1. Drake, Kirsten DNP, RN, OCN, NEA-BC

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Q I seem to be more overwhelmed and disorganized than my colleagues. What can I do?

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At some point in every nurse leader's experience, we feel busier or less efficient than our peers. There may be multiple contributing factors that lead to this feeling. Take some time to reflect on your responsibilities and actions. Make a list of all the things you're doing daily, weekly, and monthly. Remember to include time reviewing reports, reading e-mails, and attending committee meetings. Categorize critical activities, what you can delegate, and what you can stop doing altogether. You may think that you have to do all of your listed activities, but you don't! Base this categorization on organizational goals and the goals of your immediate work unit. If the activity doesn't support either of these goals, evaluate if there's any benefit to it. If your answer is no, stop wasting your time. If you're finding it difficult to prioritize your activities, try using an action priority grid.1


Managing e-mail is a challenge that we all face. One technique is creating rules and files. For example, sort e-mail into three folders: action needed, follow-up, or reference.2 Another method to organize e-mail is "do it, delegate it, defer it, or delete it." After you determine your filing preference, create rules for your e-mail. For example, have all messages from your boss automatically collected in a specific folder. Or you may want to create a rule based on a keyword in the subject line. If you manage your e-mail from your mobile device, remember to look at your specific folders so you don't miss anything. And remember to delete e-mails after you complete the associated tasks.


Next, use your calendar for maximum benefit. Schedule one-on-one meetings with your direct reports, rather than meeting spur of the moment, which can take much longer because there are no parameters. It's also helpful to schedule your one-on-one meetings on the same day in chunks of time. This allows you to stay focused on similar discussions and doesn't break up your day. Changing from one task to another may also contribute to your feeling of being overwhelmed. Another suggestion is to block time on your calendar to complete projects. This prevents others from adding meetings to your calendar if they know you're already busy. Likewise, it's okay to decline a nonessential meeting or delegate a team member to attend in your place.


Consider using tickler files for paper documents.3 This is a set of files with one file per day of the month (1 through 31) and one file for each month of the year. Items to be done or due on a specific day are placed in the corresponding file for that date. This can be done with reading materials, project reports, and meeting agendas. Items for future projects can be placed in the folder for the corresponding month. When you complete a work item, move it to the appropriate location. Make a goal to address documents once and move on to the next item. If you work with an administrative assistant, he or she can also place items in the folders for you.


Although there's no guarantee that after you're organized you won't feel overwhelmed again, you can use the tools discussed here to help you refocus.




1. The action priority matrix: making the most of your opportunities. [Context Link]


2. Kolowich L. How effective managers organize their time. [Context Link]


3. Half R. Here's how to set up a ticker file for better organization. [Context Link]