Learning Nurse Newsletter - January 2012

Welcome to the January 2012 edition of the Learning Nurse Newsletter. We have enhanced and expanded our newsletter and now post all editions on this website. We publish three times a year to keep nurses, nursing students, nursing educators and other interested parties informed about is what happening at LearningNurse.com. (For more timely updates, follow us on Twitter.)

Always short of time!How Well Do Nurses Manage Their Time?

A nurse's time management skills have a huge impact on her day-to-day life, both at work and at home. Managing time effectively allows her to achieve a more balanced and enjoyable life. When it comes to time, we are all equal - rich or poor, male or female, young or old, nurse or supervisor ... we all have only 24 hours in a day! The difference is that some people find their days almost always go smoothly, while others are forever fighting the clock.

We thought it would be interesting to see how well nurses manage their time. To gain some insight into nurses' time management skills, we analyzed the data from our Time Management Profile located on the Learning Nurse website. This TM Profile evaluates how an individual manages her/his time on four dimensions:

1.  Are you organized? You need to be organized to use time effectively. This means planning, setting priorities and organizing your documents and files so you can easily find them.

2.  Are you disciplined? Discipline enables you to get things done faster and better. Plan your work, do important tasks first, and avoid distractions and the urge to do the less important, but more enjoyable activities first.

3.  Are you a good communicator? Effective communication with your supervisors, co-workers and patients will save you time, and avoid unnecessary distractions and extra work.

4.  Can you say "No"?  If you let them, others will always try to rob you of your precious time. You have to learn to say "No" without feeling guilty and to focus on your own important tasks. 

After cleansing the Time Management Profile data, we ended up with 160 self-identified nurses in our sample. These nurses were mostly female (92%), either registered nurses (53%) or practical nurses (31%), and either had 5 years or less of work experience (47%) or 20 or more years of experience (32%). Hospitals were the primary work location (49%) while continuing and home care locations accounted for another 26% of the sample nurses.

Figure 1 shows the distribution of time management scores for the entire sample. The chart shows the percentage of nurses whose scores on each of the four dimensions fall into each quartile. For Organization, Discipline and Communication, some 61 to 64% of the scores fall in the third quartile, or between the scores of 51 and 75. Remember that a TM score of 100 means the best possible time management on that dimension, while a zero means absolutely no time management ability. Those 7 to 14% of nurses in our sample who are in the fourth quartile undoubtedly have very good time management skills. On the other hand, those in the first and second quartiles (25 to 29% of nurses) would benefit from improving their ability to manage time.

Figure 1: Percentage Distribution of Time Management Scores by Quartile 


The exception is the time management dimension of "Saying No". Most scores (60% of nurses) on this factor fell in the second quartile or scores between 26 and 50. We are not sure how to interpret this finding that nurses have difficulty saying "no". Perhaps it is the nature of the profession where it is difficult to say no to patients / clients and their families. Also, saying no to colleagues many mean that they will in turn say no when you need their help!

Figure 2 shows the average time management score for each dimension by type of nurse, i.e. practical nurse (PN), registered nurse (RN) and nursing student (NS). On the dimensions of Organization, Discipline and Communication, RNs (n=85) had the highest average scores. The PNs (n=50) had the second highest mean scores on Organization and Discipline and were tied with nursing students in Communication. The nursing students (n=16) have the lowest average scores on Organization, Discipline and Saying No. It should be pointed out that the differences between the three groups are not very large and are probably statistically insignificant.

Figure 2: Average Time Management Scores by Nurse Type 


Figure 3 shows the average time management scores based on where the nurses work - hospital (n=79), continuing care centers (n=16) and home care (n=25). There were no differences between the average scores for the dimension of Organization. However, continuing care average scores tended to be lowest on the dimensions of Discipline, Communication, and Saying No. Nurses working in home care were more likely to have higher average scores in Communication and Saying No.

Figure 3: Average Time Management Scores by Work Location 

Finally, Figure 4 shows the average time management scores based on years of work experience. This chart is complicated by the number of different time-worked ranges. Also some of the numbers are small so that the results should be only considered suggestive, not definitive.

