Career advice

How to avoid the mind fog of the nurse’s endless to-do list

Tips for coping when you are feeling overwhelmed

Tips for coping when you are feeling overwhelmed

In April, the Care Quality Commission (CQC) ruled that a nurse in charge of an emergency department had ‘too many physical tasks’. CQC inspectors said the volume of tasks distracted the nurse from being able to perform their role, which was to manage patient flow. 


Escape the mind fog of the endless to-do list. Picture: iStock

It will come as no surprise that nurses have too much to do. But after hearing this ruling, what struck me most was the sheer enormity of things nurses are expected to keep track of while also making decisions and prioritising and managing workload effectively. 

This ‘knot of thoughts’ will be common to most nurses I imagine, so how can we untangle them? 

Mind bubbles

Radio 2 DJ Jo Whiley describes the mass of thoughts whizzing through our minds at any one time as ‘mind bubbles’. She asks listeners to text, call or tweet her with their ‘mind bubbles’ and then reads them out on air.

As well as making entertaining listening, these lists of seemingly random things can serve a greater purpose, enabling us to step aside and view our never-ending ‘to-do’ lists from a different angle.

The first day I was in charge of a ward as a newly qualified staff nurse, the phrase ‘headless chicken’ could have been made for me. By the end of the shift, I felt as if I hadn’t achieved anything at all. I was so unsettled by the time I got home that I broke down the day into 15-minute chunks and tried to list what was going on and what I did. Although some of how I was feeling was due to the newness of my role, I do have a tendency to steam roll ahead. Isn’t keeping going the best way to get things done? Perhaps not.

When the tasks mount up

Over the years, I have learned that creating space to pause makes me more productive. But I still face an internal battle when the tasks are mounting and stopping even for the shortest period feels counter-intuitive to making progress.

I have two dogs, young collies, and anyone who knows the breed will be familiar with the ‘collie eye’. Their ability to fixate on a moving object makes them invaluable working dogs but it can cause a few issues with other dogs when walking down the street.

My mantra is always ‘break the stare’ – getting my dogs to focus on me reduces their intensity and everyone becomes less agitated.

Break the spiral of thoughts

Similarly, when you have a zillion conflicting thoughts rushing through your head, it is impossible to think clearly and make rational decisions or plans. Instead, you can feel out of control and start to panic and lose focus. Instead of pressing on regardless, you need to break the spiral of thoughts – breathe, collect yourself, re-group mentally and carry on.

Given the reality of most nurses’ working lives, taking the time to pause can feel impossible. But battling on will risk your well-being and potentially the safety of your patients, so here are some top tips on how to 'pause':

  • Create a mantra: find a short phrase like ‘break the stare’ that will help you in the heat of the moment. Adding humour will help you relax and slow down your thoughts.
  • Breathe properly: this is something I still have to remind myself to do. When I am in ‘quick’ mode, my breathing is shallow, but by taking a deep breath and then exhaling slowly, I make myself pause.
  • Mentally score tasks: quickly run through everything you have to do and score each task out of ten according to priority, then start with the higher scores and work down. Re-score the tasks as necessary throughout your shift.
  • Create acceptance: if you don’t get to the end of your list it doesn’t mean you are a failure – it means you are human. Prioritise, do what you can, delegate where appropriate and hand over to colleagues on the next shift. Above all, be kind to yourself.

Mandy Day-Calder is a life/health coach and former nurse

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