Chapter 10. Time Management/Organizational Skills

Dr. Hammer is the Director of the Bracken Pharmaceutical Care Learning Center and Teaching Certificate Program in Pharmacy Education for the University of Washington School of Pharmacy. Dr. Hammer received a B.S. in pharmacy from Oregon State University, worked in hospital and community independent pharmacies, and then returned to school to earn M.S. and Ph.D. degrees in Pharmacy Administration with an emphasis on education from Purdue University School of Pharmacy. Her teaching responsibilities include an introductory pharmacy practice course series, and electives in pharmacy education. Her research involves assessment of students' educational outcomes and professional development, and interprofessional education. Dr. Hammer has served on the editorial boards of several pharmacy education, practice and research journals, and has won awards for teaching, innovations in teaching and education, and educational research. She practices her time management skills balancing a faculty position, relief work in an independent pharmacy, and parenthood of two children.

After completing this chapter, readers should be able to

1. Determine if they need to improve their time management skills.

2. Critically analyze the choices they make in how they spend their time.

3. Describe common myths or pitfalls with regard to time management.

4. Take action to avoid time management pitfalls.

5. Discuss various theories and approaches to time management.

6. Apply concrete suggestions, through a series of steps, to improve their time management skills.

7. Explain how time management techniques apply to pharmacy practice.

8. Recognize the relationship between poor time management and stress.

Revisit the Krista Connelly scenario from Chapter 2. It appears as though Krista is a good time manager—she seems to attend all her classes, prepares for classes ahead of time and reviews material with professors, holds down a part-time pharmacy job, and even is able to squeeze in routine home activities and downtime with friends and family. Granted, Krista may not be taking very good care of herself with regard to diet, exercise, and sleep, but all in all, she seems to have her act together. One question remains, however, after reading about Krista: When does she study? Perhaps she is one of the “genius” students who does not seem to have to study very much but is still able to achieve high grades. Consider a different scenario below.

Tom Chan is also a second-year pharmacy student. Tom describes himself as a busy pharmacy student, although he would not necessarily say that he is stressed out most of the time. Tom tries to get out of bed by 7 a.m. so that he can get to class by 8 a.m., but he often oversleeps and misses his first class. He realizes that he should go to bed earlier, but it seems that the only time he can find to study or maybe watch some TV to unwind is between 10 p.m. and 2 a.m. Tom's normal day consists of attending classes, getting in an hour of basketball, and then heading to work at his pharmacy intern job at a local chain pharmacy. In between classes, he usually hangs out with friends, eats, or attends extracurricular activities and meetings. Tom finds it hard to try to get in any quality study time during the day and usually puts off studying for major exams or completing large assignments until the night before they are due. Because of this, he usually pulls all-nighters once every week or two. During midterm and finals weeks, he sometimes will stay up all night on several occasions. Tom averages B's and C's in school, although he got a D in pharmacology last year and had to repeat the course.

Tom usually works about 20 hours per week to help pay his tuition and other school-related expenses, as well as costs related to his cell phone, cable TV, and Internet subscriptions; car payment and insurance; rent; and other living expenses. He usually manages to have a little left over each month to buy music, go to movies, and go out on the town with friends, but he also maintains some credit-card debt from furniture and apartment supplies he bought when he started pharmacy school. The local chain that employs Tom as a pharmacy intern has an intern development program that helps interns to learn chain pharmacy management and administrative skills. At a recent employee annual review, Tom's preceptor shared his disappointment with Tom's tardiness to work, his inability to prioritize work tasks very well, and his lack of desire to want to improve or become engaged in management functions. Tom was discouraged with his preceptor's observations and is not sure what to do.

Do you have classmates like Krista and Tom? Do their lives sound similar to yours? Read on to find out how applying some simple time management and organizational skills can make you a better pharmacy student, better future pharmacist, and a more productive, healthy person.

1. How do I know if I need to manage time better?

2. What can I do to better manage time?

3. What are some resources I can use to help me better manage time?

4. What are some of the common pitfalls with regard to time management?

5. How does personal time management relate to time management in pharmacy practice?

6. How can time be better managed in pharmacy practice?

7. How does poor time management affect stress levels?

There are 24 hours in a day. Research tells us that for a person to be healthy, roughly 7 to 8 hours of that time should be used for sleeping. That leaves 16 to 17 hours to accomplish everything else we need and want to do in a day: go to school and/or work (usually 3 to 10 hours per day), study (rule of thumb for lecture courses is 2 hours outside class for every 1 hour in class, so let's say approximately 6 hours per day), eat (approximately 1 hour per day), shower and get ready (0.5 to 1 hour per day), exercise (0.5 to 1 hour per day), routine maintenance (e.g., pay bills, pick up room, etc.—1 hour per day), participate in a nonschool or nonwork interests (1 hour per day), relax and have fun (0.5 to 1 hour per day), and spend time with family and/or friends (face-to-face, or via e-mail or phone—0.5 to 1 hour per day). Not all of us participate in all these activities each and every day, but if we did, we are looking at spending anywhere from 14 to 23 hours per day engaged in them. And this estimate does not even include time spent on transportation or unexpected events.

Time is one of the most valuable resources we have. Several philosophies have been iterated about time:

• The gift of your time is the most valuable gift you can give.
• If you want to know what people's real values are, look at how they spend their time and their money.
• Time is money.
• Time management is not about managing time; it is about managing yourself.

Many advances in technology and other areas are all about saving time. Think about computer programs for word processing, spreadsheet creation, and statistical analyses. Think also about personal digital assistants, cell phones, microwaves, airline travel, and overnight mail. All these inventions were created to make our lives easier and allow us to be more productive and spend the time we save through their use on other activities. It has been written, however, that we can never save time—we can only spend it—so we must make wise decisions about how we choose to spend our time (Ensman, 1991).

Time management and organizational skills are important both personally and professionally. Poor time management can lead to frustration, stress, and a failure to complete daily tasks or achieve personal and professional goals. We already know that frustration and stress can be physically detrimental. Poor time management can also cause others to lose respect for and faith in us—we may be considered less reliable and dependable, less likely to follow through on commitments, and less responsible. If others feel this way about us, we are less likely to be involved in committed relationships or receive promotions at work. Safety can also be compromised—personal safety, for example, if one is constantly late and so feels compelled consistently to drive over speed limits. Patient safety certainly can be compromised if pharmacists practice in a manner that is hurried, disorganized, and haphazard. Conversely, good time management skills can lead to a higher quality of life for most people because they affect so many aspects of our lives, both personal and professional. The reasons to become a better time/self-manager are compelling and important—readers of this chapter should be motivated to improve their time management skills.

“I don't have time…”

How often do you hear this phrase or utter it yourself? The truth is that we all have 24 hours in every day to accomplish what we need and want to do, so saying that you don't have time is actually a lie. The difference is how we choose to spend our time. Thus, unless you are in prison or some kind of work camp where you do not make the decisions on how your day is spent, most of us consciously decide how to spend our time. It was your choice to apply to pharmacy school. It is your choice to go to class. It is your choice to study. It is your choice to get a part-time job. It is your choice to read this book. No one is forcing you to do these things. Granted, there may be significant consequences if you do not choose to do these things, but the bottom line is that you choose how to spend your time. The next time that you feel compelled to say, “I don't have time to ____________ [fill in the blank],” rephrase it to, “I can't take the time to ____________ [fill in the blank].” At least that way you will not be lying.