Those nurses that have been working 6 to 10 years had the highest average time management scores in Organization, Discipline and Saying No. Nurses in the work force for 11 to 15 years tended to have the lowest scores in Organization, Discipline and Saying No. As interesting as these findings are, we have no explanation for these differences in time management scores based on years of work experience.

Figure 4: Average Time Management Scores by Years of Work Experience 

Common Time Wasters 

We examined the responses to individual questions in the Time Management Profile. Here are some of the interesting (and perhaps disconcerting) results we found.

  • 78% of nurses said that they have to resolve personal problems during work hours. (Q-19)
  • 64% of nurses said that they feel like everyone around them is only interested in their own problems, and don't understand theirs. (Q-23)
  • 62% of nurses said they sometimes or often put aside what they are doing to work on less important tasks. (Q-8)
  • 60% of nurses said they have to bring work home to meet their deadlines. (Q-6)
  • 60% of nurses said that they sometimes or often misplace documents and files. (Q-16)
  • 58% of nurses said that they neglect certain tasks because they forget about them, don't have time or are not interested. (Q-5)
  • 57% of nurses said that they supervisor doesn't understand that they can't do everything she asks them to do. (Q-28)
  • 55% of nurses said that they have poor concentration and are easily distracted. (Q-2)
  • 48% of nurses don't set objectives, they just go day to day. (Q-13)
  • 47% of nurses said people around them don't seem to understand their priorities, and they are often interrupted. (Q-31)
  • 42% of nurses said they don't delegate because they are the only ones who really know how to do the work. (Q-1)
  • 38% of nurses said that they accept deadlines that they know they can't meet. (Q-4)
  • 30% of nurses said that they like to do things that they like or that makes them feel good, even if it's not their job. (Q-25)
  • 28% of nurses said they are sometimes or often interrupted by co-workers when they are working. (Q-27)


Procrastination is the tendency to put off until tomorrow what needs to be done or could be done today. Procrastination is respectful of no one. We all suffer from it at one time or another. Procrastination is a major stumbling block for almost everyone seeking to improve her / his use of time.

Procrastination prevents success. Success comes from doing really important things critical to obtaining results. And these important tasks / decisions are most subject to procrastination, for we seldom seem to procrastinate about unimportant things. If we could only learn to shift our procrastination from important to unimportant matters, our time management problems would disappear!

One reason for our habit of postponing what is important is our tendency to confuse the important with the merely urgent - to which we are constantly responding. Important matters are seldom urgent unless they are allowed to reach a crisis state.

Why do we procrastinate? The single biggest reason is a desire to avoid unpleasant things. Another big source of procrastination is that the task is big, difficult or complex. We don't know where to start, or the task is simply overwhelming!

Other reasons we procrastinate is that we may be indecisive; we just can't pick an alternative. We may worry about what may go wrong. We may be afraid that we will fail, or be rejected in some way. Or, we may simply like things the way they are, and do not want to make a change!

Since more people procrastinate unpleasant things than anything else, here are some strategies on how to overcome this bad habit.

  • Analyze each unpleasant task and determine what makes it unpleasant
  • Learn to confront the unpleasantness and deal with it directly
  • Do the distasteful first and get it done, rather than dreading it and continually putting it off
  • Tackle unpleasant tasks in small pieces and/or over a period of time
  • Setting a deadline for a task helps; let others know about a deadline so that you have some encouragement (and pressure) to meet your deadline
  • Simply get started and reward yourself when you finish the unpleasant task or activity.

Final Considerations

The usual cautions apply to this research study. The sample size is relative small and it is unknown whether the respondents are representative of the larger population of nurses. However, the findings do provide some interesting clues and challenges regarding time management in the nursing profession. 

How do you compare? Take the Time Management Profile at LearningNurse.com and compare your results to the ones published here. Managing your time effectively is the best thing you can do to make your life easier. Your well-being depends on it. Better time management will reduce the stress in your life and will make your nursing career more enjoyable and satisfying.

