Nurses' use of time in a medical-surgical ward with all-RN staffing

AIMS: To investigate allocation of nursing time, organisation of nursing activities and whether or not allocation and organisation have changed over time. BACKGROUND: In a ward that changed to all-RN staffing, the nurses were encouraged to implement a patient-focused philosophy. The nurses perceived that they had difficulty in using the time available efficiently. METHODS: Non-participant observations were conducted with 2-year intervals. Ten consecutive weekdays were covered on two occasions. The study was carried out at a university hospital in Sweden. FINDINGS: Between observations, a significant change in the organization of the direct care had occurred, and the same tendency was found in patient administration and general management. The organization of work changed from a partly fragmented to a more coherent one. The time used for direct care and administrative activities increased between the two observations, while indirect care, personal and service activities decreased. CONCLUSION: It can be suggested that the nurses used their time efficiently and, over time, they developed a more coherent way of organizing nursing activities.