“I'm too busy…”

Once again, you choose how to spend your time. If you feel that you are too busy to maintain your personal health, achieve your personal and professional goals, or be as successful in all your tasks and responsibilities as you would like to be, then change your schedule. Do not take on as many tasks. Find your success limit, and maintain it! Contrary to popular belief, the busier people are, the more productive they are, and the more they accomplish. Think about the last time that you had a week without appointments or without deadlines. How much did you get done? Granted, you may have caught up on some needed rest and relaxation, but you may not have attended to many other items on your to-do list because you were in relaxation mode and were not feeling the subtle pressure of “something needs to be done.” Deadlines creep up once again and cause stress when the realization occurs that you do not have as much time to meet that deadline as you would like. It is certainly important to recharge your batteries once in awhile, but the quote “If ever the going seems easy, check to see if you are going downhill” should be heeded. Although it was stated that busy people are more productive, it is not necessarily true to say that all busy people are productive. Many folks spend their time working on tasks and activities that could be better handled by others. They may not be able to prioritize their responsibilities very well or may be easily distracted or consistently interrupted. And it is certainly true that some folks are just too busy. You know that your plate is too full when your health begins to fail, your personal relationships begin to fail, and you cannot follow through reliably with all your responsibilities. You begin to forget things. You miss meetings and deadlines. You may feel consistent stress, and guilt if you relax at all or “get off task.” These are not healthy feelings and can escalate to the point of illness and exhaustion. It is important to find that balance of where you feel like you are able to stay on top of things and are getting things accomplished but not that your schedule is so easy that you are wasting your potential to achieve higher goals.

“My personal time management skills have nothing to do with how I manage time at work.”

It is plausible to think this way because we are proactive at home—we determine when we want to fix dinner, do laundry, pay bills, and the like. Pharmacy practice, however, is often reactive—we help patients when they ask for it/need it, fill medication orders as they come in, and answer the phone when it rings. These different situations give the impression that personal and professional time management differ from each other. It is possible that a person might be completely organized at home and a train wreck at work, but this is a rare and unusual case. Most people who have a good sense of organization and time allocation know when to say “no” and how to apply those skills at home and at work. We do not usually purposefully apply different criteria for how we manage our time at home versus work; these skills usually are unconscious, routine, habit. The good news is that these skills can be learned.

“I need time to focus in order to…”

The ability to multitask is an absolute necessity for any pharmacist or pharmacy student. This does not mean doing several things simultaneously—if that were the case, you would never get anything fully accomplished, and patient safety certainly would be compromised. What it does mean, however, is that it is important that you have the ability to “switch gears” easily and maintain a sharp mind so that you can give your undivided attention for a few moments to the task at hand and then move on to the next task or back to the original task. Rarely will you have full days without any appointments or activities scheduled so that you can spend the entire day on one task.

“I'm a perfectionist…”

It is certainly important to do your best and to always “put your best foot forward,” but as a pharmacy student or pharmacist with many demands on your time, it is critical that you discern which tasks must be perfect and which can be less than perfect. Dosing and preparation of chemotherapeutic agents, for example, should be as close to perfect as possible—it is crucially important that enough time be spent on these tasks to make sure that they are correct because people's lives are at stake. Revising a term paper five times for a three-credit course, however, does not have such severe consequences, and the time spent in the extra three revisions could have been spent studying for an examination that is worth twice the number of points as the paper. It is okay not to be perfect all the time, unless, of course, the consequence of not being perfect is severe. In other words, sometimes we have to “choose our battles” in order to win the time management war.

“They didn't teach time management in my curriculum.”

Some pharmacy schools provide regular workshops for students or parts of courses devoted to time management, study skills, stress management, and other pharmacy school and life survival skills. If your school is not one of those, however, this chapter is here to help get you on your way to being a better time manager. In addition, there are books and articles referred to throughout this chapter that can serve to help you become a successful time manager.

In 1675, R. T. wrote a letter to a Mr. R. A. describing “the art of good husbandry, or the improvement of time: being a sure way to get and keep money.”1 In this letter, R. T. discusses several rules for merchants, shopkeepers, “mechanicks,” tradesmen, and others to follow in order to use time to their advantage for themselves and families. He describes the loss of a man's time, which includes time spent in taverns, coffeehouses, or alehouses, as “the sole cause of poverty in this city and nation.” This citation possibly may be one of the earliest that begins to describe the importance of time management.

Fast forward to the 1950s, where the industrial revolution had long been in place, Americans were enjoying postwar success, and management as a business discipline was evolving. Peter Drucker, well-known business management guru, wrote The Practice of Management in 1954, which helped to put the art and education of management on the map. Within his text, he put forth the philosophy and practice of “management by objectives” and described time as “the scarcest resource, and unless it is managed, nothing else can be managed” (as paraphrased in Applebaum and Rohrs, 1981). In a subsequent book, Drucker articulated four suggestions for helping executives to better manage their time (Drucker, 1967, pp. 26-28):

1. Find out exactly how you actually use your time.

2. Determine what does and does not have to be done (and discontinue doing the latter).

3. Delegate work to others who are equally or better qualified than you are.

4. Stop wasting other people's time.

Moving into the 1980s and 1990s, Stephen Covey became a national hero with The Seven Habits of Highly Effective People (Covey, 1989). Covey focuses on character development through the practice and internalization of seven habits, two of which relate directly to time management: (1) Begin with the end in mind, and (2) put first things first. Both tenets center on determining what is really important to you and then finding ways to make sure that those goals are achieved. Covey states that the essence of time management is to “organize and execute around priorities.” Covey created a time management matrix (Table 10-1) to help us categorize our daily activities and understand how we can maximize our time by doing so. Covey says that we are the most effective personal managers when we are operating primarily in quadrant II. In the section on putting first things first, he also offers suggestions for long-term organizing, weekly organizing, and how to say no.

Julie Morgenstern describes a different approach in her book, Time Management from the Inside Out (Morgenstern, 2000). Morgenstern, founder and owner of Julie Morgenstern's Professional Organizers in New York City, draws a comparison between time and space and describes each day as “a container, a storage unit that has definite capacity you can reach.” Her book through four phases:

1. Laying the foundation—thinking about creating a time management system that works for you.

2. Analyzing—defining your personal style, preferences, needs, and goals.

3. Strategizing—mapping your ideal schedule and staying on track.

4. Attacking—putting your plan into action.

Morgenstern's book was featured in a Pharmacy Student article entitled, “Yes, You Can Find the Time” (English, 2003). It also contains helpful appendices with lists of time management resources and additional references.

Marilyn Paul, author of It's Hard to Make a Difference When You Can't Find Your Keys (Paul, 2003), offers a “seven-step path to becoming truly organized”. She claims that unlike other self-help organizational books, hers takes a more holistic approach and incorporates mental, physical, emotional, and spiritual aspects of one's life into the context of getting organized and thus living a better life.