Learning Nurse Users

Analyzing the Learning Nurse website statistics from January 1 to December 31, 2011 shows the following:

  • 94,245 unique visitors (IPs), an increase of 260% over 2010
  • 154,000 visits with 2.44 million page views and 254 GB of traffic
  • 24 hour traffic (many from night shifts)
  • 23% spent 15 minutes or more per visit (13,200 visits were 15 to 30 minutes, 12,900 visits were 30 minutes to 1 hour, and 9,200 visits were over an hour long).

The geographical locations of Learning Nurse visitors were as follows:

  • 49% from 45 states in the United States -with the highest traffic from California (12% of all US traffic), New York (9%), Pennsylvania (7%), Texas (6%), Minnesota (5%), Florida (5%), Ohio (4%), Illinois (4%), Georgia (3%), Michigan (3%), Massachusetts (3%), Wisconsin (3%), Indiana (2%), Kentucky (2%), Maryland (2%), New Jersey (2%), North Carolina (2%), Virginia (2%) and Washington (2%)
  • 13% from the United Kingdom (Great Britain)
  • 10% from Canada - all 10 provinces with the highest traffic from British Columbia (35% of all Canadian traffic), Ontario (20%), Alberta (11%), Saskatchewan (9%), New Brunswick (9%) and Manitoba (8%)
  • 8% from Australia with the highest traffic from Victoria (33% of total Australian traffic), New South Wales (23%), Queensland (22%), Western Australia (12%) and South Australia (5%)
  • 3% from Malaysia, 3% from New Zealand, 3% from India and 2% from Philippines
  • The rest of the traffic came from 40 other countries - United Arab Emirates, China, Columbia, Cypress, Egypt, Ireland, Israel, Iran, Jamaica, Japan, Korea, Kuwait, Pakistan, Portugal, Saudi Arabia, Singapore, etc.  

The above traffic analysis was done only on those visitors that viewed 342 pages or more. There were visitors from 48 countries. It is likely that people from many more countries visited the site, but we were only interested in the regular and heavy users of the Learning Nurse resources. The Learning Nurse website has a loyal following with a high rate of repeat visits. This is demonstrated by:

  • Some 80% of visitors come directly from a bookmark or URL entry
  • 17% come to the website from a search engine - Google, Yahoo and Bing; "nursing quiz(zes)" and "learningnurse" are the most common search terms with Learning Nurse being listed at the top of these search engines
  • Only 3% of traffic comes from links on other websites with Facebook being the top referrer
  • Over 138% of visitors bookmarked the website in 2011.

Despite the fact that our visitors are increasing every month, we are still a long way away from reaching the approximately 5 million English speaking nurses on this planet.

New, Improved and Planned

Since the September 2011 Newsletter, we have made several additions to the Learning Nurse website. These include:

  • Added and completed a new section of quizzes - Body Systems Terminology: 12 quizzes with 616 questions
  • Completed our Nursing Care of Older Persons quizzes: 11 quizzes with 826 questions
  • Added Antiviral Drugs quiz and Antifungal Drugs quiz
  • Added Phobias quiz
  • Added links to Canadian and US student nursing associations.

We plan to add three more sections to our Test and Quiz Center. These are:

  • Clinical Microbiology - 4 quizzes on bacteria, fungi, viruses and parasites
  • Diseases and Disorders of the Body Systems - 13 quizzes
  • Pain Management - 4 quizzes on acute, chronic, child and geriatric pain management.

We have already acquired the content resources (the latest textbooks) and will be developing and posting these quizzes as time permits.

For some of our more recent quizzes, we have started using Tanida Quiz Builder rather than Wondershare's Quiz Creator software that we have previously used. Although slightly more difficult to use, Quiz Builder (QB) has some distinct advantages over other quiz software we have evaluated.

QB enables the users to print out a complete copy of their quiz results which include their responses and the correct answers. QB also provides a Certificate to those that successfully pass the quiz. (We have set the passing grade to 80%). The Quiz Builder software also allows us to better track and analyze the responses for each question. It also records the actual time each visitor took to complete a quiz.     

Quiz Results

We now have 134 nursing quizzes with 8,910 questions. However, from our poll at our Test and Quiz Center, nurses say they want even more quizzes!

