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I've lost the plot - can someone help me find it please?

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  • I've lost the plot - can someone help me find it please?

    About 2 years ago I started with GTD, and managed to get massively organised, cleared out my overloaded filing cabinet holding stuff going back 15 years, created my lists of areas of focus, projects and next actions, and was beginning to get a bit of control.

    So why am I sitting in my office on a Friday afternoon with a bulging tray for processing, a pile of unread e-mails, a backlog of work, and the feeling that I just want to run away?

    The biggest problem that I can see is that I have a heavily committed hard landscape (I'm a doctor and a manager, so have both appointments to see patients, and meetings). On top of that the demands on my time and responsibilities are coming in faster than I can action them. The two-minute rule has made a big difference, but the result is that my list of things that aren't yet done are largely projects that will take some time to do.

    I seem to spend my time "firefighting", doing the things that have hard deadlines e.g. writing the training programme for the new doctors that start on Monday, completing a court report due for the hearing next week, writing policy documents that are needed to underpin a new government ordered immunisation campaign starting in October. I've never really managed to do a consistent weekly review, though until recently I have been keeping my e-mail inbox clear, and I've been returning all phone calls within a reasonable time. But I'm getting complaints about the things I have failed to do.

    I now feel so overwhelmed I don't even know where to start. My own manager, not to mention his manager, are equally overloaded.

    Please can someone help me identify the next actions to get back on the GTD wagon?

    Many thanks


  • #2
    First off, Don't Panic!

    Seriously, you're in a common situation. The road to comfortable productivity isn't a smooth upward slope; there are hills and valleys. You're just in a valley. Don't worry; happens to all of us.

    Okay, some advice. The Weekly Review is arguably the primary key to the GTD system. If people are complaining that you're not getting things done, that's a big red flag that you need to re-commit to the Weekly Review. That's where all your commitments become big and visible, and where you can prioritize your time and work for the coming week.

    Overwhelm is also a flag that you need to do a Weekly Review.

    Are your Projects list and NA lists up-to-date? Where is the overwhelm coming from; too-long lists, or lists that don't reflect your actual work and need to be updated?

    You may want to consider my GTD tweak, in which my Projects and NAs consist only of the work I plan for this week. Longer-term work stays on my Someday/Maybe list. This keeps my lists small enough that I can really focus on them and (hopefully) complete them.


    • #3
      It sounds like a lot of serious work with looming deadlines. I understand that sometimes there isn't any time for the weekly review. I promise you, however, that you can use the weekly review to push aside some projects that you know are not as important. That alone will free up your time and lessen the stress a bit. It is also not possible to have projects active in every area of focus.

      Aside from that I would like to make the suggestion of getting additional help in the form of an assistant who can take care of many professional and personal tasks and/or a technical writer/researcher who can assist you with your documents. There are many sources available in your communities or on the internet. You don't need to hire people full-time, rather you can use them on a per case basis. You will need to track their work though. Perhaps you can also engage the help of a trusted nurse or doctor's assistant in your practice who can make some of the more basic patient phone calls.


      • #4
        Step back and breathe, if you can

        Originally posted by RuthMcT View Post
        So why am I sitting in my office on a Friday afternoon with a bulging tray for processing, a pile of unread e-mails, a backlog of work, and the feeling that I just want to run away?
        When was the last time you read the book (or listened to it)? Revisiting the source may help you see things that will be very helpful to you in your current situation.

        In a similar vein, do you have enough control over your own schedule to block out a day or two to lock work outside and tackle your stuff? Maybe even an afternoon? I have fallen off the GTD wagon more than once, and taking a step back to "start over" has usually helped me a great deal.

        There is an interesting piece in the out-of-print "GTD Fast" audio program where David walks up the various levels of focus from someone's point of view. At one level there are things to do, but at another level those things shouldn't be done, in order to do other things for growth and change, etc. Who can you hand things off to? Who should you approach about getting an assistant or finding other ways to lighten the relentless workload? Who can you groom now to move into a position that does some of the work you do now?

