Chapter 9

Life-Long Skills

Stress Management

Time Management

Stress Management


This section is designed to help you understand what causes your stress and how you can deal with it in a productive and positive way.

Stress is inevitable. There are positive and negative stresses. Some of the positive stresses we accept daily are:

Adventures, holidays

Self-motivated change

A new relationship

Risks for possible personal gains

Raising children

There are also negative stresses which may, or may not, lead to positive changes:

Stagnation, powerlessness

Fear, anger, conflict

Change forced by others

Believing we have limited choices

The principle difference between positive and negative stress is our perception of the stress and our personal view about whether or not we have some control over that stress. For some people conflict is always seen as an opportunity for change or improvement while others concentrate only on their perceived powerlessness. For some people adventures in the "great outdoors" are chances to learn new skills while for others, adventures are just another way of describing an outdoor torture perpetuated by the knowledgeable against those of us who enjoy a good movie and popcorn!

The stress cycle for positive and negative stresses is the same. It begins with a specific situation and your thoughts and beliefs about whether or not you think the situation is good or bad for you. These thoughts lead to specific feeling. People often believe that their thoughts and feelings cannot be controlled or changed. This is why people sometimes feel overwhelmed by relatively minor inconveniences. Based on your feelings you are likely to follow an action. If you have faced the situation before, you may respond in the same way (whether healthy or unhealthy). Managing stress is about having control over your thoughts, beliefs, feelings and actions regardless of the situation. This is easier said than done but does work with practice and determination.

People in health care are a stressed group. There are so many requirements of the managers. They have to be clearly prepared to stop on a dime, switch directions, have fabulous planning skills, terrific communication skills, be able to leap tall buildings. If the stress levels on them are too great, it suppresses their positive behaviors and spills out onto their staff. So we constantly monitor this stress through management forums where the president asks the question, “What’s cooking?” We have some assertive people who will stand up and say, “Staff is really feeling the pinch, they’re stressed out and it’s impacting on the clients in some negative ways. It is also impacting on other staff members who may not be dealing with clients but who are supporting the clinical services”. The quick response was, “let’s collect some information.” We did a rough survey and sure enough people were experiencing stress in a wide variety of ways and we are looking at ways to reduce those stresses and it is sort of like the real estate industry—the answer seems to be location, location, location. I think for stress, it is communication, communication, communication. And as much as we communicate, it is still not enough. It seems like a lot of staff are asking for communication sessions where they are not getting information as much as having an opportunity to express how they feel. And that is a tough managerial skill—not to talk; but to listen. Very tough. I see that as an extremely important given the whole atmosphere of rapid change. So the uncertainly levels climb sky high in an organization and that has to be monitored very, very carefully.

Larry Lewis

Recognizing When You Are Under a Lot of Stress

Watch for some of the following signs to warn you about excessive stress (whether positive or negative). Experiencing some of these stresses once or twice is common. However, if you experience some of these stresses regularly, then your stress may be hazardous to your physical, mental and emotional health.

You are working late more often than not, or harder than you know is really required.

You are having problems making any decisions, large or small.

You are constantly making "safe" choices, rather than taking realistic risks.

You use an increased amount of alcohol, drugs or cigarettes.

You are over or under eating (a change from your usual).

Your speech or writing patterns have become vague, disconnected.

You experience an increased level of anxiety, worry over relatively trivial concerns.

You constantly repeat the same topic at meetings, in conversations, even though you know the point is not particularly important.

You experience inappropriate anger, hostility or outbursts of temper.

You experience feelings of sadness and crying.

You are constantly putting yourself or others down.

You become overly concerned about your health.

You have greater difficulty sleeping.

You begin to confuse or forget dates, places, times or other details which you remembered easily before.

You are having difficulty in getting along with people.

You just know that something is wrong but are not sure what it is.

Exercise #1

Review the previous list of stress signals you may have in your life right now. Put a check mark beside those signs that apply most specifically to you.

Try to identify major stresses in your life now that cause these signs to appear:

Which of these stresses is most dominant in your life right now? You may choose this example for Exercise #3 to identify ways of dealing with this stress.

Ways to Start Dealing with Stress

When I was 23 years old, a drunk driver ran his car into my body. Over the course of the next 8 years, I began to lose functioning in my arms, hands and legs and various other systems in my body became progressively compromised. I lost my ability to continue in graduate studies, to work part time, to walk any distance, to sit, to stand. I lost everything in my life. One day in abject sorrow, I searched for something that was mine alone that had not been taken or diminished since the accident. It occurred to me that I was abundant with suffering. From that day on I studied myself and how I suffered and how those around me suffered.

