Do you ever find yourself overwhelmed or constantly at your wit’s end with all that you have to do? This can feel like driving a car bumping along the “rumble strips,” those grooves in the payment designed to slow vehicles down and alert them to danger ahead. This phrase came to me from a coaching client, Gabrielle (not her real name), a successful surgeon, researcher, educator, and mom of two. She had just spent 7 hours in the Operating Room before logging onto a zoom coaching call with me. She described a scenario that is all-too-common among academic faculty and educators, the problem of: Too Much On My Plate.  

She had a busy OR and clinic schedule at baseline, and had then volunteered to take on an extra OR day, plus all the preparation time that entailed, in addition to an evening course, and all the individual meetings and teaching responsibilities of academic life. She shook her head then looked up at me, “I think I’m on the rumble strips. I know I did this to myself,” she said, “and I want to figure out why I ended up in this situation again.”

If you ever feel like a car bumping along on the rumble strips, pay attention to this warning as something is trying to tell you to course correct. Staying in a state of chronic overwhelm can lead to “mental slowness, forgetfulness, confusion… or impaired ability to problem solve.” If you can relate to Gabrielle, keep reading. Here are some short and long-term strategies to help you get on the road.

Short-term strategies

First, assess what you need to do to just get through the day and the week. Today, try to at least allocate 15 minutes of planning time. A few minutes to pull your head up from grindstone and look at what is going on will allow you to assess, prioritize, and strategize to at least make it through the short term.

Second, take stock of what is causing the stress and overwhelm. The 80:20 rule often applies here. What are the 20% of things that are causing 80% of the stress? If you can identify the main sources of the stress, then you can hone in on ways to de-stress, minimize, complete, or step away from them. If it is something that is not required for your job, or is not that important to you, see if there is a way you can take it off your plate or cancel it. If it is not something you want to cancel, think about how you could delegate parts of it, or create what, in business, is called a minimum viable product (MVP). Do enough that it is a functioning product, but put off adding bells and whistles until you have gotten through the short-term overwhelm.

Third, find ways to get through the next week. If that means ordering out, creating MVP dinners, or skipping optional meetings for the week, do what it takes to get the biggest things done to create more mental freedom and planning time.

When you are in ‘survival mode’ it is hard to think creatively or strategically. Once you get off the rumble strips, then you can take time to do some bigger picture planning. This is where you can really make changes to prevent getting into the same situation again.

Longer-term strategies

First, ask yourself: Are you driving? Or is the car swerving around because no one has their hands on the wheel? When we end up in the TMOMP rumble strips, we sometimes start to feel like victims. We feel like there are so many things we have to do or are forced to do. The first step is to remember that you are the one driving. Anything on your schedule or to-do list is there by your choice, which means you get to choose whether to keep it on there in the long term, or whether to phase it off. Those committees you are on? Yep, you applied for them or accepted the invitation to serve. The extra OR day you volunteered for? That was a choice. In academia it is easy to feel like we are out of control when, in fact, the only way to get more control of our time and our days is to remember that we are the ones driving.

Second, are you carrying too much baggage? If you are teaching, researching, working clinically, mentoring, volunteering, writing, driving kids to four different sports and activities, and also trying to exercise, eat healthy, and hand-sew your matching Halloween costumes, there is a good chance things are going to start falling off your metaphorical roof-rack. It is time to take stock and prioritize.

A quick exercise to help identify your priorities comes from the Japanese concept of ikigai, which refers to what gives you a sense of purpose. The things that will give you most meaning and value occur at the overlap of: what you love, what you are good at, what the world needs, and (ideally) what you can get paid for. Draw that four-leaf Venn diagram on a piece of paper, and then write everything that you do on it in the relevant spot. There will likely be many things you do that you love and are not paid for, and some things that you do not love and are paid for. Hopefully there will also be some in the center, overlapping with all four requirements. Items that end up outside all four circles, or only overlap with one, are great candidates to decline, delegate, or not renew. 

Third, are you driving too fast? In high-performing, competitive careers, it is easy to feel like the Red Queen from Lewis Carroll’s Through the Looking Glass, who says “Now, here, you see, it takes all the running you can do, to keep in the same place. If you want to get somewhere else, you must run at least twice as fast as that!” Because the world, it seems, is moving so quickly, we have to run just to stand still. But once you have created a little breathing room to plan and strategize, look at whether you have bought into this lie and tried to run without break. We do not drive our cars without stopping to refuel and for regular checkups, yet we tend to do just that to ourselves.

Finally, are you on the right road? If you are constantly feeling stressed and overwhelmed, or like you are swerving back and forth without a clear path, then maybe it is time to pull off the road and check the map. Reassessing, soul-searching, and planning are the difficult work that it takes to understand deeper levels of why you find yourself on the rumble strips: Is it out of a need to prove your self-worth? Out of a need to look competent? A desire to help people? A deep sense of empathy? A need to prove people wrong who said you would never make it? A sense of obligation? A fear of irrelevancy or failure? A need to leave a mark or legacy? Clarifying what matters to you is the first step to strategically making the difficult choices about which road to be on.

Gabrielle and I talked through why she had found herself over-committed that week. She made plans for how to cope with the rest of the difficult week and decided that to keep herself on the road in the future, she would adopt some specific strategies. Before signing up for extra shifts, she would check the whole week’s schedule to see how that shift would fit in with the week and month overall. She would pause and notice when she was jumping in to try to help too early and would allow time for others to step up. She would use the experience on the rumble strips as a reminder that when your schedule is already full, it only takes a few additional things to wipe out all your extra capacity, and to go from full to overwhelmed. She planned to build in and protect more buffer time so that she had capacity when urgent needs came up, making her schedule more resilient.

Whether you are on the rumble strips, unsure of which way to go, or need to make a U-turn, you can use these practical strategies to help get back to loving your beautiful journey.

 

Did you know that the Harvard Macy Institute Community Blog has had more than 335 posts? Previous blog posts have explored topics including leadership is everyone’s business, designing programmatic assessment structures to support learning, and designing a framework for health science education innovation.

 

Christina Shenvi

Christina Shenvi, MD, PhD, MBA (Educators ‘22; Assessment ‘22) is an Emergency Physician and medical educator. Christina is Associate Professor of Emergency Medicine and Director of the Office of Academic Excellence at UNC-Chapel Hill. Christina. Her areas of professional interests include coaching and teaching physicians and other professionals on time management, leadership, and productivity, geriatric emergency medicine, and undergraduate medical education. Christina can be followed on Twitter or LinkedIn and reached by email