is classified as physical and mental fatigue, which strongly affects the nurses emotions and motivation. (“Nursing Burnout”). Burnout is caused by various factors within the workplace, such as dealing with a hectic, fast-paced environment, caring for too many patients at one time, and working odd hours. When nurses deal with multiple patients per shift, high levels of responsibility, and their own personal problems, they can become exhausted and overwhelmed. Stress due to burnout can also affect the nurse’s mood in a negative way, causing the nurse to become impatient or irritable, which can oftentimes results in verbal or emotional abuse towards the

The profession of nursing requires a capacity and joy for caring and healing others both mentally and physically. Nurses spend their careers caring for patients and their families often in the worst and most frightening periods of their lives. Nursing responsibilities can be lengthy, stressful and physically and emotionally demanding. The demands of the nursing profession coupled with the nursing shortage and longer work hours put even more stress on nurses. Despite these extreme demands, many nurses do not fully appreciate the importance self-care. Yet without proper care for themselves, nurses are not able to provide the best care for their patients.

Self care is essential to the nursing profession because it is a reflection on the quality of health care nurses provide to their patients, it portrays an image to the patients on what’s necessary towards healthy living and can help nurses battle with stress and personal health. Self care can be expressed as taking care of ones self’s health and overall wellbeing. This can be shown through eating healthy, exercising daily, getting enough sleep and completing weekly activities to reduce stress. Improving your overall health can benefit nurses from overworking themselves and help minimize the affects certain stressors can have on them. By doing so, the overall atmosphere in the workplace and the quality of healthcare provided to the patients will be greatly improved.

Self-scheduling is an aspect of nursing that has been considered for quite some time. Prior to discussing the pros and cons of this particular practice, it is necessary to briefly elucidate some of the reasons why organizations and nurses have experimented with this technique in the past. The goal of self-scheduling, of course, is largely synonymous with the goal of assigned scheduling to fully staff a particular health care organization so that it can deliver the best care possible to its patients. The primary difference between these two methods, however, is that the former affords nurses greater authority and autonomy (Pecci, 2012) in this process, by allowing them to determine the times that are most convenient for individuals to fulfill this goal. As such, there are a number of benefits and detrimental aspects of letting nurses determine their own schedules. Some tangible pros include allowing nurses to better manage their personal and private lives, reducing the work load and the amount of stress nurse managers deal with, and overall improving the scheduling and staffing process; common cons include staff unavailability, preferentialism, and pressure to adhere to the wishes of a bevy of others (Bailyn et al, 2007, p. 73).

One mistake that new nurse leaders make is that they believe that the only way to get things accomplished, is to be direct and autocratic (Kerfoot, 2008.) The new leader’s fear of failing can influence them to take on the autocratic role to try and earn respect from their employees. However, this is not considered to be very effective among staff. When the professional nurse takes on the autocratic leadership trait and uses it on a daily basis, employees feel micromanaged. When a manager micromanages their employees they take the risk of lowering morale, and losing good workers (North, 2011.) Nurses have a lot of autonomy in their profession. They work independently and take responsibility for their actions. When they become micromanaged by their nurse leader, it takes away that autonomy and creates a work environment that is very low in morale, and can hurt the relationship between manager and employee. Often managers are experiencing a substantial amount of stress from the administration concerning budgets, deadlines, and high performance issues, but this does not justify micromanaging employees (North, 2011.) It is important to give your staff some independence; this lets them know you trust their judgment (North, 2011.) A nurse leader may also change their leadership style depending on if they are dealing with an inexperienced new graduate nurse, or an experienced veteran nurse.

The current and growing shortage of nurses is posing a real threat to the ability of hospitals, long-term care facilities, and others to provide timely access to quality care. Nurse staffing shortages and nurse turn-over contributes to the growing reduction in the number of staffed patient beds available for services, increasing costs, and rising concerns about the quality of care. Health care organizations highly depend on nurse managers and leaders to reverse this trend. This paper discusses the reasons for nursing shortage and turn-over, different approaches to solve this issue, and my personal philosophy about this issue.

Stressful work environments, long work hours and inadequate sleep all contribute to an increase in physical and mental exhaustion amongst nurses. Typically, people choose nursing as a career to help others and to make a difference in their lives, without realizing the number of duties this career demands. Nurses may suffer in silence when they are experiencing stress. The effects can impact safe and reliable care by decreasing job satisfaction, decreasing productivity, causing poor personal health, and compromising patient care. Many facilities would benefit from implementing evidence-based strategies to address nurse fatigue and burnout.

There are numerous elements that contribute to stress in the healthcare setting. Nurses’ days are full of physical, mental and emotional demands. There are societal demands and workplace demands created by the shortage. These stressors can become increasingly overwhelming and if there is no stress relief, job performance can and will be hindered. When fatigue and stress combine there is potential for “performance decrements”. This can include diminished capacity to manage a specific level of workload resulting in errors in the delivery of nursing care. This can produce damaging effects on the safety and advantageous outcomes for both the nurses and patients. (Reese, 2011). Therefore, finding a balance between lowering stress levels of

Time management is a critical component of modern nursing. It is, “a key factor in how nursing work is organized and understood” (Cucolo & Perroca, 2015, p. 122). There are many factors that influence nursing behaviors, but time is one of the most important (Chan, Jones, & Wong, 2012, p. 2021). Managing and using resources appropriately is a key nursing responsibility, and time is indeed a resource. In fact, Yoder-Wise proclaims time to be the most valuable of resources available (2015, p. 533). Unfortunately, time is not infinite as a working resource, and is often scarce (Chan et al., 2012, p. 2020). Furthermore, “nursing work is often characterized by a shortage of time” (Chan et al., 2012, p. 2021). In the current climate of nursing practice with expanding workloads, staffing inadequacies, and growing responsibilities, time management is becoming an increasingly necessary issue to research and improve upon. Efficient time management skills are required for any nurse to be successful, and have been shown to make some individuals more successful than others (Said, 2014, p. 746; Yoder-Wise, 2015, p. 533). The purpose of this paper is to demonstrate the importance of time management in the nursing profession by identifying its effects when used efficiently and inefficiently, and to provide strategies for individual nurses as well as institutions to improve