banishing busy

Medical professionals are busy people and exist in a constant state of “being busy.” How do we resolve chronic “busy-ness”? How do we manage our time effectively? In her recent talk at the CORD Academic Assembly 2020, Dr. Christina Shenvi, EM Physician and Associate Residency Director at UNC, provided 5 key actions to help us be productive, complete our work effectively, and strive for work-life balance. Dr. Shenvi recorded her lecture again to be shared with the ALiEM Faculty Incubator. This series of posts breaks down her talk into 3 sections in order to summarize her key points and to help us “Banish Busy” from our lives. This third post will address how to take control of our time.

 

Timeline:

  • 00:21 Review Parts 1 & 2
  • Key Point #3: Managing our Minds
  • 00:36 What is Metacognition?
  • 2:06 Why is it important to be aware of our emotions?
  • 7:51 Activity C: Why are we so busy? Evaluate the emotional motivations behind your actions.
  • 11:43 How can we take control of our emotions?
  • Key Point #4: Do a 168-Hour Inventory
  • 16:28 Why is it important to do a 168-Hour Inventory?
  • 19:15 Activity D: What does a 168-Hour Inventory look like? Perform your own 168-hour inventory
  • Key Point #5: Stay in the deep end and drain the shallows
  • 19:18 What is the difference between deep work and shallow work?
  • 23:15 How can we spend more time in deep work?
  • 24:13 How can we be more efficient with our shallow work?
  • 29:55: Review
  • 31:55 Activity E: What would an absolutely perfect schedule look like? What is keeping us from it? Write it down.

Previously on:

In part 1 of this series, Dr. Shenvi introduced the framework for her lecture on “banishing busy” through her 5 key points on improving time management. She discussed the importance of value-based scheduling and laid the groundwork for the importance of avoiding self-sabotage by exploring the connection between procrastination and emotion.
In part 2 of this series, Dr. Shenvi provided 7 ways to prevent self-sabotage by adjusting our mindset and allowing us to get out of our own way.

Managing Our Minds

What is Metacognition?

Metacognition is thinking about our thoughts as separate from ourselves. Agency about our thoughts gives us the ability to manage our thoughts and our time. If we can actively manage our thoughts, we can change the perception of our current circumstance, which will result in the production of positive and adaptive emotions, rather than negative emotions. Positive emotions will result in productivity.

ACTIVITY C: Why are we so busy?

Take 2 minutes and write down all the positive motivations that keep you busy. What activities bring you joy, that keep you busy? What things are opportunities for growth?

Take 2 minutes and write down all the negative motivations that keep you busy. What activities do you do out of fear that keep you busy?

Can we do less of the tasks that have to do with negative motivations? Can we potentially change the motivation so that we can think about the negative tasks in a more positive light?

These are the steps we have to take in order to take control of our emotions and manage our thoughts:

  • Awareness (of emotions):
    • By having self-awareness and self-management, we can manage our emotions and our actions. Additionally, it is important for us to have awareness of others’ emotions and to manage our relationships with others [1].
  • Intentionality:
    • Deliberately choose sequential, believable, new thoughts. If we have persistent negative thoughts, they become ingrained. It can take time to get out of this vicious thought cycle!
    • Ingrained negative thoughts and emotions lead to the development of “Thought Pits.” These deep, dark spaces can feel impossible to escape. To get out, we can create a “thought ladder.”
    • Replace negative thoughts with something that is believable yet positive. With each negative thought, think about 1 positive thing that is happening and the next thing that will happen. This creates the “rungs of a ladder” to get us out of the pit. We want to move from negative thoughts to positive, and move from external motivation to internal motivation
  • Internal locus of control:
    • This is created from the Attribution Theory or the Self-efficacy Theory: We are in control of what we think, and therefore of how we feel, and subsequently what we do.
    • Internal motivation results in more ownership, unlike external motivation
  • Grace:
    • It takes a lot of time and practice to turn negative thoughts into positive ones
  • Perseverance:
    • Keep going!

Do a 168-Hour Inventory

We can’t be successful in managing our time if we don’t know where it is going! We should take stock of how we allocate out time and effort. By taking inventory of where we spend the hours of our week, we might be surprised where it is actually going compared to where we think it is going. Can we be more intentional where the hours are going [2]?

ACTIVITY D: 168-Hour Inventory

Log the hours of your week and tally them up. What activities make up those hours? How do they align with your values? Don’t just estimate the hours, do an actual log in 15 minute or 30 minute increments. There are free programs you can use to do this. Dr. Shenvi uses Clockify and has set categories for work, driving, housework, getting ready, family time, entertainment, friends, etc. Alternatively, you can make a quick Excel file. Add up the categories at the end of the week to see where your time goes and what time you could repurpose into more productive time.

Stay in the deep end and drain the shallows

The goal is to spend more time doing work in a focused way. High quality work is a combination of time spent and intensity of focus. There are 2 types of work: deep work and shallow work [4].

What are deep work and shallow work?

Deep work tends to bring joy and fulfillment. Deep work is focused, distraction free, involves deep thinking and planning, revolves around developing ideas or strategies, and is spent thinking ABOUT things, not just OF things.

On the other hand, shallow work is classified as short, often interrupted, with little creativity or deep thought. It is usually neither fulfilling nor rewarding. It is often required to keep our job, such as administrative responsibilities. It doesn’t tend to bring joy.