All the books discussed thus far offer meaningful and valuable advice related to time management and other life challenges. Additionally, a comprehensive Internet-based resource can be found at http://www.effective-time-management-strategies.com/index.html. Whatever approach you choose to use to improve your time management skills, it is important to find strategies that are compatible with your personality and that will be effective for your personal and professional lives.

1R. T. 1675. The art of good husbandry, or The improvement of time. A copy of the original reference is available via Microfilm from the University of Michigan, Ann Arbor, MI (1991). Also available at http://eebo.chadwyck.com/search/full_rec?SOURCE=pgthumbs.cfg&ACTION=ByID&ID=99830667&FILE=../session/1210961294_2335&SEARCHSCREEN=CITATIONS&SEARCHCONFIG=var_spell.cfg&DISPLAY=AUTHOR; accessed on June 28, 2011.

There are many resources on time management. Some sources focus specifically on the busy professional and go into detail about how to manage meetings, phone calls, interruptions, and other activities that potentially can waste time in a busy professional's day. Other sources address time management as a subset of the “whole” person—personal and professional goals or mission in life, personality, communication style, and other traits because all these affect how we use our time. Although discussions about each of these subjects are beyond the scope of this chapter, this section highlights many of the principles from these references because they apply to all of us, no matter what our full-time job or personal characteristics.

Care has been taken to distill the most common themes from a variety of references that would apply to the busy pharmacy student. The steps/themes involved in practicing better time management are

• Recognize the need for improvement.
• Conduct an honest analysis of how you currently use your time.
• Establish your “mission” and set goals.
• Get organized (sort through tasks, create a master list, schedule tasks, use a system).
• Take action.
• Review, revise, and modify.

These themes are described more fully as follows along with a variety of helpful tips from many different sources.

Recognize the Need for Improvement

Almost all literature that describes successful behavioral change programs, such as 12-step programs, start at the same point: the recognition that one's behavior needs to change or that a person desires to change his or her behavior. Hopefully, you have decided already that your time management skills could use some improvement. If you have not decided this, then the chances of your being able to improve are much less. If you are in this latter category, then the next section may just convince you that you could benefit from changing some of your current habits.

Conduct an Honest Self-Reflection or Analysis of How You Currently Use Your Time

Conducting a thorough review of how you currently spend your typical day or week can be very helpful in determining how to best proceed with improving your time management. Asking yourself some key questions can also help to identify problem areas and how you should best plan your time based on your personal preferences and style. One of the most useful tools to help you diagnose the areas that could use some improvement is to keep a time journal. On a detailed calendar, document how you spend your time in blocks of 15 minutes. The most accurate way to do this would be to keep your calendar with you at all times and document an activity and the time you spent on it each time you change activities. Do this for an entire week, and be honest, for example, 75 minutes surfing the Internet for fun, 15 minutes day dreaming, 30 minute power nap, and so on. After a week, analyze those areas where you think your time could have been better spent, and evaluate factors that could have contributed to wasting time. For example, Tom Worrall, ambulatory care clinical pharmacyspecialist for the Ralph H. Johnson Veterans' Affairs Medical Center in Charleston, South Carolina, explained that as a student he chose to study in the city library instead of the school's library so that he could get more done. “What takes 4 hours at the student center can take 2 hours at the city library because of fewer distractions” (English, 2003). Another author suggests asking a coworker (or significant other or roommate, for that matter) to observe your habits for 1 week and provide some constructive feedback (Wick, 1997). Be sure not to be too hard on yourself—it is important to reward hard work. Vida Farrar, a former graduate student in medicinal chemistry, indicated that “3 to 4 hours of straight studying deserves a 15- to 20-minute break. And the second round gets a half-hour to an hour break” (Dance, 1991).

When conducting the analysis of how you spend your time, Bond (1996, p. 51) suggests asking yourself these questions with regard to each activity:

• Why am I doing this?
• What is the goal?
• Why will I succeed?
• Is what I am doing at this minute moving me toward my objective?
• What will happen if I choose not to do it?

Bond continues with a few general questions about how your time is spent:

• What am I doing that does not really need to be done?
• What am I doing that could be done by someone else?
• What am I doing that could be done more efficiently?
• What do I do that wastes others' time?
• If I do not have time to do it right, do I have time to do it wrong?

Douglass and Douglass (1993) advocate creating a pie chart to depict where your time was spent. They also suggest asking yourself 12 questions when reviewing a day in your time log to better determine how well you are managing your time (Douglass and Douglass, 1993, p. 44):

1. What went right today [with regard to spending your time wisely]? What went wrong? Why?

2. What time did I start my top-priority task [assuming that you have identified your top-priority task; see the section on getting organized]? Why? Could I have started earlier in the day?

3. What patterns and habits are apparent from my time log?

4. Did I spend the first hour of my [work] day doing important work?

5. What was the most productive part of my day? Why?

6. What was the least productive part of my day? Why?

7. Who or what caused most interruptions [or what kept you from staying on task]?

8. How might I eliminate or reduce the three biggest time wasters?

9. How much of my time was spent on high-value activity and how much on low-value tasks?

10. Which activities could I spend less time on and still obtain acceptable results?

11. Which activities needed more time today?

12. Which activities could have been delegated? To whom?

While not all these questions are applicable to the typical pharmacy student, many of them do provide good food for thought with regard to self-evaluation of how you use your time.

Morgenstern offers a more thorough approach to analyzing your “personal relationship to time” and suggests that readers complete four miniexercises. The first exercise is to determine “what's working,” and the author suggests that you ask yourself 12 questions, including, “No matter how busy I get, I always find time for ____________ [fill in the blank],” “I never procrastinate about ____________ [fill in the blank],” and “I have no problem tackling difficult projects when ____________ [fill in the blank]” (Morgenstern, 2000, p. 47). The second exercise suggests nine questions to ask yourself to determine “what's not working,” including, “I never have time to ____________ [fill in the blank],” “I am usually late for ____________ [fill in the blank],” and “One thing I wish I could do every day is ____________ [fill in the blank]” (p. 51). The third exercise involves identifying your time management preferences. Morgenstern advocates circling each preference in a set of 12 opposites, such as “working independently versus collaboratively,” “concentrating in short bursts versus long stretches,” and “tight deadlines versus long lead times” (p. 54). The last exercise in her self-analysis, which consists of two parts, helps the reader to identify personal energy cycles and sources. The first part asks the same set of two questions for each period of the day (mornings, afternoons, evenings, and late night): “(Mornings) are the best times for me to ____________ [fill in the blank] and the worst time for me to ____________ [fill in the blank].” The second part asks you to identify what helps you “recharge” from a potential list of 13 items. Douglass and Douglass also include mini-diagnostic quizzes throughout their entire text to help readers determine their strengths and weaknesses with regard to several areas of time management (Douglass and Douglass, 1993).