It was in the years of losing everything that I found an ability to let most things roll off of me. Strong emotions created physical pain for me and I soon learned that I was not allowed freewheeling sorrow. I needed to tend to my emotional and spiritual needs daily. So I began at the end of the day to go to bed early to think over how I had greeted the day and it me. I would take note of what hurt, what helped, what made me laugh and what made me cry. I would balance out each day with music, with time to think, with praying for the day to end, so that tomorrow, if I was lucky and slept well, I might have less pain.

As I learned to walk and negotiate the world again, I kept many of the lessons learned at the center of my being. I fell often. My friends would often walk several steps ahead before they realized that I was “missing in action” and would come back and search for me. I could not change what was but I could change how I responded to such incidents. I asked people not to get upset but to help me laugh as they picked me up and brushed me off. The pain and stress was quite overwhelming but if I let it rule me, it would cause me more harm. To this day one of my colleagues can be heard to say that I always find everything funny. It isn’t that I find all things funny but that in the sorrow, there is something profound and sacred about human struggle and integrity. For me humor captures this and allows me to conquer that which threatens to destroy me.

While I still live with pain and a diminished capacity, I am able to accomplish a great deal. I do this through stress and time management. For instance, while working full time, I did a Ph.D. I have trouble sitting after a long day so I found a distance education program that allowed me to study at home. Pacing and balance became the basic stipulations to lead my life. If I pushed myself too far my pain would increase and my body would lose functioning. I wish sometimes that others had the fortune of knowing the limits I know so that they might be more kind to themselves. We are hard on ourselves, others are hard on us and life can be hard. If we do not start with our own self-care, we will eventually pay the price--now or ten years from now when our body gives out.

Michèle Chaban

The following suggestions reflect a wide range of alternatives for dealing with stress. Choose some of the following techniques to add to the stress management skills you already have. Try to practices your choices regularly. Some of these suggestions can help you resolve short-term stresses immediately. Improvise these tips to fit your own situation. These are not golden rules as much as helpful techniques.

Work on developing the capacity to recognize when you are under stress. If you don't recognize the stress you are under, you will never deal with it well.

When you are facing a stressful situation try to isolate what the particular stress is. Can changing your perception reduce the stress? For example, many people think going to the dentist has to be stressful. Can you visit your dentist with a big grin, ask them how they are doing, ask them to educate you about what they are going to do, tell them you are nervous and ask them what other patients do when they are nervous? Use the stressful situation as an opportunity to learn, to laugh and to understand why the situation is stressful.

Laugh! Few stress reduction techniques work as well as laughter. Laughter relaxes you physically (15 minutes of belly laughing equals 5-6 hours of meditation according to Buddhist monks) and laughter relaxes your mind. Laughter is also contagious and your family members or colleagues can join in the laughter and make you feel even better. It is a myth to believe that you must have a reason to laugh. Just start for no reason at all but to feel good.

You cannot control some things. There is a famous prayer that reads: Grant me the serenity to accept the things I cannot change, the courage to change the things that I can, and the wisdom to know the difference. An overbearing boss or subordinate is unlikely to change until you are able to resolve some specific conflicts. In the meantime you do have control over how you react to any situation so use your sense of humor to help you get through.

Ineffective use of your time is a leading cause of stress. Don't procrastinate as much as you usually do. We spend 80% of our time doing only 20% of the things we need to do, e.g., rearranging our desks or going through our mail three times before deciding what to do with it. Learn new time management techniques to use your valuable time wisely.

60-hour work weeks are not productive so cut back. Research shows that productivity drops among people under high stress, but peaks under moderate stress. Long weeks are sometimes necessary but good time management means you should have fewer of these long weeks.

We need friendships to reduce stress. Make an effort to improve a few supportive relationships. Remember friendships take time. People who have supportive relationships suffer less under moderate and severe stress than people who are socially isolated. For example, social isolation is the method we use to punish prisoners.

Schedule short breaks in your day. For example, physicians are wise to leave one or two 15-minute breaks in their office schedule as a safety measure against an increasing backlog as the day progresses.

Not every argument is worth winning. Give in when you have little to gain. Save your energy for what is really important but do not let little irritations build up to a major problem. Talk things out with people before problems escalate. Learn conflict resolution skills to minimize conflicts.

When you are uptight it is important to breath deeply and to stretch your muscle groups. You can also tense and relax your muscles starting with your arms, face and neck, shoulders, abdomen, and finally the legs. These Exercises can be done while you are sitting at your desk, while standing at a bus stop, or relaxing at home.

Don't try to control family members, friends or colleagues. Be supportive instead of judgmental. A supportive environment is much less stressful than one where people play power games.

Take a warm shower or bath to soothe tense muscles and provide a few moments of heavenly privacy.

