Time Management for New Grad Respiratory Therapists

RT Jaime
Mar 9, 2021
4 min read

Time Management for New Grads

If you’re a new grad Respiratory Therapist who just got hired into the ICU, it is so important to learn how to manage your time properly. Here are some of the things I learned during my ICU practice as a new grad.

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Plan

So after you get report, you can write out your therapies, neb treatments, etc, in a quick and easy way so you can plan out your day for the scheduled treatments. It may look something like this.

So the V stands for Vent Assessment, the HFNC stands for High Flow Nasal Cannula, O2 is Oxygen, Xop is Xopenex, Muc is Mucomyst, and so on and so on. So if I wrote it three times, that is a Q4 treatment, if I wrote it twice, that is Q6 and if I wrote it once, it is BID (bi-daily) meaning it is done once per shift. Sometimes nebs or therapies can be Q3 or Q2, so be sure to read your orders carefully.

The point of this is so that you can have a clear first glance look at how your day already looks. So by looking at this cheat sheet, you know how busy you are going to be. Of course always set aside some time to be taken by unforeseen events.

Click Here to check out my other blog post about expecting the unexpected.

Prioritize

Based on the report you get from the previous shift, you can prioritize who needs to be seen first. Usually a good rule of thumb is to see the sickest patients first. The ones who are pointed out as “highlighted” patients during report. This means you are seeing patient’s based on acuity.

Sometimes you will be told within 15 minutes about an admit, a planned intubation, and an escalation of care for a patient. You will simply have to rank them in terms of their priority/acuity. Perhaps you will get the vent ready for an admission, and then intubate another patient, and then setup bipap for another patient. You will have to prioritize who is the most important or time constricted to see. Obviously if a patient crashes, that is the one that takes priority and odds are the nursing and other healthcare staff will be running into that room as well.

When you first start out, you may start out by having 20 or 25 minute conversations with your stable patients on the floors, however, that time may have to be shortened once you realize how many patients you have to see that day. You will adapt and start getting the hang of how much time you should be spending per patient. Keep in mind you still have to chart on your patients as well.

Charting

Many times charting is one of the main things that holds new RT’s back from managing their time. The charting skills will come with time as you get used to the software. I used to take a computer on wheels with me and chart in real time. I was not going to write all the numbers down and then chart later. If I did that I would have been working all day long. Charting in real time is extremely helpful if you have the option to do it. But, do not let charting in real time take away from your patient assessment. Always do a thorough assessment on all of your patients.

If you start to drown

Keep in mind this is hospital dependent, but if you find yourself starting to drown, then you need to call for help. Call another therapist, the charge therapist, or team lead to come help relieve some of the many phone calls you are getting. Below are some reasonable requests for your team lead or charge therapist.

Having to transport a patient at the same time as an important treatment or therapy for another patient.
One patient is crashing and you get a call for ER pickup or a call for a new admission at the same time.
Basically any situation in which you are being called to two important things that cannot wait. Admissions, ER pickups, RRT calls, transports, coding, intubation, specialty gases (iNO), etc.

Communication is key all the time, but especially when you are drowning. If you leave the unit, always let the other RT or RT’s know so they can be prepared to step in for your patients. Always let your bedside nurses know as well, so they can have a backup person to call. There are some shared responsibilities that RT’s and RN’s have, such as suctioning. If the nurse calls you to suction a patient and you are caught up in transport, just ask her if she feels comfortable doing it herself. She may be a new nurse or just not comfortable with suctioning. Feel free to share your knowledge with her so she can be comfortable and independently practice suctioning, etc. Always follow your hospitals policies and procedures when it comes to shared responsibilities of RT’s and RN’s. Keep in mind, not all responsibilities are shared.

I hope you guys got something out of this blog post and feel more confident in being able to manage your time! Good luck out there, you are going to do great!