Case Study Katie Roseman, RN, has worked

Case Study Katie Roseman, RN, has worked as a staff nurse in a busy outpatient hemodialysis unit for over 18 months; the unit averages 20 clients per day. Recently, Katie completed orientation to the relief charge nurse position. For the past two days, Katie has been assigned to work as charge nurse for the day shift because the regular charge nurse is on vacation. At the end of her second day as charge nurse, Katie thinks to herself, “I have three more days as charge nurse and I am so disorganized and frustrated. I just can’t seem to get everything done and I am afraid the patients are going to suffer for it!” As Katie recalls the charge nurse’s primary responsibilities that she learned in orientation (make patient rounds, review all lab results, follow up on identified problems, make staff assignments, monitor and assist staff, and delegate tasks as needed), she decided to review how she used her time as charge nurse today and made the following list: Made the daily nurse and technician assignments. Helped the technicians set up the dialysis machines and get patients’ vital signs and weights. Restocked supplies that were running low. Answered every phone call as it came in (at Katie’s request, the receptionist was to page her for any phone call) and followed up on the following calls: Gathered information to complete the supply usage report at the request of the administrator. Called three staff members at home to find one to work an extra shift after a nurse from the evening shift called and reported she would not be in that afternoon because her child was ill. Talked to the social worker to help begin planning next month’s patient/family education program. Talked to other staff nurses to find someone to trade a shift next month with a nurse who called to say she needs to change days off for a doctor’s appointment. Made patient rounds (which were not completed because of phone call interruptions). Paged the nephrologist three different times during the first half of patient rounds to report patient complaints, report critical lab values, take verbal orders, and follow up with instructions to the patient’s primary care nurse. Reviewed most of the lab reports, filed the normal ones in the chart, paged the nephrologist to report the abnormal labs, and followed up with verbal orders and chart documentation. Completed a nursing assessment on a new dialysis patient, visited with the patient and his family to orient them to the unit, and initiated their hemodialysis education and training program and the patient’s care plan. Called the hospital medical records to request discharge summaries on two patients who recently returned to the unit after being hospitalized. Contacted the dietitian to discuss the cases of three different patients who needed further assistance with understanding and maintaining compliance with their special diet. When Katie reviews her list, she begins to see several things she might do differently to better manage her time, experience less frustration, and accomplish the charge nurse’s most important tasks. 1. If Katie were to prioritize her tasks for the day, which would be most important? Least important? 2. What tasks should Katie delegate? And to whom? 3. What are some time management strategies that Katie should implement? 4. How could Katie use her experience in learning how to better manage her time as charge nurse to help other nurses new to the charge nurse position? Give an example Site reference supporting your thought process.

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