May 13, 2017

#1 Tip For All New Nurses | Task Versus Process Nursing


I've been training a graduate nurse for the past few months. If there is one tip I could give any new nurse, it would be to find a balance between task nursing versus process nursing. As a nurse, you will be expected to manage both tasks and nursing processes. You might prefer one over the other, but both must be mastered for proper time management to take place.

Task-based nursing, in my opinion, involves focusing solely on completing certain tasks or checklists. It centers around the documentation aspect of nursing. It seems benign, but documentation is a significant aspect of the nursing profession. As your professor once said, "If you didn't chart it, it never happened." That concept holds true in bedside nursing today. I work in critical care. People heal and people crash. And in the middle of all that lies documentation. Some forms are time-sensitive, while others must be completed by the end of the shift. The problem with being task-oriented is the lack of human communication. Don't let the computers and fancy machines fool you. Assessments are the juggernauts of the nursing profession. There is no substitute for the assessment, and there never will be. No electronic form can detect pulseless electrical activity (PEA) versus sinus tachycardia. You must feel and you must asses the rhythm.

Monitoring your patients (with your eyes) is just as important as completing forms. You are the nurse, not a robot. As nurses, we must treat the patient and not simply stare at the monitors. I could give you five reasons why an arterial wave form could be inaccurate. We could go on and on about why a blood pressure cuff could produce erroneous results. You must determine if the numbers are truly accurate before blindly trusting them. You must go into the room and assess the situation and patient. I've taken many reports from task-oriented nurses. Their charting is immaculate, but their patients are hot ass messes, both figuratively and physically.

Now, on the flip side of that conversation, we have process-based nursing, which, in my opinion, involves the physical actions of the nursing profession. From giving baths to passing medications, these nurses truly value the profession and focus on the patient's needs and priorities. They monitor their patients with pin-point precision, and when an alarm goes off, they are the first individuals to go into the room. The issue with this form of care is the lack of documentation. These tactics might work out initially but will cost you your nursing license in the end. Ask my co-workers. I document every form of communication, every encounter, and every abnormal result. I paint a full and detailed picture as to leave nothing to chance, as medicine is a legal process and should be treated as such. Whether it's a STAT verbal order or you're giving medication during a rapid sequence intubation (RSI), you must document every intervention. You must have an order for every nursing intervention that takes place. Doing the physical job isn't enough. Your word isn't enough.

In the end, you must find the balance between task and process nursing, for both are essential and required. As a new nurse, finding this balance will take time, but lean on your preceptor and ask for support if needed. Make sure you don't start on your own without some foundation in place. Like all professions, perfecting your approach and critical thinking skills will take time. Don't get overwhelmed, just understand what is required of you and rise to the occasion.