Doing the One Thing that Matters Most

By Rose O. Sherman, Ed.D, RN, NEA-BC, FAAN

Knowing where to spend your time as a leader today is very challenging. With COVID, there are so many crisis meetings that few leaders successfully make it through their task lists. When we create these task lists, especially during times like these, we can think that everything matters equally, but the truth is that it does not. Success is sequential, not simultaneous. It is one step at a time. In his book The One Thing: The Surprising Simple Truth Behind Extraordinary Results, Gary Keller suggests that we should focus on the one thing right now that will matter most. This one thing may not be your only thing on a to-do list, but it is the one thing right now.

Keller is a firm believer in the Pareto principle or the 80/20 law of the vital few. This principle has research support. The rule proposes that a minority (20%) of actions, inputs, and efforts lead to a majority of results, outputs, or rewards. In other words, a small amount of effort in the right areas can lead to the most significant outcomes. It would help if you looked for an action that has a domino effect. Trying to multitask and make many things happen at once is overrated in terms of effectiveness. Ask yourself, What is the one thing that would have the most significant payback for me today? During this crisis, I have asked nurse leaders about their one thing that would have the greatest payback for them if they invested in doing it. The following are some of the answers that they have given me:

Conduct leadership rounds more regularly.
Ask more staff – “What’s on your mind?”
Have a coaching conversation with at least three staff every day
Mentor our new leaders who are transitioning during this challenging time
Don up and spend two hours with staff on a COVID unit.
Ask my team how they are really doing.
Demonstrate more vulnerability
Learn more about the childcare issues that staff is having so I can think about initiatives
Attend a unit governance meeting
Talk less and listen more.
Set boundaries around work and leave work by 6 p.m

When leaders ask themselves the question, they are almost always accurate. Most nurse leaders instinctively know what matters most. It is taking the next step that becomes important, which means going small for the fewer things that will have the most effect.

Read to Lead

Keller G, Papasan J. The One Thing: The Surprising Simple Truth Behind Extraordinary Results. Austin, TX. Bard Press; 2013.

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