Woodhull (1997) suggests that identifying your time management style will help you to better know how to use your unscheduled time, or “white spaces.” She states that workaholics often have no white spaces in their schedules, which is unhealthy. She describes the four basic types of time managers:

• “Leaders, above all, value getting the job done and moving forward…. Their communication style is direct and succinct. Their motto is ‘be brief and be gone.’ Say what you have to say in 10 words or less. They are experts at making quick decisions” (Woodhull, 1997, p. 43).
• “Analytics value getting tasks done with precision and accuracy. They pay a lot of attention to detail. Their style is systematic. They use facts, logic, and structure. When communicating with them, make sure you tie new ideas to old concepts and make sure you provide a thorough explanation” (Woodhull, 1997, p. 45).
• “Relaters believe that getting along with others is the most important thing. Nourishing the primary relationships in their life is of utmost importance to them. They dislike making decisions that affect others. Sometimes they feel overburdened by all the things they have agreed to do for others” (Woodhull, 1997, p. 45).
• Entertainers. “Once considered too offbeat for the normal world of work, these types are now the ones who generate new ideas that are keeping companies alive. Unlike the other three types, entertainers do not like having a precise, predictable schedule. Instead, they enjoy a great deal of variety and flexibility” (Woodhull, 1997, p. 46).

If you are unsure of which type of time manager you are, Woodhull (1997, p. 47) offers a quiz you can take to find out. She advocates, however, that better time managers incorporate features of each style in order to be more flexible and adaptable to a variety of situations.

Now that you have thoroughly analyzed your time management style, preferences, and current use of time, you are ready to move on to the next step of becoming an improved time manager.

Establish Your “Mission” and Set Goals

While this step and the diagnostics just described are not necessarily critical to becoming a better time manager, completing them will help you to improve your time management. Setting short- and long-term personal and professional goals is critical to help determine priorities and stay focused. Covey (1989) and Douglass and Douglass (1993) each advocate writing your personal mission statement; from this, all your goals and priorities should flow. According to Covey, a personal mission statement is “the most effective way I know to begin with the end in mind” (Covey, 1989, p. 106). Your personal mission statement, or philosophy or creed, “focuses on what you want to be (character) and to do (contributions and achievements) and on the values and principles upon which being and doing are based” (Covey, 1989, p. 106). Covey provides several examples of people's mission statements and guidance on how to write such statements. Douglass and Douglass describe a personal mission statement as focusing “directly on your roles, relationships, and responsibilities… where you really figure out who you are and why you are here,… carefully consider your relationships with [a higher power, significant other, loved ones], friends, community, employers, and self. What kind of a person do you really want to be? What should the sum total of your life add up to? Write out your rough ideas, then edit and refine them” (Douglass and Douglass, 1993, p. 179). Some authors advocate writing your obituary as a way to help define how you want to be known and what you want to accomplish in your life. Although these ideas may seem irrelevant to practical time management, many experts say that without thinking these ideas through and setting goals, many of us will not achieve our potential in our lifetimes. And remember, there are only 24 hours in each day!

Once you have thought through these deeper questions, it is much easier to identify long- and short-term goals and priorities. Douglass and Douglass (1993, pp. 16–17) describe how to write SMART (specific, measurable, achievable, realistic, and timed) goals:

1. Goals should be specific. The more specific a goal, the more direction it provides, and the easier it is to measure progress. For example, you may have a goal of studying more, which is stated very broadly. However, if you were to say, “I will increase my study time by 1 hour every day or at least 6 hours a week,” this goal is more specific and clearly defined.

2. Goals should be measurable. Similar to the preceding comments, it is easier to determine if you are making progress toward your goal if you can somehow try to quantify the specifics in your goal. The preceding example would be easy to quantify if you were keeping track of how your time is spent each day.

3. Goals should be achievable. “Goals should make you stretch and grow,” but they should not be set so high that they are realistically unachievable. For example, a person may want to be a famous singer, but if that person has no previous musical training or talent, this goal may be unachievable. Goals “should be set at a level at which you are both able and willing to work. In general, your motivation increases as you set your goals higher. But if a goal is so high that you don't believe it can be achieved, you will probably never start.”

4. Goals should be realistic. Closely related to achievability, goals should be realistic—take into account available time, resources, and skills. The preceding example illustrates this case well.

5. Goals should be timed. You are much more likely to achieve a goal if it has a target date by which it should be accomplished. Assigning target dates for accomplishing goals increases motivation, commitment, and action. Goals without time schedules quickly become daydreams under the pressure of daily affairs. For each step along the way, you should set a realistic target date that can, and should, be adjusted if conditions change.

Douglass and Douglass go onto to describe three additional recommendations to help you achieve your goals: Goals should be compatible—because if they are not, working to achieve one goal may prevent you from accomplishing another; goals should be your own—otherwise, your motivation to achieve them is much less—you should take ownership of at least part of the goal if it is not your own; goals should be written—writing helps to clarify goals and makes them more real—our commitment to goals improves if they are written and posted in a place where they can be seen regularly.

If you have a lot of goals, some people find it easier to focus on them if they categorize them into personal versus professional and short-versus long-term. It is important, however, to keep your goals posted somewhere, perhaps in multiple places, so that you will look at them regularly. The more often you are reminded of your goals, the more likely you are to continue working toward them. Morgenstern (2000, pp. 71–72) tells readers to classify their “big picture” goals into one of six categories: self, family, work, relationships (such as spouse and friends), finances, and community (such as making contributions and getting involved). She goes on to say that it is much easier to determine specific activities and then daily tasks that help to achieve each goal in each category. Often some daily tasks can be used to help achieve more than one goal, such as exercising with a good friend.

With regard to tackling one's goals, Woodhull (1997, p. 221) advocates using the Benjamin Franklin approach—do not try to accomplish all your goals in the same time frame, or you will become overwhelmed and discouraged. Instead, work on one or two at a time. Franklin also believed that it took 21 days for a new behavior to take root and become a routine habit; he would carry a card in his pocket with his goal for at least 21 days to constantly remind him of it.

Get Organized (Sort through Tasks, Create a Master List, Prioritize and Schedule Tasks, and Use a System)

You have now come to the meat of time management—getting organized. Organizing your life and keeping it that way are the absolute best ways to save time and feel good about how you use your time. There are several steps that many authors take readers through when helping them to get organized. First, you need to sort through what you already have. This refers to tangible items such as possessions, papers, e-mail messages, bills, and tasks that need to be accomplished. There are numerous resources to help people get their possessions organized. One need only think about closet-organizing companies and “storables” stores. A complete discussion of these is beyond the scope of this chapter. However, this section will provide you with some tips about organizing some of the other parts of your life that are more difficult: papers, e-mails/texts, computer documents, and tasks that lie before us.

Sort through Tasks

You probably have heard the statement “Handle each piece of paper once.” This is a very good rule of thumb for most of us that literally means that each time we get a new piece of mail, an assignment handed back, or a memo of some sort, we need to decide how we are going to use that piece of paper and do something with it—file it, recycle it, or read it later. This implies that we need to set up a filing system that works for us. Also, it is not bad to have a “read it later” pile as long as you make sure that you schedule some time somewhere in your calendar to actually read through the papers. Perhaps this is a task that you can work on once a week. These same ideas apply to e-mail messages, text messages, and computer documents. Most of us have some sort of computer file system set up on our hard drives that allows us to keep computer documents organized. Similar to handling paper, as you receive new e-mail/text messages or computer documents, you need to determine whether to file them, delete them, or read them later. Most e-mail programs allow users to create files in which to store e-mail messages in a place other than one's inbox. Just like paper, however, e-mails and computer files take up space on a server and/or hard drive that has limited capacity. With both paper and computer files, it is important to go through them periodically, at least once or twice a year, to clean them out and make sure that you are not running out of space.