For immediate relief of stress try to take ten minutes away from the situation for a quick walk. Coffee breaks filled with coffee and sugar treats tend to add to the stress. A quick walk outside, or to another area within a building, will increase your energy, clear your mind, and give you some needed perspective.

If your organization has a library a quick trip to read a magazine article is a wonderful way to hide from reality for a short time.

When things pile up to unmanageable levels, break up major projects into workable units with realistic time frames. You can accomplish all major projects, or combination of projects, if you begin with the priority items and accomplish the other parts of the project as required.

If you are worried about a small problem with a colleague, spend some time talking with that person and telling them how their behavior (and not them personally) is affecting you.

Stop comparing yourself with everyone else. No matter how hard you try you probably cannot paint like Emily Carr, sing like Lena Horne, write like James Michener or win the Nobel Peace prize. You may be able to do some things exceptionally well, but not everything and that's okay! So don't put yourself down if you are not as good as someone else; they can't do everything well either.

When one teaches stress management and similar programs, people routinely send you poems and stories to help you make your points more clearly. I received this anonymous poem recently:

Work as if you didn’t need the money.

Love as if you never have been hurt before.

Dance as if no one is watching.

I would add: Help create a loving memory for someone today.

Harry van Bommel

Learn to feel comfortable talking about your problems, hopes and fears. A close friend is a valuable resource, but avoid dumping on the same person all the time. Make sure you also take the time to listen to your friend's concerns.

Read a good book.

Watch a good comedy on television or rent a video.

Get physical. Gardening, walking or dancing are great ways to boost your energy.

Take a daily music break -- with eyes closed sit back and listen to 10 minutes of soothing music. If you play a musical instrument, take time everyday to play a tune or two.

Avoid doing everything quickly. High stress people often try to do too much within the same 24 hours we all have. Slow down and take time to reflect -- North Americans spend too much time doing and not enough time thinking!

Instead of an after-work cocktail, try ice water or juice followed by a 10-minute quiet time, relaxing with your eyes closed. There is great peace when the world is quiet for a short time. This gives you the energy to spend quality time with your family, friends or by yourself later on.

When you arrive home from work and you need to unwind, explain to your spouse and children that you need one half-hour to yourself before being together. If you explain your need your family will probably help. Make sure you give other people in your family the same consideration when they need some quiet time.

Try to make work and living areas as pleasant and comfortable as possible with pictures, plants and ornaments. Personalize your work area.

One of the greatest stress releasers is a big hug from a family member, friend or trusted colleague. Silent empathy is a great healer. Begin by giving other people that kind of support if they feel comfortable with it.

Learn to say no. Ask for time to consider a request. This allows an opportunity to decide if you really want to and can take on an additional task.

These suggestions are not a cure for stress. They are short term coping techniques to help you through some rough spots. At some point you must recognize what your stresses are and develop a whole range of techniques for dealing with them in an ongoing way. Remember your sense of humor. The perspective that you have of stressful situations in your past can provide great background for humorous stories or stories for teaching other people new skills. (Remember that horrible date you once had, the day everything at work went berserk, the vacation trip that failed before you even left!) Ask yourself what will this situation mean in 10 years?

Physicians experience a lot of stress and aren’t readily available to see this in themselves or tell other people about it. Our medical education still gives the message that we must be effective and cope all the time and that to do otherwise would mean that we aren’t good doctors. Team members working with physicians can help them identify their stress by role modeling stress management and good self-care, and by gently labeling signs of stress they may see in their colleague. Encouraging people to be gentle with themselves can also help a lot.

Elizabeth Latimer

Physically Coping with Stress

Deep Breathing

Deep breathing, taking a brisk walk, doing relaxation exercises, tensing and relaxing our muscles are all ways to immediately relieve the pressure of stress. Deep breathing is one of the easiest techniques to master since it is useful at work, at home, while caught in traffic, and at times when you cannot do any of the other techniques.

Deep breathing can take only 10 seconds or last a half-hour, depending on the circumstances. Regardless of the length, use it to the fullest and enjoy the feelings. Here's one method of deep breathing.

1.Place your hands on your abdomen, right below the navel. The fingertips of each hand should touch one another.

2.Breathe in through your nose; it is healthier than breathing through your mouth.

3.Inhale slowly; as you do, push the abdomen out as though it was a balloon expanding. With your eyes open or closed "feel" the air passing through your nostrils.

4.As the abdomen expands, your diaphragm will move downward, allowing fresh air to enter the bottom of your lungs. Keep your back straight to aid the process of maximizing your breathing. Exhale through your mouth.

5.As you continue to breathe imagine the air filling your lungs, your abdomen and, with each new breath, imagine the air filling your arms, legs and every part of your body. This will help you to concentrate on the various parts of your body and should help you to relax each area.

