Race Against Time

For many athletic trainers, every day feels like a race against time. But it doesnít have to be that way. This author suggests strategies for afternoon crunch time, scheduling, and rethinking your duties.

By John Reynolds

John Reynolds, MS, ATC, is an Athletic Trainer and Teacher at George C. Marshall High School in Fairfax County, Va. He is also a member of the writing team for the NATAís Appropriate Medical Care for Secondary School Age Athletes Task Force.

Training & Conditioning, 14.4, May/June 2004, http://www.momentummedia.com/articles/tc/tc1404/racetime.htm

Few would argue that athletic trainers work too little. Balancing all our responsibilities is very challenging, and time management is a struggle for most of us at one point or another.

Too often, thereís not enough time to do everything we have to do as well as we would like. In the end, tough choices have to be made: Some tasks are completed, others pushed back, and some are never really finished.

Our athletes, coaches, administrators, co-workers, parents, and physicians all expect us to accomplish certain things in a certain time period. Many of these expectations are non-negotiableóthey are simply part of the job. Evaluating, treating, rehabilitating, keeping records, communicating, and covering practices and games are all daily duties of the athletic trainer. Many of us also add teaching responsibilities, research activities, and committee obligations to this list.

Fitting each of these duties into a given day is like working a big jigsaw puzzle. How difficult we perceive the puzzle to be directly influences how successful we will be in satisfying all of our obligations. When we perceive our list of tasks to be manageable, we tend to get everything done in a timely manner. But when faced with a seemingly overwhelming list of chores and responsibilities, some important tasks are neglected in favor of the most urgent ones.

However, the jigsaw puzzle doesnít need to be as complicated as it first appears. Through effective scheduling, athletic training room management, communication, task delegation, and policy development, athletic trainers can fit those pieces together each and every day.

Planning Ahead
Planning and scheduling are the first steps to effective time management. Whether you work with a few select sports or a large number of teams, providing coverage and completing your other duties can create conflicts. Thatís why itís important, before the season, to compile a master schedule that lists events on the horizon.

A master schedule allows the athletic trainer to identify conflicts or other trouble spots and plan accordingly. For example, do you find one or more days with multiple events occurring simultaneously? Will an afternoon meeting conflict with another obligation?

In my experience, situations that surprise me tend to be the most disruptive. Events that seem to appear out of nowhere often force me to drop everything in order to adequately deal with whatever is happening. Then, with my attention focused on the latest crisis, I slip further behind on the more routine, but essential, aspects of my job.

Proactive planning helps us to prepare for crunch time and difficult situations. When we donít plan we are forced to react to the events before us, creating a situation that often causes stress and anxiety. Of course, we canít predict the future and there will always be surprises. But it is better to prepare for situations you can predict.

These principles also apply where multiple athletic trainers work together. Having more than one athletic trainer on staff to share responsibilities can be tremendously helpful, but scheduling and planning become even more critical. The key is to make time for communicating and scheduling. Each staff athletic trainer should participate in creating the master schedule and take time to evaluate it for conflicts. The group as a whole can then make arrangements in the event of a conflict or an absence to ensure responsibilities are fulfilled.

In our athletic training room, we use a dry erase wall calendar that we fill in at the beginning of each month with both scheduled games and other commitments, including days when any staff member will be out of the office. We identify any conflicts and decide who will cover which evening activities. We donít always get everything arranged at that time, so we frequently go back and re-evaluate the calendar, which is especially critical when weather forces the rescheduling of events.

Always having a master schedule allows me to determine the feasibility of any long-range projects that arise. For example, before I agreed to write this article, I identified periods of time during the school day as well as after school to work on it.

Having a schedule wonít help, however, if you donít look at it on a regular basis. The idea is to see trouble spots ahead of time so you and your staff can plan accordingly, avoiding surprises. By acting in a proactive manner and communicating with your colleagues in advance, youíll recognize more potential conflicts and find yourself reacting less often to situations that could have been addressed early on.

Afternoon Strategies
Imagine a typical afternoon in the athletic training room. Several teams will begin practice within the hour and you have a line of athletes waiting for treatment. How many of us, when faced with this situation, feel pressured to ensure each individual makes it to practice on time?