Create a Master List

Organizing and prioritizing your tasks are often more difficult than organizing papers and e-mails. Many authors advocate creating a master list of all the tasks you need to do and then prioritizing and scheduling them. You can create your master list on your computer, on paper, in your planner (different planner options are discussed below), or by other means as long as it is on something that you can refer to regularly and are unlikely to misplace. Some folks have more than one master list, such as a “work list” and a “home list.” Whatever system works best for you, the main idea is to document all tasks that you need to complete at some time or another. This includes any new tasks that may come your way after reviewing your mail, e-mail, phone calls, and conversations. Make sure that you keep your list(s) in a place that is easily accessible so that you can add to it when the need arises, as well as cross off tasks as you complete them.

Prioritize Tasks

Creating a master list is not too challenging as long as you remember to document everything. The more difficult task is determining how to approach the multitude of tasks on your list. Where do you start? Sometimes it can be overwhelming to think about if you have a variety of tasks that all seem very important. Thankfully, experts in the field have helped us determine how best to prioritize tasks and responsibilities so that we can be most effective and satisfied. Three general approaches to prioritizing tasks are (1) the goal-achievement approach, (2) the deadline approach, and (3) the consequences approach. Using a combination of these three will be help you to prioritize the tasks in your life effectively.

Briefly, the goal-achievement approach advocates prioritizing tasks that you know will directly help you achieve your goals as most important. For example, if one of your goals is to achieve a grade-point average (GPA) of 3.5 or higher, then the task of studying at least 4 hours a day should be high on your priority list. As another example, if you are seeking a certain internship position, then completing the paperwork and other tasks necessary to get hired should be high on your priority list. The deadline approach is relatively self-explanatory—when are your tasks due? Often others provide the deadlines for tasks such as assignments, examinations, and birthdays. Using the deadline approach is easy when the deadlines have been set by others as long as you allocate yourself enough time to complete the task. The deadline approach is not as effective, however, when certain tasks have no externally assigned deadlines, so that you have to set a deadline yourself. Regular exercise, for example, is easy to put off because it does not have a deadline (unless you are training for an athletic event). The deadline approach is also not very effective in helping you to achieve your goals. The consequence approach is somewhat related to the deadline approach and essentially asks the question, “What will happen if this task is not completed or not completed on time?” The more detrimental the consequences, the higher the priority of the task. For example, if the brakes on your car are beginning to fail, it is extremely important that you get them fixed right away, or the consequences could be fatal. On the other hand, if the penalty for turning in a late assignment is only a loss of 5 points out of 100, then completing that assignment on time may have a lesser priority than getting your brakes fixed. Some people also consider the number and importance of people who would be affected if the task or project were not completed or not completed on time—the higher the number of people or the more “important” they are, the higher is the priority of the task.

There are additional ways to prioritize activities and tasks. Many of them are similar to the goal, deadline, and consequence approaches. Covey (1989, p. 150) tells us that activities in our lives can be classified into four quadrants (see Table 10-1). Two factors that define any activity are how urgent it is and how important it is. Urgency refers to activities that require immediate attention, such as a ringing phone. These activities usually are visible, popular or pleasant, easy, and “in front of our noses.” Often, however, these activities may be unimportant. They may be important to others but not necessarily to you. Urgent activities require us to be reactive. Importance, on the other hand, requires us to be proactive. Brushing your teeth is an example. This activity may not be urgent, but it is certainly important, and you must motivate yourself to complete this task regularly.

Covey advocates using his quadrants approach as a way to categorize and prioritize tasks and activities. Go through your master list and try to classify each task as quadrant I, II, III, or IV. How many tasks do you have in each quadrant? For those whose tasks are primarily in quadrant I, Covey explains that this is a crisis-driven, problem-minded approach that leads to stress and burnout. He says that many folks who feel that they are in quadrant I are actually in quadrant III, which can lead to short-term focus, a feeling of lack of control, and continual operation in crisis mode. They may feel like most of their tasks are urgent and important, but usually these impressions are based on the priorities and expectations of others. This is where the consequence approach may be helpful—ask yourself and others exactly what the consequences are if this task is not completed or not completed on time. This will help to determine if certain activities should be in quadrant I or in quadrant III. People whose tasks are primarily in quadrant III or quadrant IV “basically lead irresponsible lives” and often are fired from jobs and are dependent on others for the basics (Covey, 1989, p. 153). Optimally, Covey advocates that most of our tasks and activities should be in quadrant II—activities such as exercising, preparation, and preventative maintenance—these are all very important in helping us to be happy and healthy, but because they frequently do not seem urgent, they do not always get done. The results that come from primarily operating in quadrant II, however, are vision and perspective, balance, discipline, and control, and few crises arise (Covey, 1989, p. 154).

Bond (1996, p. 54) also advocates the “important and urgent” categorization process and describes the categories in this way:

• Important and urgent (priority 1). These tasks are yours alone and must be planned into your day. They consist of the most important steps to “completing your priority” (i.e., achieving your goals, avoiding negative consequences). They generally must be done well and immediately.
• Important not urgent (priority 2). Importance outweighs urgency. Important things are those which only you can do or which can advance you toward your life goals.
• Urgent not important (priority 3). Priority 3 tasks and paperwork are delegated, if possible, or assigned a small time slot and made part of a routine.
• Neither important nor urgent (priority 4). Priority 4 tasks get the least, if any, attention and are worked on in spare time or when all other tasks are completed.

Another approach to prioritization is to employ the Pareto principle. Commonly known as the “80/20 rule,” this principle was first discussed by Italian economist Vilfredo Pareto in the nineteenth century when studying the distribution of wealth in a number of countries. He observed that about 80 percent of the wealth in most countries was controlled by a consistent minority—about 20 percent of the people.2 This principle suggests that we should focus on those few tasks that produce the most significant results (Petersen and Halstead, 1983). When applied to the “important and urgent” prioritization scheme, the 20 percent of the most fruitful activities fall into quadrant II or priority 2, and it is on these activities that we should focus most of our effort (Douglass and Douglass, 1993, pp. 28–29).

Similar to these approaches is the “big rock” approach. You may have heard the story about the time management seminar speaker who was presenting to a class of business students one day.3 He had a large glass jar and proceeded to fill it up with large rocks. He asked the class if the jar was full.

“Yes,” the students responded.

He then took a bag of gravel and proceeded to add it to the jar and shake it down—the gravel filled up space among the large rocks in the jar. “Is the jar full?” he asked the class.

“Probably not,” replied one student.

“Good!” the speaker responded. Then he added a bag of sand to the jar, which filled up any remaining space among the rocks. “Now?” he asked the class.

“No!” the students emphatically responded.