6.When you feel comfortable, take deeper breaths and hold the breath for a count of 3-5 seconds. Do the same when you exhale your breath, hold for 3-5 seconds before taking your next breath.

7.Picture yourself in a place where you feel particularly comfortable (e.g., on a beach, on a nature walk, in a favorite room, playing a sport, in a childhood memory). Pick just one spot to concentrate on while you continue to deep breathe for as long as you wish.

8.When you are ready, slowly begin to stretch your muscles as if you were yawning. As you feel more relaxed you can begin to return to "the real world".

The definition of stress? Working twelve hour shifts on a general surgery floor on weekends with little medical coverage. Sometimes, it would be all I could do to cope with my own patient assignment, let alone constantly ringing call bells, never ending admissions and discharges and patients in crisis. When my own stress level was high and I felt like I couldn’t handle any more, I would escape to the staff washroom or lounge and take a minute or so to deep breathe. While this didn’t leave me 100% refreshed, I was at least able to regain some control of my stress so I could get back to caring for my patients effectively.

Beverley Powell-Vinden

Negative Stress

One of the most effective steps towards managing negative stress is learning to recognize what causes your negative stress. Each person's list is unique and individual. Think of your friend who never gets upset in traffic jams but faints at the sight of blood.

Exercise #2

Pick a day, or a few days, and list the ordinary, day-in, day-out little annoyances that seem inevitable at work or at home. Also list those stresses that are constant in your life (e.g.,, an unhappy working relationship, financial concerns, car problems). Once you have listed some of these stresses, develop some actions that you could try to minimize, prevent or conquer these stresses. Put a star beside techniques or actions that really work for you. Use your imagination!

Stress                                                                                                        What You Can Do

For Particularly Difficult Stresses

Use this sample form to help you resolve some of your really difficult stresses that seem "hopeless". Keep in mind that all stresses are an opportunity to learn about yourself and to discover ways to deal creatively with those stresses. People have gone through concentration camps, wars, the death of a spouse or child, and physical disabilities and many of them have survived and grown stronger. So can you! See the “Resolving Conflicts” section for added suggestions.



How can you overcome this stress?


How can you get away from or prevent the stress from happening again?


How can you live with the stress if it cannot be overcome?

How can you build up a resistance to this stress?

How can you change yourself or your perceptions about this stress?

What is the best option in this case?

I'd Pick More Daisies

The following is a quote attributed to Brother Jeremiah. It has become very popular, however, we were unable to trace its origin. Whenever this was written the words and sentiments are timeless.

If I had my life to live over again, I'd try to make more mistakes next time. I would relax. I would limber up. I would be sillier than I have been this trip. I know of very few things I would take seriously. I would take more trips. I would climb more mountains, swim more rivers and watch more sunsets. I would do more walking and looking. I would eat more ice cream and less beans. I would have more actual troubles and fewer imaginary ones. You see, I am one of those people who lives cautiously and sensibly and sanely hour after hour, day after day. Oh, I've had my moments; and if I had it to do over again, I'd have more of them. In fact, I'd try to have nothing else. Just moments, one after another instead of living so many years ahead of each day. I have been one of those people who never go anywhere without a thermometer, a hot water bottle, a gargle, a raincoat, aspirin and a parachute. If I had it to do over again, I would go places, do things, and travel lighter than I have.

If I had my life to live over, I would start barefooted early in the spring and stay that way later in the fall. I would play hooky more. I wouldn't make such good grades except by accident. I would ride on more merry-go-rounds. I'd pick more daisies.

Brother Jeremiah

Exercise #3

To complete this exercise, imagine yourself nearing the end of your life. Write your own "If I had my life to live over again" in the space below. It is a real gift to be able to write this now and to make those changes you want to make.

If I had my life to live over again I would:

Things I want to do before I die:


It is difficult to summarize the best ways of dealing with stress. Each of us copes in different ways with the same stresses. The following summary reflects a personal bias. Use those parts of the summary that fit your personal style and use the following page to add your own summary.

Few people can deal with stress alone. We need the support of other people. Therefore we need to have love and friendship in our lives. If you have these things in your life then you must constantly work to maintain and improve them. If you do not have love and friendship in your life right now then you need to develop it by showing how you care about yourself and how you can care for other people.

Make firm commitments to your family and friends and spend time with them to be supportive and to receive support. Encourage honest and open communication between you. Try to be nonjudgmental and accept people as they are while you try to show them alternatives to the way they do things. Accept their ideas and suggestions for modifying your life as well.

People cannot support and encourage you without you caring about yourself. Identify what stresses you have and what strategies you can use to prevent or deal with these stresses. People respect someone who has the self-esteem to try new things to solve old problems.