Afternoons will always be crunch time. That reality is hard to avoid. To make them manageable, however, itís important to look at the options available to us.

One time-management strategy involves scheduling when athletes report for treatment. Athletes generally report just before their practice or game, and arrivals are staggered over several hours so the athletic trainers are less likely to be overwhelmed at any one time. While there is logic to this arrangement, in my experience, time ends up being wasted rather than saved.

With this plan, athletic trainers are tied up for several hours as the athletes from individual teams gradually report. The low-intensity activity in the athletic training room slows down the flow of athletes and encourages them to lounge around and socialize.

A different approach is to ask all athletes, regardless of when their practice or game begins, to report at the same time. In this scenario, all athletes arrive at once and the athletic trainer evaluates and treats everyone together. Yes, the athletic trainer will be extremely busy for a period of time, but the total time is less than in the first plan. The benefit to the athletic trainer is additional time devoted to administrative duties, communicating with coaches, parents, or physicians, or even attending to other responsibilities outside of the athletic training room.

Will athletes complain that they have to wait in line to be seen? They might, but if you make this system the norm, they will learn and adapt. If a trip to the doctor or dentist office involves waiting a few minutes, why shouldnít a trip to the athletic training room? Explain to the next athlete in line that he or she needs to wait a minute or two while you finish your documentation on the previous patient, or even take a few seconds to catch your breath. In my experience, most athletes will wait patiently if they understand the process. Once the athletes realize they need to arrive for treatments a few minutes earlier, you will find yourself less frazzled and better prepared to take care of other responsibilities.

A System for Communicating
Communicating with others is a key part of our job, but also a time-consuming one. For example, when there is a change in an athleteís participation status that you need to discuss with the coach, how much time do you spend trying to track down that coach during practice? We can spend a considerable amount of time walking from one field to the next, looking for a particular coach. All too often, we canít find the coach, or our services are suddenly needed elsewhere. Worst of all, the important information you set out to deliver never gets shared.

With an understanding that good communication between athletic trainers and the athletes, coaches, parents, and physicians is an essential component of quality athletic health care, how can athletic trainers facilitate good communication in a time-efficient manner?

My best advice here is to develop a really good form for sharing information with others. This form should be short and designed to be completed quickly. Some of these forms contain fields an athletic trainer checks off or highlights indicating what the athlete did that day. There may also be an area to indicate any participation recommendations or limitations and a space for the athletic trainer to record a brief note. We use a computer-based record keeping software package that allows the ATC to print copies of an individualís injury report, which is much faster than writing a note by hand. When the athletes leave the athletic training room, they deliver this form to their coach or take it home to their parents.

A word of caution: This form is not intended to replace a more permanent record-keeping system. Instead, the form is designed to help the athletic trainer quickly and effectively communicate with athletes, coaches, and parents.

A second word of caution: If you feel in a particular situation that verbal communication is needed, do not let the form do the talking. I believe very strongly that communication is one of our top priorities. If a message needs to be delivered to a coach or parent verbally, make time for it.

This idea also works well when communicating with physicians. When an athlete visits his or her doctor, what type of communication do you expect to receive back? Why not develop a referral form to facilitate dialogue with your area physicians? This form could include a brief checklist highlighting the results of your evaluation, the treatments performed, and a space to write notes. The form could also include space for the physician to indicate his or her diagnosis, any recommendations for participation, and a checklist to note specific treatments or rehabilitation exercises.

The biggest stumbling block with these forms is making the time to develop and use them. Too many of us have good intentions, develop some sort of form or some type of policy, yet in the end, never use or enforce them. If you get in the habit of providing the form to each individual, it becomes routine. The key is making it short, easy to complete, and informative.

Rethinking Your Duties
As I mentioned at the start of this article, evaluating, treating, rehab, record keeping, communicating, and covering practices and games are all non-negotiable duties of the athletic trainer. Or are they? When an athletic trainer has more tasks in the day than there is time to do them, there may be no choice but to re-examine those tasks and figure out how some can be restructured.

Start by thinking about who you can turn to for help. In addition to the athletic trainer, who else within the athletics program is responsible for ensuring the safety of the athletes? Though it is not their main job, coaches and athletic administrators should share the responsibility of student-athlete health with you. No, they should not evaluate or treat athletes. But there are some duties they can take on, both large and small, to ease your load.