Then the speaker brought out a pitcher of water and proceeded to pour the entire amount into the jar without causing the jar to overflow. “What's the point of this illustration?” the speaker asked.

One student responded, “The point is, no matter how full your schedule is, if you try really hard, you can always fit some more things in it!”

“No,” the speaker replied, “that's not the point. The truth this illustration teaches us is: If you don't put the big rocks in first, you'll never get them in at all.” He goes on to explain that the big rocks in our lives are time spent with family and friends, taking care of ourselves, our faith, and time spent on other worthy causes. The sand and water are “fillers” in our lives, and although some quantity is important, if we fill up our jars with these activities first, then we will have no room left for the big rocks.

Lastly, you probably have observed that some of these approaches discussed delegating certain tasks. As you review your master list, especially the tasks that are of lesser priority and importance, ask yourself if any of those tasks could be done by someone else or if someone else could help you with them? Would it be appropriate to enlist the help of a significant other, a roommate, a friend, a family member, or another person to complete a task? This is a very important question to ask so that you can avoid getting bogged down in activities that detract from your higher-priority tasks. One pharmacy student who was active in student organizations described delegation in this way: “You have to ask yourself if an activity suits you personally or your role as a member of an organization. You must ask, ‘Is this something I need to do? Is this something the president of a corporation would do, or would someone else benefit from this experience?’ Depending on the answer, you delegate. It frees your schedule and gives someone else an opportunity to have some responsibility” (Dance, 1991, p. 12).

Establishing priorities, both in your professional and personal lives, can have a significant impact on your overall time and stress management skills. By focusing on what is most important to achieving your personal goals and practice responsibilities, you should be able to have more time to focus on these activities and less stress in worrying about how you will be able to get everything done. More discussion about this can be found in the subsequent sections of Time Management in Pharmacy Practice and Stress as a Primary Consequence of Poor Time Management.

Schedule Tasks

This is not without its own set of challenges because it is often difficult to know how much time a particular task will take—especially if it is a task that you have not done before. It is best to take a conservative approach and allow yourself more time than you think you will need to complete a task. It is always better to undercommit and overdeliver (e.g., telling your boss that you will have a particular project done by a date later than you actually think it will take for you to complete and then turning the project in early or telling a patient that her prescription will be ready in 15 minutes when you are positive that it will only take 5 to 10 minutes) than to overcommit and underdeliver. Convince yourself of the phenomenon that “things always take longer than I think they will” to allow for unexpected interruptions and other unscheduled events. Then, when you finish a task early, you can reward yourself with a break or fun activity that you had not scheduled previously.

Morgenstern (2000, pp. 143–149) advocates timing yourself and then using a mathematical approach to estimating how much time tasks will take. For different activities that you work on at any given time, ask yourself how long you think it will take you to complete the task, and then keep track of how long it actually takes. The more often you do this, the better you will be at accurately estimating the amount of time tasks will take. Morgenstern tells the story of her brother who had 10 weeks to study for his medical board examination. Based on his experience as a medical student, he knew he could effectively study 10 pages of material per day. Since he had 420 pages of material to review, he calculated that it would take him 7 weeks of going through the material the first time if he studied 6 days per week. This left him with 3 weeks to review any weak areas and also served as a buffer if for some reason he was not able to study 6 days a week for 7 consecutive weeks. This schedule put him at ease and helped him to relax more about the test.

It is also important to break larger tasks into smaller ones with their own deadlines. If you are working on a semester-long research paper for a class, for example, you are much more likely to do a better job and save yourself a lot of stress if you set some deadlines for yourself to complete the paper:

• Month 1: Complete literature search and reading about the topic; draft outline of paper.
• Month 2: Complete rough draft of paper; turn in to instructor voluntarily for feedback.
• Month 3: Revise first draft based on instructor's feedback; turn in final paper.

Breaking down large tasks also makes them seem less daunting and less overwhelming. Setting intermediate deadlines and sticking to them helps you not to procrastinate.

Lastly, it is important to schedule all tasks if not on paper at least in your mind; otherwise, they will not get done. Some doctors make weekly appointments with themselves to make sure that they can squeeze in some personal or downtime without being interrupted by another appointment. This is not to say that you need to be so rigid that you have every activity in your life entered into a master schedule, but at least allocating time for quadrant II activities is vital to make sure that they are accomplished (e.g., family time, working out, and personal time). It is also important to review your schedule and master list several times a week to make sure that you are prepared for tasks that are coming up. Some authors advocate doing this each night before going to bed.

Use a System

You have the tasks on your master list prioritized and scheduled—but how are you going to keep track of all this? Many people have found that the busier they are and the more tasks they need to complete, the more they rely on some sort of planner system to stay organized. There are a wide variety of daily, weekly, monthly, and yearly planning systems available. While a comprehensive discussion of such systems is beyond the scope of this chapter, several useful approaches are described:

• Paper calendar. Many people use a simple portable calendar on which they can document scheduled tasks as well as their master or to-do list. If this system sounds appealing, make sure that the squares on the calendar are large enough so that you can legibly write down all your tasks and appointments. You also want to make sure that your master list can be attached easily to the calendar so that you can keep track of unscheduled tasks that need to be completed. The written calendar system has the advantage of allowing you to easily review daily tasks as well as others coming up in the week or month.
• Paper-based planner/organizer systems. You may have heard of the Franklin–Covey planner system or the Day Runner system or seen them in stores. These are just two examples of popular paper-based organizing systems that go beyond the traditional calendar. These systems help the user to prioritize and schedule tasks and to keep a detailed calendar, master to-do list, and address book. They allow the user to customize it so that you only include the types of pages you use most. They come with instructions on how to best use their systems in order to get the most out of them.
• Personal digital assistants (PDAs)/phones and computer programs. In this technological age, more and more people are opting for digital systems. Many pharmacy students already own PDAs for their ability to store drug information references as well as keep a daily schedule and check e-mail, or they have applications for these on their cell phones. These systems have the ability to sound an alarm to alert you of an upcoming meeting or event. Another advantage is that many of them can be backed up to a computer system, or they exist in “the cloud” so that if either system crashes or is lost, you do not completely lose everything. One challenge of these systems, however, is that it is difficult to look at multiple pages easily. The master list may be kept in a different place than the daily schedule, and the weekly schedule may not show up in much detail. Many of the paper-based organizer programs are now available as computer programs or phone apps. The former works well for those who work on a primary computer most of the time, but if you are not able to download the information onto something that you can carry, such programs may not be as useful.

Morgenstern (2000, pp. 109–134) devoted an entire chapter in her book to “selecting a planner that works for you.” She mentions that many of us probably have tried to use a particular planner system but then abandoned it for one or more of these three reasons:

1. You did not pick a planner that was right for you.

2. You did not take time to master its features and make it yours.

3. You did not make it the one and only place to record. Your appointments and to-dos, so you never came to rely on it.

She advocates determining your style and preferences first (refer to the earlier section of this chapter on self-reflection and analysis) and then considering whether you prefer visual/tactile options (such as paper-based calendars and appointment books) or linear/digital options (such as computer programs, cell phone applications and PDAs). She also warns that no system is perfect. Whatever your choice, Morgenstern recommends that you customize it, use it to its fullest, and accept its imperfections.

