Nurses are typically busy people, and the COVID-19 pandemic has added to our burdens. In many cases, we are home schooling children, and our significant others may be laid off from work, which creates financial constraints. Nurses may need to work extra shifts to care for higher numbers of patients. All of this often adds up to too much work and not enough time.
Numerous reports suggest that the time pressure from having a great deal of work to do and little time in which to do it can be stressful. This stress, particularly if it becomes chronic, can have deleterious effects on health. How can nurses manage these time pressures?
The impetus for examining this question arose out of a research study in which we interviewed farm wives in Eastern North Carolina about challenges they faced in maintaining their family health. All noted that time pressures were one of the main stressors that affected their health and the health of their families.
Farm wives are not alone; nurses face the same time pressures. Nurses, like farmers work “dark to dark” with 12-hour shifts common and mandatory overtimes not uncommon. Nurses may have families, care for extended family members, and be responsible for all housework. So how can nurses manage? We offer suggestions based on our own experience and some gleaned from consumer and business literature.
Framing your day
Sarah Ban Breathnach, in her book Simple Abundance: A Daybook of Comfort and Joy, outlines principles that add order and grounding to a person’s day. She notes that gratitude, simplicity, order, harmony, beauty and joy are secrets leading to fulfillment and authenticity. Order, harmony, gratitude, and joy, especially, can provide nurses with tools to lower stress and quiet our lives.
Creating order and harmony. Creating a sense of older and harmony is a good antidote to time pressures, particularly when things seem out of control outside the home. When work or other duties consume all of one’s time, the result is often a messy or chaotic house, with dirty clothes and dishes. It’s difficult to feel a sense of harmony when things are piling up!
Start by making a list of what you need to do each day or optimally make one for the week, so that you can include items that don’t have to be done immediately but should be accomplished by week’s end. Writing your list helps you readily identify the highest priority items, which items could be done online, and which you could delegate to someone else. List the most important things first. We find there is satisfaction in finishing and crossing something off the list! A good resource on “to-do-lists” is the book To-Do List Formula: A Stress-Free Guide to Creating To-Do Lists That Work, by Damon Zahariades.
Consider hiring or delegating what you can. Barring financial constraints, it may be possible to hire a young person once a week to run errands. He or she might be willing to work for close to minimum wage, and 2 hours can result in crossing a lot of errands off your “to-do” list. If funds allow (and after social distancing ends), hiring a person to clean the house, even just once a month, saves a great deal of time
Feeling gratitude. Nurses appreciate the beauty and complexity of the body and the gift of good health. Gratitude for the body goes hand-in-hand with maintaining a person’s health. But time pressures undercut that gratitude, leading us to the fast food drive-thru rather than eating a healthy diet, skipping exercise because we are too tired, or consuming alcohol in excess as a source of “relaxation”. Here are some suggestions for self-care, which will help you feel gratitude for your health.
- Get up 15-30 minutes earlier than the rest of the household. This is your quiet time. Your body will not miss a little sleep, and you can use the time for meditation, devotional reading, journaling, or just enjoying the stillness with a cup of coffee. Keeping a quiet focus on your inner spirit will help maintain a sense of calm when things get busy later in the day. The American Holistic Nurses Association offers guidance on various techniques for self-care, focusing, and centering oneself.
- Exercise regularly. This may seem like a time-robber, but even a small amount of exercise is better than none at all. A stationary bicycle is ideal, if there is room in the house, because is allows you to multi-task, for example, make your to-do list for the day. If a bike isn’t possible, try parking as far as possible from the door of your workplace and getting in a few extra minutes of walking each day.
- Cook smart. When you make something like soup or a casserole, make two. Freeze the part you won’t use immediately and then, when a day is particularly difficult, you can just reach in the freezer for a ready meal.
Gratitude includes being thankful for the technological resources now available to us. Technology can also be used in a variety of ways to help with time management:
- Consider shopping online for groceries and other items, including those from your local stores.
- Use your bank’s secure online site to make deposits and pay bills online; consider setting up monthly recurring payments of bills.
- Send birthday or holiday cards or notes through greeting card sites. You can plan ahead by specifying the delivery date in advance.
- Consider sending condolence messages or flowers to the bereaved via the funeral home’s website when you aren’t able to be there in person.
- Download apps that help you organize your time and prioritize to-do lists. Read a comparison of these types of apps at Capterra website.
- Organize family events online. For example, Cozi Family Organizer is a shared-calendar app in which access is shared across the family. It can be color-coded and anyone with the calendar is able to add events.
- Get help with meal planning from app such as BigOven, which compiles information from multiple sites and cookbooks to save the meal plans in one place. You’ll also get help with recipe inspiration.
Your children can help find and install apps, making it a family endeavor.
Finding joy. Most nurses entered the profession motivated by altruism to help patients and families, relieve suffering, and express care for others. Many factors in the current healthcare environment are less than joyful, such as staffing shortages, increased paperwork, and high acuity levels. We can forget the joy that was inherent in nursing. It is important to be mindful of why we went into nursing and recapture whatever simple joy we can find. For example:
- Take just a moment before entering a patient’s room to center your attention and focus your mind on your “care” for this person. Or repeat an affirmation to yourself as you enter the room, such as “I will care for this person as I would wish he or she would care for me.”
- When tempted to reply sharply to another nurse, instead remember that he or she may be harried as well and so respond kindly.
Your quiet time in the morning also will help you set your intention toward finding joy in moments with patients and other nurses.
Stopping the time robbers
You can’t frame your day effectively without stopping time robbers. Time robbers abound. They may be enjoyable in the short run but ultimately take their toll. The Franklin Planner blog site outlines three major time robbers—interruptions, procrastination, and poor planning.
Interruptions, particularly phone calls, emails, and texts, aren’t totally avoidable and may be important, but few rise to the level of vital. If you’re doing something important, you can simply not answer phone calls, and you can avoid notifications by setting the phone so it doesn’t notify you with every “breaking news” item.
Procrastination is particularly problematic when there are time pressures. When you make your to-do list, not which items are unpleasant and consider getting those out of the way first to avoid putting them off for another day.
Poor planning can be overcome with quiet time at the beginning of the day and organizing lists. Some people find it helpful to break down a task into small manageable elements. In your daily list you could write, “I will ride the stationary bike for 4 minutes this morning before I get dressed.”
Another time robber is the tendency to browse the internet. You go online to find one item, but get distracted by other things and end up losing an hour. It can be fun, or it can add to your stress, but either way, it’s a time robber.
Finding comfort and joy
Life is short and every day is precious. The pandemic has brought this fact to the forefront for us all. We hope these few suggestions will help busy professionals manage time to find a day of comfort and joy.
Mary Ann Rose is a professor of nursing and Robin Webb Corbett is an associate professor of nursing and chair of the advanced nursing practice and education department in the East Carolina University College of Nursing in Greenville, NC. Mary Lisa Pories is the sponsored programs officer at East Carolina University. Robin Tutor Marcom is director of the North Carolina Agromedicine Institute in Greenville, NC. Hailey Hutto is a student in the honors program at the East Carolina University College of Nursing.