Have more fun by laughing and being with positive people. Take time to do something by yourself every day. For example, read for a few minutes, meditate or pray, and reflect on the good things in your life for which you can be thankful. Make an effort to think of something special you can do for each day to brighten someone else's day such as bringing in some home made cookies, sharing a new joke, lending them a video of a favorite film, or bringing someone a fresh rose.

Make an effort to reflect daily on the positive qualities you possess and your daily successes, no matter how small they seem. Watch your “self talk”, the messages that you say to yourself. Try to reduce the negative, for example, “I could have chosen different words but I handled myself well in a difficult situation”, instead of, “What a blunder I made”.

We constantly hear about living a better lifestyle. Choose parts of a healthier lifestyle that make you comfortable. Perhaps it is walking a bit each day, having only one ice cream instead of two, or perhaps cutting down on fatty foods. If you choose not to change your lifestyle then try other activities to compensate, e.g., relaxation Exercises, better time management, or resolving conflicts.

You cannot prevent all negative stress, but you can have fun trying to minimize it!


The following resources are only a few of the many useful resources that you can find in your local libraries, within your own organization, and in your local bookstores. Look for other books but also for journal articles, magazine reports, films, videos and audiocassettes. Also keep in mind how much you can learn from experts in the field, including people within your own organization!

Bernstein, A.J., & Craft Rozen, S. (1994). Sacred bull: The inner obstacles that hold you back at work and how to overcome them. Toronto: Wiley & Sons.

Blumenfield, L., & Gawain, S. (Eds.). (1994). The big book of relaxation: Simple techniques to control the excess stress in your life. Roslyn, NY: Relaxation Company.

Cherniss, G. (1995). Beyond burnout: How teachers, nurses, therapists, and lawyers recover from stress and disillusionment. New York: Routledge.

Davis, M. (1997). Relaxation & stress reduction workbook. New York: Fine Communications.

Newman, J.E. (1992). How to stay cool, calm and collected when the pressure’s on: A stress control plan for health care facility/team people. New York: AMACOM.

Noer, D.M. (1995). Healing the wounds: Overcoming the trauma of layoffs and revitalizing downsized organizations. San Francisco: Jossey-Bass.

Powell, J.R., & George-Warren, H. (1994). The working woman’s guide to managing stress. New York: Prentice Hall.

Stearns, A.K., & Lamplugh, R. (1995). Living through job loss: Coping with the emotional effects of job loss and rebuilding your future. Saint Loius, MO: Fireside.

Warner, J. (1999). Creative time management for the new Millennium. Stamford, CT: Hannacroix Creek.

Yeomans, W.N. (1996). 7 survival skills for a reengineered world. New York: NAL-Dutton

Time Management


This section is not designed to totally change your present methods for managing your time and organizing your work. The following information is not a specific "method" that you must follow to the letter. Instead, the information in this section is to help you to build on your current time management and organizational skills.

Do we need to manage our time? According to a report on CBCs The Journal (July 5, 1988) we spend, on average:

5 years of our life in line-ups

6 months waiting for red lights

4 years doing tasks in the kitchen

8 months looking at junk mail

2 years playing telephone tag trying to speak with others

Nearly 1/3 of our life sleeping

Nearly 1/3 of our life working and studying

Compare that to:

4 minutes of each day talking with our spouse

30 seconds per day in meaningful discussion with our children

Little or no time spent doing creative problem solving

In this section we will spend some time understanding how we use our time now and how we can use it better in the future. The key to successful time management and organizing our work is to take control. To take control means you need to understand that your day may include work, sleep, eating, family time, listening to music, socializing, exercising, studying, writing letters, personal phone calls, movies, illnesses, vacations, holidays, celebrations (birthdays and anniversaries) and time to do absolutely nothing.

Once you understand your day a bit more you can begin to divide your valuable time based on your personal priorities. Some people find it extremely important to work very hard to achieve financial success. Other people find it more important to spend time at home with children or to do volunteer work or to study.

This section should help you make some of those decisions and give you tips in achieving your own goals.

General Goals and Priorities

To manage your time effectively you must decide what your priorities are. Priorities are where you plan to place most of your time and energy. General areas of priority include:

Family involvement

Physical health and appearance

Emotional concerns

Educational interests

Spiritual development

Economic well-being

Career enhancement

Within each area of priority you need to set goals. Goals are specific, time-limited actions which can be easily identified and measured. If goals are left vague, you will never know if you have achieved your goal or not. When you set a goal, ask yourself if other people would be able to see that you have achieved it or not. Examples of specific goals within an area include:

A promotion in your work within the next 18 months.

An extra one-hour a day with family members.

An improved grade in your studies to give you an overall average of B+.

Increased physical fitness to improve your health so that you can walk for an hour comfortably, or decrease your blood pressure to a certain amount, or lose/gain "x" pounds within 12 months.