Take Action

You are ready! On paper or computer you are extremely organized and ready to hit the ground running. In order to help you be successful in accomplishing all your well-organized tasks, Douglass and Douglass (1993, pp. 22–23) feel that it is important to review some of the realities of human nature and how we normally spend our time—not all of which are bad. Some highlights from their 21-item list are noted:

1. We do what we like to do before we do what we do not like to do.

2. We tackle what we know how to do faster than we tackle what we do not know how to do.

3. We do activities that we have resources for.

4. We do things that are scheduled before we do nonscheduled things.

5. We respond to the demands of others before we respond to demands from ourselves.

6. We wait until a deadline approaches before we really get moving on projects.

Being aware of some of these patterns can better help you to avoid them and to stay on track in accomplishing your tasks. Always keep the big picture in mind—think of the goals that you want to achieve and how completing a task will help you do that. A great slogan for dieters who are having trouble with self-discipline is “Nothing tastes as good as thin feels.” Constant self-motivation is important when you are trying to change your behavior.

Morgenstern (2000, p. 195) says, “Plan your work, and then work your plan.” She recommends three actions to help you stay focused and disciplined so that you can overcome bad habits and achieve more each day (p. 196):

1. Minimize interruptions (i.e., unexpected events) and their impact.

2. Conquer procrastination and chronic lateness.

3. Overcome perfectionism.

She goes on to provide helpful suggestions on how to do all these things because they sound much easier than they are (pp. 196–210). In the end, if you are able to “containerize” your activities, you will be able to get your to-dos done and move through your day “feeling energized, optimistic, and satisfied” (p. 195).

General Tips from the Experts

Although many parts of this chapter contain helpful hints to improve your time management skills, you may have missed a few, and they are worth mentioning again:

• Take care of yourself. It is extremely difficult to be productive and successful if you subsist on junk food, get less than 7 hours of sleep per night, or only exercise when you walk from your apartment to the bus stop.
• Most people do their best work in the morning, so tackle the tough projects at that time.
• Schedule meetings and less intensive activities in the afternoon.
• Check your e-mail, text and phone messages only twice a day, once in the morning and once in the afternoon or evening.
• Cluster tasks and activities together when possible. For example, if you have a class or meeting in building A, what other tasks or activities can you accomplish that need to be done in or near building A before you trek across campus to building Z?
• Quantity does not equal quality.
• Busy does not equal productive.
• Working harder does not equal working smarter.
• Reward yourself. It gives you something to shoot for and look forward to. Besides, all work and no play is unhealthy and no fun!

Douglass and Douglass (1993, pp. 184–186) offer 39 tips for becoming a “top time master.” They have even created a poster with these tips that they offer free to anyone who contacts one of the authors (contact information is included in their book). They describe it as “an excellent way to keep reminding yourself to develop good time management habits” (p. 186).

Review/Revise/Modify

Now that you are working on your plan in full swing, it is important to review periodically all the steps that you went through to determine if your system is working well. Are you accomplishing tasks and goals to your satisfaction? Are you feeling less stressed? Do you procrastinate less often? Have your preferences or your style changed in any way? Do you want to try out a new organizational system? Have your goals or priorities changed? What major changes have occurred in your life to modify your goals and priorities? When you ask yourself these questions, especially the first three, remember to cut yourself a little slack. Real change takes time, and old habits are hard to break. It is okay if you did not follow your plan to a tee. Celebrate your successes, learn from your failures, and keep striving to improve.

Bond created a 43-item questionnaire to help us review our goals and priorities to see if they have changed (Bond, 1996, pp. 89–92). Questions include

• Do you feel as strongly about your priority (goal) as you did when you set it?
• Do you reward yourself for daily or weekly successes?
• Are you adhering to your priority (goal) deadline?
• Do you spread yourself too thin and run out of time?
• Do you review your activities to determine which ones can be shortened, reorganized, or terminated?
• What are the most important factors in your success?

Analyzing your responses to these questions, along with what contributed to or detracted from your success, is an important process to help you make adjustments and corrections. As long as you are making progress toward your goals, that is what is most important. Remember, slow and steady wins the race. It is also helpful to remember that as much as we might like to, we will never have complete control over all our time. Douglass and Douglass (1993, p. 147) remind us to recall the Serenity Prayer:

• God, grant me the serenity to accept the things
• I cannot change,
• The courage to change those things I can,
• And the wisdom to know the difference.

2Pareto principle. 2011. Available at http://en.wikipedia.org/wiki/Pareto_principle; accessed on June 28, 2011.

3Gerald Nash. 2011. “The Rock Parable.” Available at http://www.psybersquare.com/work/parable.html; accessed on June 28, 2011. The story has also been described as filling up the jar last with beer instead of water, with the moral being, “no matter how full your life gets, there's always room for a beer.”

So how does all this information about personal time management relate to pharmacy practice? As mentioned earlier, it is unlikely that a person who is extremely disorganized at home will be very organized in his or her work environment, and vice versa. Certainly, however, time management skills in practice depend on the type of job you have. If you have a position that is more administrative, project-based, or appointment-based, you will have more control over how your time is spent, and you can better use many of the skills described in this chapter. For example, White (1996) wrote a helpful article that describes how pharmacy managers can better control their time. She updated this piece in 2007 and offered several strategies that any pharmacist could use to improve work efficiency (Table 10-2) (White, 2007). In most pharmacy environments, however, we do not get to determine how we spend our time—the nature of the job involves responding to the demand of medication orders and questions from patients, health care providers, and others. Rarely do we have the luxury of planning our daily work activities.

Time management in practice is based on two issues: how organized you are personally at work (e.g., Can you work well in a scattered, chaotic environment, or must you work in a very structured and systematic fashion?) and what the workflow is like in your environment. Most of us have some control over the first issue but not always the second. If you do have some say, however, in yours' and others' duties and how the workflow progresses, there are numerous recommendations about how to improve efficiency and patient safety. A full discussion of these is beyond the scope of this chapter, but a few specific recommendations are shared below.

Mark Jacobs, pharmacist for Shopko Pharmacy in Beloit, Wisconsin, published his thoughts about making more time for patients in the pharmacy in the book 101 Ways to Improve Your Pharmacy Worklife (as noted in Jacobs, 2002). He suggests six specific tasks for handling the volume of phone calls in practice that can help to improve your professional satisfaction and ability to care for patients (a few of which apply specifically to outpatient and community practices):

1. Make full use of pharmacy technicians. If you work with capable technicians, use them as fully as the law will allow. One example is never to answer the phone yourself unless it is a prescribers' line. Jacobs mentions that no other professionals (e.g., doctors, lawyers, etc.) answer their own phones.

2. Respond to questions on the phone through your pharmacy technicians whenever possible. This does not mean that you should avoid talking with patients on the phone at all possible costs, but by training your technicians to ask the caller the proper “triage” questions, you can avoid calls where the patient wants to talk to the pharmacist and then goes on to give you a prescription number to refill. Doctors most often respond to patients on the phone through their nurses.

