Creating Effective Routine for a Nursing Shift

NursingMarch 14, 2017

Due to the inherent unpredictability of illness and injury, the nursing profession must inevitably embrace a certain need for flexibility. Crises emerge, emergencies happen, things take longer than expected, staff members call in sick…the list goes on. Part of being an effective nurse is being agile at adapting to changing circumstances. Sometimes that involves dropping what you were doing and responding promptly to a rapidly unfolding situation. At other times, it might involve adopting a department-wide change in policy.

In other words, a routine is arguably something of a contradiction in nursing. Nevertheless, every nursing shift must have some semblance of routine built in. Certain duties must be performed regularly, for example, and various tasks, such as restocking, taking inventory, preparing for the next shift’s needs, charting, etc., must be attended to reliably. Implementing routines helps ensure that all these tasks get completed before the end of your shift, regardless of the day’s workflow.

The Pros and Cons of Routine in the Nursing Workplace

There are two opposing schools of thought regarding routine within the context of nursing shifts. On one hand, a routine can save time, prevent supply problems, and boost the efficacy of procedures designed to optimize patient and employee safety. On the other hand, illness and injury follow no schedules, so nurses must be flexible enough to abandon routine as needed to attend to individual patients’ needs, as they arise.

The latter approach is viewed as more likely to yield the sort of attentive, patient-centered, individualized medical care patients want and deserve. There’s even a phrase coined to describe this sort of going-the-extra-mile approach to nursing: “beyond-the-routine”. Proponents of the former approach maintain that a routine is essential for ensuring that adequate safety and professional standards are met and maintained. As with most things, the sweet spot probably lies somewhere in the middle between these two.

Assuming that any nursing shift will necessarily include a list of tasks that must be accomplished within a certain time frame, the question of work-shift routine becomes one of time management. Experts agree on some general principles when it comes to managing your time as a nurse.

Time Management for Nurses


Prioritization is the place to begin with any list of routine tasks. Identify tasks that absolutely must be accomplished, and make them a top priority. To help you prioritize and rank the importance of tasks so you can tackle them accordingly, answer a few questions first:

  • What shall I do first? Why?
  • Which task is most important? Why?

How will doing this task impact the patient? Will it contribute directly to his or her wellbeing, safety and/or comfort? (A “yes” answer raises the priority of the task).

Trust Your Instincts

There are certain skills nurses bring to medicine that no machine will ever be able to replicate or replace. Nurses fill many needs in patients’ lives, from providing reassurance, information, and instruction, to providing the occasional human touch (not to be minimized, despite the lack of recognition of this simple aspect of nursing care), to dispensing medications as assigned, taking vitals, charting, and performing other routine tasks. Nurses who go “beyond-the-routine” to provide superior care often rely on intuition to discern when something may be going wrong with a patient.

Suggestions for a Smooth Routine

At the start of your shift, experienced nurses suggest you review your orders during or immediately after the shift change handoff. Discuss any medications, dosing, and their administration schedules with the outgoing nurse.

Keep Your Workspace Organized

Arrive early, never late, and take control of your shift by organizing your workspace at the beginning of your shift. It gives you an edge and helps get your head in the game. It’s also one less potential source of stress, should things go sideways during your shift.

Inventory Supplies

Review scheduled tests that may have been ordered, gather the supplies needed and organize any related paperwork. It’s all about making things go more smoothly, even when chaos erupts. Restock supplies for your own or the next shift’s use, as appropriate. 

Break Strategically

Take scheduled breaks at the times when your workload is at its lightest if you have the option. And don’t give in to the temptation to skip your break(s). They’re mandated for a good reason: Humans need to rest and recharge occasionally to remain effective at performing their required duties. Some nurses even try to avoid using the bathroom, to save time. This is counterproductive because your personal health and wellbeing are crucial to your ability to do your job properly. Stay hydrated, eat some healthy snacks to maintain your energy levels, and use the restroom as needed.