Time Management Brings Order to Nurse Leaders' COVID Chaos

Nurse leaders indicated they couldn't get enough time with their team because of administrative tasks, so their CNE gave them the gift of a time management course.

When COVID-19 brought chaos to nurse leaders at Allegheny Health Network (AHN)'s 14 hospitals, a time management course designed just for them helped them feel less overwhelmed about their day.

"They were saying, 'We work really hard all day, but we feel like we don't accomplish anything.' And that is a hit on their morale," says Claire Zangerle, DNP, MSN, MBA, RN, FAONL, NEA-BC, chief nurse executive for AHN, based in Pittsburgh. "They live in chaos all day, and the issue for them is, 'How do I control the chaos?' "

Nurse leaders indicated that they couldn't get enough time and engagement with their team because of other tasks such as staffing schedules, disciplinary actions, overseeing budgets, developing their team, and self-care, Zangerle says.

Zangerle had recently taken an effective time management course and thought that might be a solution.

She worked with Carol Perlman, PhD, a cognitive behavioral therapist specializing in time management, who surveyed nurse leaders about their time management strategies and how they felt about how they managed their workday. From those responses, Perlman then created a word cloud chart, which is a clustered list of words mentioned by the nurse leaders, portrayed in different sizes. The bigger, bolder words are those that are mentioned the most.

"The biggest two words were 'busy' and 'chaotic,' " says Zangerle.

Perlman provided a customized time management course for the nurse leaders with the objectives of teaching them to create a daily schedule, helping them attain skills for centralizing a task list and prioritizing daily tasks, encouraging them to incorporate time for self-care, and creating a plan for engaging and developing their staff.

"The goal was to reduce their stress level and to help them feel that they were in more control of their day, which would lead to them being able to spend some time on themselves to eat right, plan their meals, take time for exercise, take time for meditation, or whatever would contribute to their health and well-being while in a chaotic environment," Zangerle says.

Setting up the 'classroom'

AHN provided the course for CNOs, nursing directors, and nurse managers at all the health system's hospitals.

Each participant was given an 18-month planner, customized with AHN's colors, along with a workbook. The 21-day course included daily self-paced work that generally took less than five minutes, plus weekly virtual sessions.

For one of those weeks, each individual discipline group—all CNOs, directors, and nurse managers—met with their peers to share information related to their leadership level, Zangerle says.

They also set up a Google classroom where the instructor posted lessons and participants could post their work, ask questions, and offer hacks, she says.

"Now, the nurse managers want their assistant nurse managers and supervisors to take the course," Zangerle says. "They recognized the need to cascade the same valuable information to this group of newer nurse leaders so they could also learn how to prioritize tasks, deal with the unexpected, and block out time appropriately."

For the 300-plus nurse leaders who have completed the time management course, "They feel that they're a lot more in control, and that contributes significantly to their wellness," says Zangerle.

The time management course resulted in collateral benefits as well, Zangerle says.

Allegheny Health Network CNOs pulled together directors from their hospitals and worked on lessons together, learning how to delegate and do succession planning, says Zangerle.

The results

A post-course questionnaire revealed:

• 62% of nurse leaders rate their current time management strategies as "very good," as compared to 29.61% before the course.
• 76% felt they got many targeted tasks done by the end of the day, as compared to 35.9% before the course.
• 46% felt that time management affected their overall job performance "a lot," as compared to 32.45% before the course.
• 58% use a master list to organize their tasks every day, as compared to 26.2% before the course.
• 28% felt their ability to create and implement a leadership development plan for their staff was "extremely effective," as compared to 7.3% before the course; 54% felt their ability was "very effective" post-course, as compared to 28.7% before the course.
• 60% felt they used strategies to manage procrastination that interferes with their productivity "very well," as compared to 30.92% before the course.
• 78% can use a system to address unexpected demands "very well," as compared to 24.68% before the course.

A second word cloud created by Perlman after the course also revealed changes in how the nurse leaders felt about their day. Instead of "busy" and "chaotic," the biggest, boldest words in the post-course word cloud were "productive" and "good."

"The chaos is still there, but they feel like it's controlled chaos," she says. "We're going to have chaos for a while here, and the value is in de-escalating the chaos to control what you can, so that you can better manage the things you cannot."