For example, many athletic trainers spend a lot of time dealing with hydration. Not only are athletic trainers expected to deliver water, but they are also asked to fill, store, and clean coolers and water bottles. Why is this the responsibility of athletic trainers? Water coolers and bottles can be assigned to each team at the beginning of the season. Coaches are then responsible for filling and maintaining the coolers and bottles throughout the season. Once the season is complete, these materials are returned to the athletic trainers for distribution to other teams during the following season. With this plan, the coaches fulfill part of their obligation to provide a safe practice environment, and the time-consuming task of managing water is removed from the athletic trainersí to-do list.

Practice and game coverage is another time-consuming task. Have you ever counted the hours you spend watching practices and games? Have you ever counted the times you are actually needed on the scene? Can athletic trainers better manage the amount of time they spend fulfilling this very time-consuming task?

Certainly, athletic trainers have the necessary skills to manage a wide variety of practice injury situations. However, the athletic trainer doesnít necessarily need to be the one to provide the initial treatment and first aid when something happens at practice. With proper first-aid training and a detailed emergency plan, coaches are able to provide first-response care for most minor injuries that happen when their team practices. When an injury occurs and the athletic trainer is not available, the coach provides the initial treatment, notifies the athletic trainer, and requires the injured athlete to report to the athletic training room as soon as possible.

To aid coaches in their role as first aid providers, the athletic trainer can provide fully stocked first-aid kits for coaches to bring to practices and games. Athletic trainers are then freed from spending idle time at practice and can concentrate on using their specialized skills to provide comprehensive rehabilitation programs and tend to administrative duties.

Some schools will insist on game coverage by the athletic trainer, but this, too, can be lessened. The key is developing a coverage policy. A coverage policy dictates which events receive athletic trainer coverage, based on injury exposure and severity data. Athletic trainers can evaluate the records and calculate the injury exposure rate for each sport during a given season. Sports with a greater incidence of injury should receive coverage priority. In addition, injury severity data can be calculated based on the amount of practice and game time that injured individuals miss. Sports with more moderate and severe injuries should receive coverage priority.

Through this analysis, you may find that athletes in some sports suffer few injuries, and those injuries that do occur tend to be minor. The question then, is this: Do these sports require athletic training coverage or, based on the injuries that do occur, is first-aid coverage sufficient? If so, coaches could be asked to provide the necessary first aid in the absence of the athletic trainer.

There are some duties, however, that should not be skimped on. For example, record keeping is an important task frequently pushed aside when we feel burdened. In our haste to accommodate everyone, we delay recording treatments performed or choose not to update an individualís record because it will take one minute too many. Record keeping can be boring and monotonous, a perfect opportunity to lighten the load, especially when several individuals are waiting to be seen. But record keeping is quite possibly the most important aspect of our job. Record keeping is the only means for demonstrating what we do on a daily basisósomething than can protect us in a lawsuit and is evidence of the valuable services we provide.

After thinking about which duties you can give up and which you canít, be sure to speak with your athletic director (or other supervisor) about your ideas. Developing a coverage policy is not something an athletic trainer can or should do independently. It requires the assistance and support of the athletic administration. Youíll also need the administrationís support for the small things: Asking coaches to be responsible for their own water should be a policy the athletic director implements, not a suggestion from the athletic trainer alone.

Earn the support of the athletic administration by effectively presenting your ideas. Show your injury data and ask that the athletic director work with you to establish a coverage policy that satisfies everyone. Ask that your athletic administrator support first aid instruction for all coaches. Explain that this will allow you to focus on rehabilitation and administrative duties while maintaining an appropriate level of care.

Athletic trainers, as a whole, have a "can do" attitude. Our willingness to help is one of the traits that got us into this profession, but we can contribute more if we take our time seriously and demonstrate to our co-workers that our time is valuable. Take control of things you can, and work with your administration to create effective policies that help you use your time most effectively.

Finally, demonstrate your results by keeping coaches and administrators in the loop. When an athlete gets back on the field because you had more time for rehab with him, let the coach know. When a coach handles an injury situation well, let your athletic director know. And when your frown of stress turns into smiles for your student-athletes, you can pat yourself on the back for figuring out the puzzle of time management.