        Go through your stuff, get as much clarity as you can, and start pruning.


        • #5
          Originally posted by RuthMcT View Post
          I now feel so overwhelmed I don't even know where to start. My own manager, not to mention his manager, are equally overloaded.

          Please can someone help me identify the next actions to get back on the GTD wagon?

          Can you commit to spending one hour doing a weekly review? Just commit that hour and do what you can to review - remember no doing, just reviewing

          PS, keeping the inbox clear and phone calls processed is great. Keep up the good work.

          - Don


          • #6
            I'll add my voice to all the other posters who say the Weekly Review is key. It's especially critical if you spend most of your time fighting fires -- which is of course the time you feel least able to do it. It's the only way you'll be able to triage the fires, much less get a handle on the things that aren't critical now, but soon will be.

            Get it done. Stay late, come in early, come in on the weekend if you have to, but get it done.



            • #7
              Your own manager

              Originally posted by RuthMcT View Post
              My own manager, not to mention his manager, are equally overloaded.
              have a look here:

              I think it could help you a lot.

              Then, for the general vision I agree with Brent. "There are hills and valleys. You're just in a valley. Don't worry; happens to all of us."

              Recently, I read the book for the second time to tune my system. And now I'm happier than before!

              Keep in touch!


              • #8
                Hi Ruth,

                Here's what I'd do. First, you need to be able to set aside at least an hour for an emergency review. In that time, you'll sort out your projects into three categories:
                • Things you can delegate
                • Things you can renegotiate
                • Things that only you can do, and that need to be done now.

                The things that can be delegated can be handed over to whomever can do them. If you've got access to admin staff, they can do typing, phone calls, whatever. If not, you could try finding a virtual assistant: Google turns up a whole heap of places that will take over. Some of them can provide people who are capable at medical admin tasks, such as Virtual Assistant Jobs (I just got them from Google, so am not associated with them).

                Remember though that there is a certain time overhead associated with handing tasks over to others.

                The things you can renegotiate include projects that you've been given by your superior: see them and tell them that you're swamped, and try to get a deferral. If you're really lucky they may reassign the project to someone who's less swamped, or at least give you an extension. It's worth a try.

                Then you're left with the stuff you have to do, and soon. That goes onto your NA and projects lists, and you may need to set aside time each day to work on that stuff. If you get lots of interruptions, tell your staff that you'll be unavailable for the morning (or at least some regular time during the day), set the phone to take messages, and crank through your crucial stuff.

                If the situation persists (see your doctor? ), you may need to inform your superior that you're chronically overloaded and will need some extra staff. Plead if you have to: you're less productive when you're overwhelmed, and the stress might lead you to leave or have a health crisis, so avoiding putting on extra staff is a false economy.

                And good luck!


                • #9
                  Many thanks to all for your moral support and practical ideas. It's helped me to take a step back and think about what I can actually do.

                  I've identified a number of places where things are obviously going wrong:
                  - no weekly review
                  - overcommitment
                  - poor administrative support (the head of department is already trying to deal with that, but getting a decent secretary on the salary the UK National Health Service pays them is hard going)
                  - lack of medical staff to delegate to. We have one trainee who I am planning to train to take on some of my work, the rest of the trainees are at too low a level to be much use. Anyone in a permanent post is already overloaded. We are bidding for money to employ extra permanent medical staff, but won't know for at least another three months whether we are successful
                  - my project and NA list needs clearer separation between things I HAVE to do by a certain date, other projects I should be working on in the next couple of weeks, and everything else which should go on the someday-maybe list.

                  The action plan so far:

                  Firstly, I've blocked out an hour at the end of every Thursday afternoon for a weekly review (I don't usually work Fridays). There is space for it to expand to 2 hours if needed by working an hour later.

