Get More Done by Clustering Tasks

Nursing involves a fair amount of cerebral work: critical thinking, analyzing assessment information, and planning your plan of attack. It also involves a mountain of tasks. Often “tasking” can be so overwhelming that you lose sight of the big picture, and it is axiomatic that the more you run from task to task, the more behind you will get.

You can spend time to make time by clustering.

If you’re a student, better to figure this out sooner rather than later, because it’s just as easy to play possum as a student—by “play possum” I mean you look busy, but you really aren’t getting anything done. Rushing around reading chapter after chapter isn’t going to help you, even though you look productive, if you aren’t organizing the material in your head. Similarly, running around randomly completing tasks because they’re next on the computer is not going to help you as a nurse. Either way, a plan will bail you out.

It seems counterintuitive if you’re behind the eight ball, but don’t start anything at all until you have a comprehensive idea of everything you need to do. If you’re a student, know what you need to accomplish by the end of the day, and by “accomplish” I don’t mean simply “read.” If you need to know the Krebs cycle by the end of the day, your goal is much more than “read about the Krebs cycle.” If you’re a nurse, your goals will change up on you by the hour, but in general you can formulate a few top goals for each patient.

Once you’ve got your master plan, which will immediately run afoul (just plan on that), scan through it and see what things can go together. This is the part where spending time will save you time. Things can go together geographically, temporally, conceptually, or any other way that is convenient to you. I work in a big ER, so I cluster things by where things are a lot. For example, if I have three (noncritical) patients who need IVs started and labs drawn, I could start each IV, give meds, and Reebok the blood waaaaay down the ER to the lab tube and then repeat times 3, but that’s bad geographical clustering. Instead, I could start all three IVs, take all three sets of blood in one trip to the lab tubes, come back to my station, and dole out meds one-two-three.

Temporal clustering works well on the floor. You usually have an hour window for medication administration, so don’t run around giving meds scheduled at 7:00, 8:00, and 9:00. Give them all at 8:00. If several of your patients need to be turned regularly, get them on the same schedule so you aren’t turning patients every half hour for your whole shift. Do all your assessments and chart them all in a row (because you’re never interrupted while charting).

Conceptual clustering works for more cerebral tasks, and it isn’t always apparent how to use it. It often shakes out that you have a few patients with similar issues, so you can focus on similar tasks all at once. For example, everyone needs urine samples or everyone is going to the OR in 30 minutes or everyone needs splints right now. Zero in on whatever you can group together (e.g., get all three consents signed or delegate obtaining bedside commodes to your CNA or drag your entire splint cart down to where you need it and do all the splints at once).

Look for ways to group things together and just drop off activities that aren’t getting you toward your goal. Making flashcards may make you feel like a good student, but if it isn’t helping you learn the Krebs cycle, ditch it and instead learn the darn thing. Running back and forth to the lab tube may make you feel like you’re working hard, but you could be working smarter.

About Megen Duffy

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Megen Duffy, RN, BA, BSN, CEN, is a practicing nurse, blogger, and contributing editor for the American Journal of Nursing. Megen has practiced in a variety of settings from emergency rooms to prisons.