Time Management As A Practice Nurse

Debbie offers advice on her techniques for effective time management as a Practice Nurse whilst keeping the patient experience as her top priority.

Hello, my name is Debbie and I'm a Practice Nurse in London. Today I'm going to be discussing time management as a General Practice Nurse.

Dealing With Existing Time Constraints

Now, as commonly known in GP Practices, time is such a big factor. We're given 10 to 15 minutes, some people even less, to see one patient.

The problem that we often deal with is the fact that a patient can come in for one thing but have many things due or many things that they are requesting you to see. For example, I can see a patient for a blood test, but I would look at something called the ‘red box alert’ that will notify me that not only do they need a blood test, but they need their blood pressure checked. If they're diabetic, they need a foot check, they need a flu jab, for example, and a few other things.

This can be quite daunting, because as much as you would like to do all the tasks that they need and make it a ‘one-stop shop’ there just isn't always the time.

So how do I deal with this?

I think, number one, how I start is by prioritising.

Sometimes I have to look at my list and ask myself, is this doable? Am I able to complete all the tasks that I need to do within the timeframe, even if I go over one or two minutes, can I do it?

Some patients are more complex than others. There are some patients that I know when they come in their blood pressure might be on the higher side, just from what I've seen in the past or seen from their trend.

I will make the decision in that moment if I should call them back in for another day for a complete check or if I can do it today.

So prioritising, for me, is being able to say, do you know what, I know I have you here at the moment, but it might be best if I can do a full and intensive check for you on another day. And that way I'm also able to see my other patients and they don't have to wait such a long time in the waiting area.

Focusing On Who You Have In Front Of You

Another thing when it comes to prioritising is the number of messages that we can get in a day.

For example, we have something called screen messages and tasks, and in a day, you can be sent quite a few.

A habit that I try to make is that unless I have a time slot, or a space, or an admin slot whereby I can stop and look at those messages, whilst I'm seeing patients, I do not open any messages. It could be, you know, that there's a patient waiting outside, they don't have an appointment, but they would like to be seen for X, Y, and Z, their dressing has fallen off, things are happening.

If I open that message at that point in time, you know, it will slow me down and I'm having to think, okay, where can I squeeze this patient in? Or can I see this patient? Or when can I see this patient? I've got to now look through my appointment’s slots for the rest of the week and things like that. And that can really slow me down. So I make it a priority for myself not to open any of these messages until I have that space or that gap to do so.

If You Can, Document Your Patient’s Care During The Appointment

Now number two is, and this one for some people can be a bit tricky, but I am someone that documents on the go.

There are some people that see all their patients and then they document everything later. I cannot do that.

I think I'm someone that wouldn’t remember everything that's happened. So instead of just typing away and making it seem like I'm not listening to a patient, what I tend to do is whilst they're there, as I'm typing, I'm also looking at them and reiterating what they've told me so that they can see that I'm actively listening and that I'm typing the information they have given me. That way it's done there and then, and the patient knows that I have put the information that they have said onto their notes, and that saves me so much time from having to come back later during my lunch break or any break, you know, to write it all again.

Use Your Team When You Have Unavoidable Delays

Now, number three, and this is something that I know not a lot of people are privileged in having because sometimes there's only one Practice Nurse in the team, but it's asking for help.

One thing that I always do is I tell the reception team, just let patients know that there is a bit of a delay, and I think that's what people just want to know. They just want to know that they've not been forgotten about in the waiting area.

You know, there's been a lot of times that my Healthcare Assistant in the team and my other Practice Nurse would say, you know what, if you're running behind, just let me know and I'll see one of your patients quickly, or we'll do a swap, or we'll just rejig things around so that it can accommodate all of us.

It's so helpful when you have a team whereby people are able to just help you when you feel like you're running behind or you feel like you're just really inundated with too much work.

And I think another key thing for me is not to panic. When I'm running behind, you know, I know that I'm not running behind due to laziness or due to things that were in my control.

Sometimes you have just one patient that comes in and you can be doing so well, everything is on time, everyone is on time, and you just have that one patient that can set you back literally 30 to 45 minutes, and you are just there, like, how has this happened? Don't panic.

Keeping Patients Informed If Waiting

One thing that I always do is I tell the reception team, just let patients know that there is a bit of a delay, and I think that's what people just want to know. They just want to know that they've not been forgotten about in the waiting area.

There have been times where I have gone to my GP practice and I'm thinking my time slot has gone, you know, and I'm hoping that I've been checked in properly, or I'm hoping that, you know, I haven't been forgotten, X, Y, and Z.

I had a patient recently who came to tell me that in her previous General Practice she was sitting down in the waiting area for about an hour or so, just to find out later that the doctor that she was here to see didn't turn up that day, you know? And it was just like, what a waste of her time.

So letting the reception team know that I am running behind, to let patients know there will be a bit of a delay and that way, communication on both parts, is effective, and patients don't feel so much like they've not been seen or heard. I think this is really helpful because when I do call the patients in, they're less frustrated. I apologise, oh, sorry for the wait, for the delay. And they're like, oh, it's fine, I know if you could have you would have seen me sooner. These are just a few tips on time management.

Build In Flexibility

I think what is very important for me as well, and just a side note, I have the privilege of being able to book in my own patients for follow up. So if I see a patient today, I can tell them, okay, come next week or the week after, at this time, you know, and because I'm in control of my own timetable, I'm able to say, okay, you know, I can put them in certain slots that I know would favour me.

As you get to know your patients you would know, okay, this patient is better off not to be seen in the mornings, or it's better not to put them off, this type of patient, or do you know what, I can squeeze this patient in because I know it's going to be a quick appointment, things like that. But as you get to know your patients, you would know what is best and where to put them best on your list.

So I hope this was helpful.

I think in ‘GP Land’ timing and the pressure that there is to see everyone and do everything in such a short space of time is crazy. And I say that, you know, if you are a patient, even me as a member of staff, when I'm a patient, you know having to go into my GP, I'm just like, you know what, there are some things that are just not in our control.

As much as we try and see everyone on time and do everything on time, you can literally walk in, have the best day, and walk out and it's like, that was the craziest thing I ever went through, simply because you had just one or two patients where it just completely just went awry, and time just flew out the window. So be patient with your healthcare professionals because the pressure is serious.

I hope this helps.