The Challenges of Time Management for Nurses

Managing Time as a Nurse with ADHD

There are many things about ADHD that contribute to being a wonderful nurse. For example, individuals with ADHD are likely to have high levels of empathy, they are spontaneous, high levels of courage, the ability to hyper-focus on a task, and amazing attention to detail.

Unfortunately, there are also struggles that come with being a nurse with ADHD such as lack of general focus, inattention, and poor time management. As a nurse one of my biggest struggles has been time management.

When I was hired into the ICU as a new nurse I was required to work for three months on a medical surgical floor first. I laugh when I recall crying in the storage closet every day feeling completely overwhelmed with feelings of inefficiency trying to manage all the tasks.

All eight of my patients needed things at the same time that they felt were most important ranging from pain medicine, medication for high blood pressure, a walk, a bed bath, a turn, fresh water, ordering lunch, and countless others.  

Fast forward nine months and I began a job in a nationally ranked Neurosurgical Intensive Care Unit. This position was vastly different than the 10 bed Medical ICU in the small town I had been working in.

The struggle with time management only became more intense. Whereas in the medical ICU it was required to assess the patient every four hours, input and output every two hours, and medication management, the Neurological/Neurosurgical Intensive Care Unit had a much more regimented set of monitoring which included hourly neurological assessments, the amount of fluid they received as well as the amount the patients put out (through surgical drains, urine, etc) every hour, drawing labs at a certain time, changing the rate of continuous infusions to keep patients alive, charting, updating and educating families, changing surgical dressings, monitoring the pressure inside the head hourly, and many more important tasks.  

All the tasks on my “to do” list felt like trying to paint a multidimensional piece of art with the same color grey. Having timed tasks that coincided with urgent tasks starts from the moment I clock in. Trying to organize the mountain of tasks heightened my anxiety and I found I would lose track of time as I was focused on a particular task at hand.  

Once the tasks were (somehow) complete as a nurse I must take time to chart the information for doctors to see on the computer so they can recall it at any point. Charting has always been my bane of nursing because there is always something else I could be doing that (to me) felt more important.  

Time Management Solutions for Nurses

All nurses have what they call “a brain” which is a sheet of paper that they take notes about the patient that they deem important. I developed a report sheet that worked perfectly for my ADHD mind.

Not only did it have defined boxes for each body system, but it has a table at the bottom to put tasks, when those tasks are due as well as the important numbers that needed to be documented throughout the shift (Input/output, intracranial pressure, increase rate of tube feeds, and other similar notations).

Once I began using the sheet I created I gained the ability to see the tasks in a more organized way of priority. Not to mention the way it was written on this sheet gave me the ability to use recall that “something” was due at a certain time.  

There have been other things I have learned through the years to help with my time as a nurse. I have learned to set alarms if something needs to be reassessed like pain and blood sugar. Not only do I use alarms as reminders to do a task, but I’ve also found it helpful to set them to remind me to move on from a task.

We have the ability to become hyperfocused and get lost in doing something without realizing the amount of time that has passed, so setting an alarm to notify us five minutes before we need to move on to something new is very useful for ADHD Nurse brains.

Time Timer Products That Can Help

I’ve also started using the Time Timer Watch for things such as IV push medication that I have to administer over a certain period of time like tPA and Lasix. It is easy to second guess exactly what second you began your 60 second countdown, or the exact minute for the four minute IV push. I love having the ability to set the exact time and visually see the time changing. There are many things to overcome as a nurse with ADHD, especially considering our natural struggles with time. Thinking outside the box and utilizing methods and devices that work for us can be empowering as we start to become nothing short of incredible in our field. 

About the Author:

Jami Fregeau is a Registered Nurse who creates educational and supportive content for neurodivergent individuals through her podcast, The Neurodivergent Nurse and lnstagram account. Jami knows personally the difficulties of living and thriving with ADHD. Her diagnosis came in December 2020 at the age of 36. She spent most of her life struggling with social anxiety, lack of self-esteem, and self doubt unknowing much of it was due to being neurodivergent with undiagnosed ADHD. This became a catalyst in creating a safe and welcoming community for individuals to ask questions and find likeness in shared experiences. Jami is nationally certified as a Critical Care Registered Nurse and been awarded North Carolina's Great 100 Nurses. She facilitates diversity education through her local hospital educating Physicians, Nurses, and other staff the importance of recognizing inherent biases and inclusion in professional and day-to-day practices.