As of this writing, some 138,500 Learning Nurse quizzes (with over 3.6 million questions) have been done and recorded. Between 200 to 500 quizzes are now completed every 24 hours! The quiz results are tracked on the website in real time, both in a searchable query table, and in a series of statistical reports for each quiz.

{mosimage}The 15 most popular quizzes are: (N)

  • Anatomy Terminology I (10,963)
  • Disease Terminology I (5,230)
  • Medical Terminology I (5,132)
  • Anatomy Terminology II (5,005)
  • Anatomy and Physiology (4,271)
  • Safe Medication Principles (4,100)
  • Cardiovascular System (3,468)
  • High Blood Pressure (3,241)
  • Endocrine System (3,238)
  • Cardiology Terms (3,075)
  • Infection Prevention and Control (2,744)
  • Blood Components (2,726)
  • Disease Terminology II (2,669)
  • Urinary System (2,658)
  • Medication Abbreviations (2,637).

The ten least completed quizzes are: (N)

  • Antiviral Drugs (1)
  • Antifungal Drugs (2)
  • Phobias (8)
  • Nutrition and Fluids (20)
  • Mental Health (45)
  • Medical Disorders (45)
  • Herb-Drug Interactions (47)
  • Perinatal Depression (65)
  • Suicide Prevention (72)
  • Rectal Disorders (75).

It should be noted that many of the quizzes in the "least completed list" were only added recently. The complete list of the Learning Nurse quiz results sorted by descending frequency can be seen here.

Average scores are computed for all of the completed Learning Nurse quizzes. The 20 highest scoring quizzes are: (average percent)

  • Medication Abbreviations (93%)
  • Fluid Dosage Calculations (89%)
  • Injection Dosage Calculations (89%)
  • Tablet Dosage Calculations (88%)
  • Intravenous Flow Rates (86%)
  • Managing Patient Rage (85%)
  • Metric Conversion (83%)
  • Cardiology Terms (82%)
  • Respiratory System Terminology (78%)
  • Anatomy Terminology II (77%)
  • Musculoskeletal System Terminology (77%)
  • Nervous System Terminology (77%)
  • Antidotes (76%)
  • Digestive System Terminology (76%)
  • Endocrine System Terminology (76%)
  • Cardiovascular System Terminology (75%)
  • Disease Terminology II (74%)
  • Fatigue (74%)
  • Immune System Terminology (74%)
  • Reproductive System Terminology (74%).

The ten quizzes with the lowest average scores were:

  • Nutritional Disorders (45%)
  • Dangerous Drug Combinations (46%)
  • Diagnostic Tests I (47%)
  • Diarrhea (48%)
  • Substance Misuse (49%)
  • Mental Status (49%)
  • Herb-Drug Interactions (50%)
  • Diagnostic Tests II (50%)

The completed list of the Learning Nurse quiz results sorted by descending average scores is available here.

The Quiz Builder quiz software now allows us to track the time of completion for each quiz. These results, where available, are shown in the attachments. The average time to do a quiz ranges from 9 minutes and 13 seconds (Respiratory System Terminology) to 16 minutes and 28 seconds for the Ear and Eye Terminology quiz. All the quizzes for which time is tracked are currently 25 questions long.

About Learning Nurse

The Learning Nurse Resource Network (LearningNurse.com) was created by Steppingstones Partnership, Inc. and went online in April 2008. The purpose of this nursing professional development resource is to make available free, informal, accessible and convenient learning opportunities for nurses. Because of the shortage of nurses in many facilities, it is very difficult to get away for traditional courses and workshops. This is particularly true in smaller and rural areas where it nearly impossible to obtain leave and funding to attend professional development events.

Although the Learning Nurse was originally designed for all levels of practicing nurses, it has become popular with nursing students, graduate students and nurses returning from leaves. Many of the visiting nurses take time during breaks in their night shift to review and refresh their nursing knowledge and skills using our quizzes and e-learning modules.

That's it for now. If you have any questions, comments or suggestions, please let me know. Thanks for your continuing interest and support.

Best regards,

Russ Sawchuk
Webmaster and Editor

Note: Permission is granted to reprint all or part of the information in this newsletter provided that the source - LearningNurse.com - is credited.


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