3. If a patient insists on speaking with a pharmacist, explain that the pharmacist is busy with another patient right now. Jacobs advocates having the technician take down the patient's name and phone number and the reason for the call so that the pharmacist can prepare for the call prior to calling back, which also saves time.

4. Find out when and where would be the best time to call the patient back. Jacobs states that this will help “condition” patients to realize that you are a busy health care professional and that you may not always be available on-demand. In addition, if they really need help right now, they may be willing to ask the technician.

5. Gracefully exit the conversation after 2 minutes “by explaining to the patient that you have time for one more question. They will either ask it or thank you for your time.”

6. Have the technician take down all the information for prescription transfers (depending on what the law will allow). At the very least, the technician can pull up the prescription on the computer or pull the hard copy before handing the phone to the pharmacist.

For some patients and phone calls, it may not be appropriate to adhere to all these suggestions, but for many calls, these tips can help a busy pharmacist to save time each day. Other efficiencies that many practices are implementing include a variety of dispensing technologies and robotics, automated refill phone lines and Web sites, and reconfiguring technicians' and pharmacists' job descriptions so that technicians perform most technical duties and pharmacists can concentrate on reviewing and monitoring patients' drug therapy, as well as engaging in patient and provider education. All these suggestions can be implemented relatively easily so as to better manage time in the pharmacy. Jeff Rochon, Pharm.D., Chief Executive Officer of the Washington State Pharmacists Association, reminds us that above all, we must make time to communicate with patients and other health care providers (Rochon, 2003).

Remember that priorities should be based on what is most important and urgent, then important but not urgent (remember Covey's Quadrant's 1 and 2), to achieving one's goals, whether they be personal or the goals of the practice site. An earlier part of the chapter discussed the importance of delegating tasks to help better manage your time. When delegating tasks to others, particularly technicians and others you are supervising, good managers help them to prioritize their tasks so that they can function effectively. One strategy to do this is matching employee abilities and interests to the job. As a manager, if you have the ability to create “specialized” tasks for certain technician positions, then find out who among your staff is good at and interested in those tasks, then delegate accordingly. Examples might include inventory control (i.e., ordering, tagging, stocking, processing returns, etc), billing (i.e., handling third-party claims and issues), customer service (i.e., has excellent people skills), compounding, and others.

Another strategy to help employees manage their priorities is discussing their job functions with them periodically. Simply engaging individual employees in a discussion about what they feel their work priorities are and how they best accomplish them can be very enlightening for the both of you. It can provide you as the manager an opportunity to clarify any confusion about what the employee's work priorities should be, and how s/he can best accomplish those tasks. These kinds of conversations are usually conducted during employee performance reviews, but they can happen any time that works for you and the employee.

A third strategy for helping employees managing priorities is to engage them in a time management course. Ideally any workshop or seminar they attend would focus on both work-life and personal-life strategies, in hopes that one will complement the other. When employees become good time managers, they can be more productive at work and at home and hopefully come closer to achieving work-life balance.

Research has shown that individual characteristics related to job stress include balance between work and personal life, a person's outlook on life, the stressfulness of family life, and various aspects of personality (Stress at Work, 1999). The issue of balance, in all aspects of one's life, is the crux of this chapter. Effective use of time management strategies should help to reduce the probability that a person will feel overly stressed.

Interestingly, it has been shown that pharmacy students reported higher stress levels as students than they did as practicing pharmacists (Ortmeier et al., 1991; Wolfgang and Ortmeier, 1993). Another study indicated that stress among pharmacy students was partially related to “excessive study load” (Dutta, 2001). A more recent study (Marshall et al., 2008) reported that the top five triggers of stress for a group of pharmacy students were:

1. Family and relationships

2. Examinations and tests

3. Monday morning examinations

4. Outside of class assignments

5. Financial concerns.

Research on consequences of pharmacists' job stress could be informative for students (Table 10-3). It is logical to conclude that what is considered “job stress” for pharmacists could be “school stress” for students or a combination of work and school. Thus, if students feel stressed about school and perhaps their internship, they likely might suffer similar consequences as pharmacists: dissatisfaction with their Pharm.D. program or internship, lower commitment to completing one's degree program or even pharmacy as a career, quitting school or the internship or both, and the potential for substance abuse and burnout.

Thankfully, coworker social support, or the material and emotional support received from one's coworkers, has been shown to buffer the impact of job stress on job dissatisfaction (Wolfgang, 1994). For students, this applies to coworkers and classmates. It is presumed that most pharmacy students probably have a network of friends in their academic class experiencing the same “stress” (at least related to the Pharm.D. program), so a natural buffer exists. How one copes with stress also makes a difference; problem-focused coping strategies, where one attempts to tackle the problems at hand, are most effective in reducing the impact of job stress on job dissatisfaction (Gupchup and Worley-Louis, 2005). Implementing time management strategies could be an example of a problem-focused coping strategy, and could certainly help to reduce of stress related to excessive study load. Emotion-based coping strategies, such as distancing oneself from the problem or trying to avoid the problem, are unsuccessful (Gupchup and Worley-Louis, 2005). Other strategies to combat stress include meditation and relaxation (e.g., yoga and massage), biofeedback, and physical exercise (Gupchup and Worley-Louis, 2005). Wick and Zanni (2002) suggest a number of strategies for pharmacists, such as:

• Keep a journal and assess your automatic emotional reactions. Ask others for feedback and try to identify new patterns.
• Keep things in perspective. Laugh often and laugh hard.
• Try to connect with people compassionately.
• Recognize that you are not perfect or superhuman.
• Focus on the positive; count your blessings.
• Recognize situations that are beyond your control; act accordingly.
• Identify your successful stress-reducing strategies and avoid stress triggers.
• Manage your environment as well as you can.
• Pay attention to diet, sleep, and exercise.
• Adopt a pet.

Marshall et al. reported that the top five coping strategies pharmacy students used to cope with stress were:

1. Exercising (running and working out)

2. Time with family and friends

3. Napping/sleeping

4. Watching TV

5. Drinking alcohol.

The study prompted investigators to help students use healthy coping strategies versus those that can have negative consequences.

This chapter has presented a lot of tips and ideas that Tom may heed so that he can improve his time management skills. While Tom may have a routine, he definitely does not have a system. At the very least, Tom must ask himself some important questions and establish some goals and priorities. He may also consider the use of a master list and implement the use of technology such as a PDA to help him focus on the tasks at hand. We certainly would not want to see him lose his job or have to resign from the school of pharmacy.

The goal of this chapter was to raise awareness about the importance of time management in one's personal and professional lives. Readers should have come away with concrete strategies about how to improve their skills so that they can achieve their full potential. Remember, time management is not about managing time, it's about managing yourself—and all of us can use some improvement so that we can be more effective in all that we do.

1. After applying the techniques described in this chapter, are you better able to accomplish your goals?

2. Are you healthier? Why or why not?

3. Are you happier? Why or why not?

4. How can you help others to learn and employ these skills?

5. How can these skills help you as a practitioner?

6. What kinds of time management techniques can you employ in your practice to help improve the process of health care delivery?

7. In addition to time management, what strategies would you employ to reduce your stress level?