Most professionals, leaders and entrepreneurs have more tasks to do in any given time period than they have time and energy to complete well. An endless stream of seemingly high priority items choke the front end of the workflow as results drip out of the other end. What do you do when there are too many things to do?

We are under constant, intense pressure to deliver in the face of countless demands all requiring immediate attention. The chime of new emails or texts or the knock on an office door by a colleague is all that's required for us to pounce on the issue leading to an accumulating and ever-debilitating feeling overwhelm.

A healthy amount of challenge promotes good health.

We are meant to grow and be put to good use in the service of contribution. This type of healthy stress is called eustress. Too little emotional, cognitive or physical capacity to handle the challenge leads to less constructive stress called distress, which in turn lowers capacity in a vicious cycle. Distress is also the result of business transitions, sudden crises, insufficient operating leverage, macroeconomic factors, new competitors and technology and shifting customer needs.

Triage is the french word for "sort", most commonly used to describe the process used in the emergency rooms of hospitals or in the field. In these scenarios, there are more sick and injured people requiring assistance than there are resources to process them all efficiently and elegantly. Triage is based on the idea that despite the apparent urgency and severity of each case, not every case is the priority. The priority is to handle the case in which immediate intervention would yield significant positive impact to the party. Others can be delayed. Sadly some patients are just going to die regardless of how much heroic effort effort the team applies to their salvation; other can be deferred for a period without catastrophic results. That person might have a miserable and shitty night, but they'll still be alive in the morning.

Only one thing at a time can be a priority.

The word priority was never meant to be pluralized. That might change a minute from now, but right now there is only one thing that's most important. An hour ago I dropped everything I was doing to go to the emergency to get my leg looked at (swollen up after a mountain bike crash.) And now, while I'm waiting to be seen the priority is writing this post: putting the overwhelm problem in perspective for the people I support so they can be less stressed and get more quality work done, hopefully in less time. That will change as soon as I get out of emergency and publish this post, at which time I'll decide what the most important thing. It's a dynamic not static way to handle activities and tasks that require my vigilance.

What this requires is counterintuitive to the servant leader mindset of the people in my community: we must let some things suffer and let others die, so I am fully present to make the difference between something really great happening and something terrible happening.

Not everything gets handled immediately.

I don't have the capacity to do everything. If I did, I'd be ironically playing too small a game. I can delegate some of the things on my list but my delegates are usually just as busy as I am. I just need to dump some of the stuff, that if I am honest with myself, really add no value. Others I need to defer to a later time (using this tactic too much is called procrastination). Whatever's left that it does not work to delegate I choose to do and stay on them until they are done or until another triage moment appears in front of me so I choose again. The "four Ds" takes considerable practice and gumption to do well.

Overwhelm is a symptom of personal habits and operating systems too small for the big game. Personal and business development is therefore about developing new skills and higher leverage systems. With such a commitment, this kind of stress appears only in the gap between the decline of the old way of doing something and the delay of the new way. Triage skills helps us manage the pile of tasks as we run the old model concurrent with the new one.