Limiting work hours to a reasonable day by leaving the office at a certain time.

Once you have set goals within each area of priority you need to compare the areas and decide what you can reasonably accomplish in the next 1, 3 and 5 years. Perhaps your educational goals will take a lower priority to your family goals, or vice-versa. Perhaps your economic concerns will not be met because you want to accomplish your educational goals. Comparing your areas of priorities will help you to set realistic overall goals.

The goals and priorities you choose are not written in cement. Your personal and professional situation will change over the years but a general sense of your future allows you the flexibility and control to make better decisions rather than let outside influences make those decisions for you.

While working full time with physical pain and reduced limitations, I set out to do a Ph.D. just in case I could not do front line social work. I set out not to succeed, but to try. T.S. Eliot’s saying, “For us, there is only the trying”, was my rule of thumb. I worked Tuesday night, Thursday night and Sunday for 6 years. The other nights were for my friends and myself. Doing so much intellectual work, I needed a physical balance so I took up swimming and eventually hiking at a gentle pace. If I became depleted, I retreated and regrouped in my silence and solitude. My disability taught me about my connectedness. My body is connected to my emotions that in turn are connected to my spirituality, which in turn helped me to think critically about what I wanted to write in my thesis. Balance, harmony and small steps, one after another, helped to make my path a successful one.

Michèle Chaban

Negative Thoughts

The real enemy of time management is our own negative thoughts about ourselves. This is true in all aspects of our work and play but is especially true in time management and organizing our work.

Negative thoughts about our abilities to meet a deadline or to achieve our goals drain us of mental and physical energy. There is a story about a man who ran a chip-wagon service along the side of the road. It was a very successful health care facility/team. He had signs along the road for miles announcing ‘Five miles to Bill's Fresh Fries!” Then the Depression of the 1930s came. Bill's son told him that the Depression was going to ruin their health care facility/team. The son told Bill not to waste their money on repainting the signs and to expect a decrease in sales. Of course that is exactly what happened since Bill and his son stopped trying to be successful managers of their time and work.

We don't need a depression to know that many of us think in negative ways about our skills. Perhaps a teacher told us that we would never be good at certain things and therefore we stopped trying. Perhaps we failed in some task years ago and now believe that we can never try again. Perhaps we did poorly in school and therefore shudder at the thought of going back to school.

If we speak to anyone over 60 years old and ask them how many of their worries actually came true, I think they will tell you that 80-95% of all their worries were wasted time and energy. The trick is to know what is worth worrying about.

The main reason we have negative thoughts can usually be found in our viewing a large task as a whole instead of its smaller parts. When I began to write this book I thought that the time and effort to research and write it was overwhelming. To break the habit of doubting my abilities, I broke down the task into smaller units that I could manage more easily. I researched these smaller units and tied them together at the end.

Just about any task can be broken down in manageable units! That's the trick.

If someone had told me as I lay looking at ceilings and not being able to cook, clean or tend to myself, that I would one day speak to large audiences of health care professionals, I would have thought them quite daft. If someone told me that one day I’d walk alone on a sidewalk without my cane, I would have smiled and said I hope it will be so. It is true that the journey of a lifetime begins with a single step. I am proof of what is possible if you dream little dreams, one after another, realizing them slowly. They have a way of adding up, of accumulating. Life has surpassed my wildest dreams.

My disability has taught me many important lessons. Perhaps the most important was this-sometimes you need to look to the horizon to see what is up ahead, but sometimes, if you keep your eyes solely on the horizon, you will trip over something and fall. That is why I always watch my feet, one in front of the other, left, right, left, right. Before I know it, I have arrived at my destination.

Michèle Chaban

The Daily Check List

Perhaps no other time management and work organizing tool has been written about so much as the daily check list. Quite simply this list helps you get through busy days.

1.Use a single sheet of paper, a cue card, or, if space is available, your calendar to make a list of the tasks you need to accomplish today.

Place a number beside each task to give you the order in which you want complete each task. Begin with the most urgent and important tasks e.g., bring children to baby sitters before work; follow with medium sized priorities, e.g., phone calls you need to make that day; and end with low priority items (usually the largest part of our list - e.g., shopping for socks, getting Christmas cards in September, etc.).

Decide which 20% of your tasks will produce 80% of the day's results and do them. So much of what we normally do (80%) leads to less than 20% of real results. Knowing the difference will help you enjoy your productive work more.

2.Make a separate list of shorter, less important tasks which you may do today or in the following days when you have a few spare minutes, e.g., writing letters to family members living far away, checking the air in your tires, or preparing for a camping trip that is two weeks away.

