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Leading When Exhaustion Sets In

December 2023, Vol 13, No 12
Katie Lawrence, MHA, CMPE
Ms Lawrence is Principal Consultant, Willow Strategy Group, Greenville, SC. Willow Strategy Group equips individual leaders and organizations of all sizes with skills, tools, and coaching to enhance culture, leadership, and operational outcomes.

She walked stoically into my office and let herself fall onto the stiff upholstered furniture, which was never intended to be a comfortable place to rest. The air escaped her lungs as she landed and sighed, “I’m exhausted.”

We both paused. The weight of the moment was sufficient to merit silence. I did not feel the need to jump in with solutions or suggestions. My first priority was to give her exhaustion the place it deserved in the room. The week had been particularly taxing. Full of projects and new endeavors. Full of chaos and efforts towards mutual understanding. Full of energy-draining conversations—both negatively charged arguments that are life-zapping and exciting new challenges that can be exhilarating in the moment but, like a sugar rush, often end in a crash.

As leaders in healthcare, these moments of exhaustion may be a regular occurrence for us and members of our team. With the year wrapping up and the busy holiday season upon us, their frequency often increases. Fortunately, there are effective strategies we can use to help reduce their impact.

5 Ways to Reduce Exhaustion at Work

1. Lean on a Trusted Coworker

Having a good friend at work is a key driver for employee engagement, according to Marcus Buckingham and Curt Coffman, authors of First, Break All the Rules: What the World’s Greatest Managers Do Differently. In fact, research suggests that being able to vent frustrations can immediately lighten the load because when we verbalize our feelings, they become less powerful. There will be some days when you are the one who needs support and other days when your colleague does. When leadership gets lonely, a trusted coworker is extremely valuable.

2. Create a Plan for Your Next 1 or 2 Workdays

Review your calendar and your To Do list. Recognize the fact that when you are exhausted, you are not at your best. You likely will not be as productive as you normally are. Give yourself permission to set personal limits and prioritize the tasks that you absolutely must get done.

In addition to meetings, block off time for each task on your calendar. Back in 1977, psychologists Daniel Kahneman, PhD, and Amos Tversky, PhD, coined the term “planning fallacy” to describe the error that most people make when estimating how long a task will take. If you believe that something on your list is going to take you 20 minutes, it is wise to block off 30 minutes. Those additional 10 minutes will account for the fallacy and give you a little extra time to buffer the slowdown that exhaustion often causes.

As leaders in healthcare, these moments of exhaustion may be a regular occurrence for us and members of our team. With the year wrapping up and the busy holiday season upon us, their frequency often increases.

3. Renegotiate Timelines for Tasks and Meetings, As Needed

There are times when deadlines will need to be extended, and communication is key to handling these types of situations effectively. Identify what you can get done by the original deadline and when the entire task will be completed. Ideally, conversations regarding renegotiated timelines should be held with your leader or colleagues before the day a task is due. However, even on the actual due date, it is better to be honest and have something partially completed than to let the deadline pass silently. Be candid. And do not make tardiness a habit.

Reschedule meetings that are not pressing. For all meetings that require work to be done by others in order to move the conversation forward, send these individuals an email to verify that the work will be completed. If key pieces of information will not be ready, consider postponing the meeting until a time when decisions can be made based on all the necessary information.

4. Close Your Eyes and Breathe

When you are truly exhausted, you might need to close your eyes for a moment. Quite the opposite of falling asleep on the job, a very small period of mental rest and intentional breathing can have a rejuvenating effect on the rest of your day.

With your eyes closed, breathe in through your nose while slowly counting to 4 in your head. Be conscious of how the air fills your lungs and stomach. Hold your breath for a count of 4, and then slowly exhale for another count of 4. Pause while counting to 4 for the fourth time, and then begin again with a 4-count inhale. This breathing technique is called Box Breathing, so you may want to visualize a square, mentally tracing along each side as you breathe in, hold, breathe out, and hold again.

Repeat this sequence 2 to 4 times. The oxygen to your brain and slowed pulse rate that results from this intentional breathing will actually improve your thinking and attention. Repeat it periodically throughout a difficult day.

5. Avoid Excessive Caffeine. Take a Walk or Drink Water Instead

When we are tired, we often tend to reach for caffeine out of habit. Since anxiety and stress can dehydrate the brain, water is a better choice than coffee or other caffeinated drinks. Caffeine affects some individuals more than others and can interfere with sleep habits, even if consumed much earlier in the day.

Take time to get up from your chair and stretch throughout the day. Walk around your workspace and make an effort to get outside. The change from sitting to standing will bring more energy to the moment. Suggest that one or more of your meetings be walking meetings.

The more you move your body on a regular basis, the more you will be physically prepared to handle stress. People who walk or run frequently are shown to have better responses to stressful situations than those who do not move as often.

Quite the opposite of falling asleep on the job, a very small period of mental rest and intentional breathing can have a rejuvenating effect on the rest of your day.


It is important to recognize that feelings of exhaustion will pass. You will not need to vent to a trusted colleague every day, and it is unlikely that you will need to extend deadlines very often. It is good practice, however, to keep monitoring your calendar, staying mindful of what you take on and when you have committed to completing tasks. Practicing intentional breathing, limiting caffeine intake, drinking more water, and incorporating more movement are healthy habits we can all strive for.

Each of these tactics is going to take some intentionality. Just admitting to yourself or a colleague that you are exhausted can feel vulnerable. If that is new for you, be especially kind to yourself. It may not be comfortable, because vulnerability takes practice. We often treat coworkers, friends, and teammates far better than we treat ourselves. Give yourself the grace to learn from overwhelming situations and the courage to put healthier habits into place.

Leadership can make you want to collapse with a sigh into your favorite comfortable chair, but you can take a deep breath and get up again. You can make small changes immediately and bigger changes over time. You can model these behaviors for your team. The world needs your presence and your contributions.

Article provided through a partnership with
Practice Management Institute
Michigan Society of Hematology & Oncology

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