By frequently performing only shallow work, we can actually decrease our ability to perform deep work. Even during mundane times, instead of flipping through something mindlessly, like email, we should spend that time thinking about a problem instead [3].

Task switching between deep and shallow work can lead to shallow work and may impair our ability to do deep work in the long term.

How do we do more deep work?

We should schedule deep work time in our calendar, and protect it as if it was a shift we had to work. Plan ahead about how we will use it. By assigning a task to a predetermined time in the future, it allows us to stop thinking about it during the day, effectively off-setting our cognitive load.

How do you commit to doing deep work while addressing shallow work?

There are several tips on how we can complete shallow work efficiently so it doesn’t infringe on the time we have to do deep work.

Open loops are the enemy of productivity and deep work. If a task is an open loop, our minds will believe it is never really done and therefore will continuously use brainpower to address it. We need to capture these open loops so that they aren’t constantly running in our minds. To do this, we can start by using David Allen’s rubric from Getting Things Done [4]:

  • Do: If the task takes 2 minutes or less, do it! If it takes longer, post-mark it for later
  • Delegate: Outsource the shallow work, as much as we can
  • Defer: do it later, especially if the task is more deep work material
  • Decline: is the task at hand in-line with our values? If it is not, decline it
  • Delete: This is not part of Allen’s framework, but deleting as many things as we can quickly will help keep our actual and our mental inbox clearer.

Create systems to tag the tasks at hand to free up our cognitive load:

  • Capture and organize our thoughts and to-do items
  • Organize our paper files and folders
  • Organize our email files and folders
    • Attempt to have a zero inbox with folders marked for deep work, folders for future events with subfolders for conferences, and separate folders for each project
    • If your current inbox is too full to feasibly organize as above, create a time stamped folder for all previous emails and start the system from that point onwards [4].

Summary

There are 5 key actions we can take to help us decrease our personal and professional business:

  1. Practice value-based scheduling: How do you want to be spending your time? What is important to you?
  2. Avoid self-sabotage: What barriers are keeping you from getting a task done? Try to motivate yourself based on what you’ve decided your values are.
  3. Manage your mind: Your feelings about your task matter! Be intentional about your work and reframe setbacks as part of the learning process.
  4. Do a 168-hour inventory: Take a look at how you’re spending your time right now, and evaluate how that lines up with your values.
  5. Stay in the deep and drain the shallows: Now that you’ve done some reflection, get to work and keep yourself on task! Banish your busy!

ACTIVITY E: Your Perfect Schedule

Now that you have gone through this entire talk and been introduced to these 5 key actions to banish busy from your life, take a moment to reflect. What would an absolutely perfect schedule look like to you? Write it down.
Think about what is keeping you from it.
Use the skills from this blog series to make your perfect schedule a reality!
Good luck!

References/Recommended readings:

  1. Bradberry T and Greaves J. Emotional Intelligence 2.0. San Diego, CA : TalentSmart; 2009
  2. Vanderkam L. I Know How She Does It: How Successful Women Make the Most of Their Time. New York: Portfolio/Penguin; 2017
  3. Newport Cal. Deep Work: Rules for Focused Success in a Distracted World. New York: Grand Central Pub; 2018
  4. Allen, David. Getting Things Done : the Art of Stress-Free Productivity. New York: Viking, 2001
Brian Barbas, MD

Brian Barbas, MD

Assistant Professor & Clerkship Director
Department of Emergency Medicine
Loyola University Chicago – Stritch School of Medicine
Brian Barbas, MD

@DrBBarbas

EM Physician and Educator. opinions are my own. Loyola EM. live in Chicago but loyal to my Detroit sports and Michigan Wolverines!
Brian Barbas, MD

Latest posts by Brian Barbas, MD (see all)

Laryssa Patti, MD

Laryssa Patti, MD

Assistant Professor
Emergency Medicine Clerkship Director
Department of Emergency Medicine
Rutgers - Robert Wood Johnson Medical School
Laryssa Patti, MD

@rwjem

The unofficial twitter of the Rutgers Health/RWJMS Program in Emergency Medicine. Tweets do not represent medical advice. instagram @rwjmsem
Eric Blazar, MD

Eric Blazar, MD

Clerkship Director
Assistant Professor
Department of Emergency Medicine
Inspira Medical Center
Rowan University
Vineland, NJ
Eric Blazar, MD

@eblazar

Clerkship director at Inspira. i like to teach. I also like Ohio State football.
Eric Blazar, MD

Latest posts by Eric Blazar, MD (see all)

Meenal Sharkey, MD

Meenal Sharkey, MD

Medical Student Clerkship Director and Core Faculty
Assistant Program Director
Department of Emergency Medicine
Doctors Hospital, Columbus, OH
Meenal Sharkey, MD

@MDSharkAttack

believer of science with a whiff of hocus pocus — special interest in emergency medicine and education 😎
Meenal Sharkey, MD

Latest posts by Meenal Sharkey, MD (see all)

Christina Shenvi, MD PhD
ALiEM Associate Editor
Assistant Professor
Assistant Residency Director
University of North Carolina
www.gempodcast.com
Christina Shenvi, MD PhD

@clshenvi

Emergency Medicine and Geriatrics trained, Educator, Professional nerd, mother of 4, excited about #educationaltheory, #MedEd, #EM, #Geriatrics, #FOAMed.
Christina Shenvi, MD PhD

Latest posts by Christina Shenvi, MD PhD (see all)