3.Evaluate, on a daily basis, the success of your time management. Which tasks are you accomplishing? Which tasks never seem to get done? Is there another way to accomplish these?

Time Management Techniques for Long Term Success

For longer-term success in managing your time, choose from the following list to help improve, or add to, your present skills in time management.

Keep a daily log of your activities for about a week. This will help you identify where you spend your time, on what, and whether you can find wasted time. Remember, though, wasted time is very different from time spent relaxing!

Schedule time to be by yourself to think, reflect and plan. We often spend too much time "doing" things and not enough time thinking and reflecting on what we are doing or why.

Set reasonable deadlines for yourself. Include enough time for unexpected events, illnesses, and car problems.

Procrastination is both a personality style and a way to avoid evaluation by others. Knowing that you procrastinate is the first step in helping to overcome it! Make plans, appointments and reward yourself for success.

Take a large project and divide it into manageable units. Schedule work on the smaller units with an ultimate view to the final completion date for the whole project.

Try to keep your work environment neat. This may help to make you feel more in control of your work and make it easier for you to see your work place first thing in the morning.

Take time to enhance some of your other skills: improve your reading speed and comprehension; write better memos, letters, reports; delegate your work more efficiently; and communicate more effectively. Pick one or two skills every year and within a relatively short time your overall performance and satisfaction will improve.

Organizing Your Work

In order to complete our work effectively within the time management system you have developed, you need to divide the work by priority, decide on the difficulty involved in completing the work, and schedule the sequence of the work. Let's look at these more closely:


Who will receive the finished work (work prepared for the President is usually more urgent than work prepared for a colleague)?

Who needs to be consulted to do the work: clients, supervisors, colleagues, secretarial staff, and external consultants?

Is the deadline for one high priority job approaching faster than work of a similar priority that has a longer deadline?

1st priority  Those things that need to be done immediately.

2nd priority  Those things that need to be done within the next few days.

3rd priority  Those things that can be delayed for more than a few days or until time permits.

Is there competition between co-workers to have certain work done first? If there is, either: plan together to determine the real priorities or have the supervisor make the final decision.


Is the work more difficult than originally thought? If so, change the scheduling to allow more time or give the work a greater priority over other work.


Identify the steps involved in finishing one project and design an Action Plan to divide the work, set deadlines and decide on evaluating the success of the project. (See the sample Action Plan in this section.)

Schedule blocks of uninterrupted time for routine matters; for time to think, plan and evaluate; and for regular meetings. These blocks can be cancelled or postponed but at least it can help you keep track of important tasks that are often left undone because of too many meetings, appointments and phone calls.

Use larger calendars to schedule various major projects at once. Break down these projects into manageable units (use Action Plan) with enough time to deal with unexpected events and illnesses, e.g., set a final deadline date but plan for a deadline weeks or months in advance of that real date.

Use a bring-forward system to help remind people of work needing attention in the future:

Use a file for each month in the year to file correspondence, reports, Minutes, etc. that require attention at a specific date in the future. Organize this material chronologically within the file.

Or when keeping a bring-forward system for several people you can use a cue card system where you have a card for each day of the year, divided by months. Use "Post-it" papers to remind yourself of a file, report, phone call, event, etc. that you need to attend to at a specific date in the future. [Individuals can use their personal calendars to do the same thing.] Begin your day by checking your bring-forward system.

Other Tips

Reward successful completion of major projects. Rewards can be personal or given by the organization. Rewards can be simple or involve extra time-off. Whatever reward is given must be personally satisfying to the people involved.

Handle paper (correspondence, reports, journal articles, etc) only once: either act upon the information, delegate it (with a note of explanation) to someone more appropriate, file it for future action, or throw it away. Do not let it pile up on your desk.

Filing systems are quite personal. Some tips:

The only irreplaceable document is one you create yourself. All other documents are probably copies. Be critical before deciding to keep a document you will probably never look at or refer to.

Keep "thick" files for general types of information. For example one thick file covering all office equipment versus many thinner files for each piece of office equipment, for warranties, for servicing companies, etc. Too many thin files makes it difficult for other people to find things if you are unavailable for help.

Be consistent in filing. Everyone leaves their position within an organization for vacations, transfers, and promotions. It is, therefore, very important to have a logical system for other people to use. Label file drawers, keep files in alphabetical, departmental or chronological order. Inform someone else about any changes you plan to make. Compare notes with other people who are doing filing before changing your system.

Learn to Say "No"

Tell the person requesting the work that you understand it is important but that pre-determined priorities have to be done first.

Try to get the person to acknowledge that you cannot do the work now (or perhaps never) by asking, "What else could be done to get this work done for you?"

If someone else is better able to get the work done, or if someone else is actually responsible for that work, tell the person asking you for help.