                  I've marked a half day on the 12th Sept for protected GTD time to really do some sorting out and taking stock. In particular, moving everything that doesn't HAVE to be done right now to the someday-maybe list

                  I plan to start half an hour early each day in September, as that way I can get an undisturbed period before everyone is in to do a daily short review and process my in-tray and e-mails. I can later take a decision whether I'll need to do that long-term

                  Switching to a paper NA list - having everything on Outlook (the only computer programme I'm allowed to use on a work computer) has become a turn-off for me. I think if I have a short NA list and leave the S-Ms on the computer it won't look so off-putting.

                  I also plan to reread the GTD book!

                  I have to say that over the last year or so my bosses have been very supportive, and we have succeeded in shifting a number of non-medical tasks to other people. Unfortunately because of the way the National Health Service runs and the state it is in, it is very difficult to get extra money to pay for additional support (we've been trying to get funds for an additional senior doctor for about 3 years now!).

                  To give a bit of background, in case anyone is interested: I am a Consultant Community Paediatrician in a very deprived area of London, UK. The day after tomorrow I shall have completed 18 years in this job. I work in a paediatric department specialising in the care of children outside hospital, especially those with disabilities. The department has 4 teams of which I work in two, and a total of 50 members of staff. Over the years I have been team leader of those two teams, and for four years I was head of the department. I also did 4 years as medical director (chief physician) of the NHS organisation I work for. Currently I have no official management position, but still have to do a lot of managing!

                  Sorry about the rambling - it's useful for me to try and get my thoughts down in writing.



                  • #10
                    I have fallen off the GTD wagon more times than I care to remember - never spectacularly but often with damaging consequences (for me anyway!). I've found your posts and the responses really interesting - I often forget to do the weekly review - and I do think that is where the problem is for me.

                    I hope that you manage to get back on it again - I've just started a new job and my problem is that I have no idea what I should be doing - but am constantly in meetings so can get nothing done in any case!

                    Anyway, really just wanted to say that you're not alone.


                    • #11
                      Sounds like the problem isn't so much with your GTD implementation, but your workload and being overcommitted.

                      It sounds like you may just have to learn to say "no" to people when they want you to take on more and more commitments or say "no" to yourself if you're your own worst enemy and are taking on the projects yourself. GTD can help you in that by at a glance showing you what you're already committed to.

                      If your managers give you grief just recite the 10's or 100's of projects you're already working on. That'll shut them up. Just because something needs to be done doesn't mean you can do it. If so other projects need to be renegotiated.

                      Alot of people get into GTD because they want to do even more work, me personally, I use it to do a certain level of work in less time so I can have more time to do what I want.


                      • #12
                        Best of luck, Ruth! I think you've got a great plan.

                        Please let us know how it goes, and if we can help in any other way.


                        • #13
                          Burned out?

                          Hi Ruth, you have recieved some excellent suggestions, and I think you are headed in the right direction. I would like to raise the possibility of contributing factors to the spiral down.

                          GTD can make you so efficient at doing work (and the thrill that gives) that if you don't then choose ways of creating balance you will burn out emotionally yet your work performance will not show it for some time. GTD-level mediocrity is still above average in a lot of places. In a job like yours where a lot of emotional energy is involved, I would think the likelihood of this is even higher.

                          Once you have taken the steps you have already committed to, I would suggest that at your weekly review you seriously look at the time you have committed to things that will re-energize you (assuming that at your core you still do care about the work you do). When you are in a place where you not interested in performing well (organized, effective, in control) at something you would normally love to do, you should consider the problem perhaps has now gone deeper than just renewing your GTD habits.

                          Best Wishes,
                          And thanks for your willingness to work with the underpriviledged,


                          • #14
                            Just one thing I'd add from my experience - it definitely works to come in early, but don't waste that golden time on email. For me it's the time I'm freshest and have the most energy so I use that time to really make progress on actions. It's a great feeling to have achieved something before anyone else is at work.

                            That said, my problem is procrastination, not overcommitment, so this might not work for you.



                            • #15
                              And I'll add that some folks are least fresh early in the morning (myself included), so processing email might be the best job for them then.