Always be understanding but firm. Do not be defensive since you cannot be expected to do everything for everyone. Help yourself and others set realistic limits about what is possible. Avoid giving long explanations of why you can't do something.

Once you get into the habit of saying “no” to certain requests, you gain a sense of control over your time and your life. It can feel great. Sometimes you aren’t sure if you want or can take on a certain task. I handle this by not answering yes or no at the outset. Rather, I gather information about the time involved, the task itself, deadlines, etc., and then let the person know I will call them back before a stipulated date. This allows me a space to look at the rest of my schedule, my own priorities and to think about the request and whether I can and wish to do it.

Elizabeth Latimer

When using calendars use pencil to write in appointments, phone calls you need to make, tasks you need to do, etc. It is easier and neater to erase.

Beside any appointments write in the person's phone number and the location of the meeting in case you have to call quickly to change the time or location.

If you require special resources for a meeting, write them down in your calendar.

When preparing work for a meeting 2 weeks away, schedule sufficient time over the next few days to complete the work. Many people wait until the night before, which is an ineffective way to prepare, and doesn't allow for any unexpected interruptions.

A Year in the Life of an Expectant Father (1992)

Everyone has years that are busier than others. This was one of mine. The list isn’t to impress you with my time management skills. There were clearly days and even weeks when I thought I would go crazy. The list is intended to show you that people survive difficult and/or busy years. The key is to live a balanced life so that when things get overwhelming you can go back to your principles of what is most important to do and what may have to wait.

Personal:  Normal day-to-day activities and social life of a married man whose wife is expecting a baby.

Baby:  Visiting midwives and doctors regularly including trips to labs and prenatal classes. Reorganizing life with a new person including new clothes, furniture and nursery. Nine-week recuperation for my wife after the birth.

Work:  I was self-employed so could juggle work and personal demands with more flexibility than most. My work included: ten-week contract with a teaching hospital to research and write manuals; research, write and edit a book; media interviews promoting the book; teaching 15 courses; public speaking; attending several conferences; moving my business.

House:  Moving from an apartment to a house and all that that entails.

Education:  Completing my masters’ thesis.

Volunteer:  Continuing to do volunteer work in palliative care including meetings, reviewing educational materials and assisting two families with a terminally-ill loved one.

Friends:  Helping an 86-year-old woman during her last three months of life.

Harry van Bommel

Action Plan

One of the easiest ways to plan your work priorities and help schedule that work is to use Action Plans (see the sample below). Have colleagues, your supervisors and/or staff participate in dividing the work.

What is the Task?                                    Who Will Do It?                    By When?                    How to Evaluate Success?


To practice what we preach, here are a few of the key elements to time management and organizing your work, in timesaving written form!

90% of all things can be done immediately!

Procrastination is often our way of avoiding evaluation of our work by ourselves or others.

The fear of evaluation and our own self-doubts/negative thoughts are of our own making.

Design your schedule to break tasks into manageable units.

Organizing your work involves consistent planning and evaluating your success. There is no magic formula, just practical tips to help you do better what you have been doing for years.

You have the power to control your time and your abilities. Take that control and enjoy yourself!


The following resources are only a few of the many useful resources that you can find in your local libraries, within your own organization, and in your local bookstores. Look for other books but also for journal articles, magazine reports, films, videos and audiocassettes. Also keep in mind how much you can learn from experts in the field, including people within your own organization!

Covey, SR. (1989). 7 habits of highly effective people. New York: Simon and Schuster.

Covey, SR., Merrill, AR., & Merrill, RR. (1994). First things first. New York: Simon and Schuster.

Moreau, D., Breuninger, C.C., & Comerford, K.C., (Eds.) (1997). Tips and timesavers for home health nurses. Springhouse, PA: Springhouse.

Moskowitz, R. (1993). How to organize your work and your life: Proven time management techniques for health care facility/team, professional and other busy people. Houston, TX: Main Street Books.

Pollar, O. (1996). 365 ways to simply your work life: Ideas that bring more time, freedom and satisfaction to daily work. Chicago, IL: Dearborn Trade.

Rechtschaffen, S. (1996). Time shifting: Creating more time for your life. New York: Doubleday.

Springhouse’s 1,001 nursing tips and timesavers: Quick and easy tips for improving patient care. (1997). Springhouse, PA: Springhouse.

van Bommel, H. (1985). The busy person's guide to note taking, speed reading, studying and time management. North York, ON: Skills Development Publishing.

Williams, P.B. (1996). Getting a project done on time: Managing people, time and results. New York: AMACOM.

Wright, R.J., & Wright R.A. (1996). Beyond time management: Health care facility/team with purpose. Newton, MA: Butterworth-Heinemann.

Practical Leadership

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Copyright © 2000 Harry van Bommel

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