High on the stress list are mergers and acquisitions. When organizations blend, some IT staffers work overtime to absorb and accommodate entire organizations, while other technology workers strive to adjust quickly to the foreign ways of new parent companies.

Growth without acquisition is painful as well. Many business development departments now regularly demand new technologies to help move companies forward.

Regardless of the triggering events, there are some basic strategies for successfully enacting and managing changes, according to industry experts. The roster of Premier 100 IT Leaders who are guiding organizations through extraordinary changes includes technology executives at FedEx Kinko's, 1-800-Flowers.com Inc., Rent-A-Center Inc. and the University of Phoenix Online.

Decisiveness -- sometimes in the extreme -- is crucial, most agree. "There is a lot to be said for the Draconian method," says Ian Campbell, president of Nucleus Research Inc. in Wellesley, Mass. "It's quick, efficient and painful -- but only for a short amount of time."

At the same time, IT leaders should remain compassionate in the face of inevitable resistance, especially if they are to make the most of existing talent. To reduce stress, some enterprises turn to outside vendors during times of change. Others assure staffers of payback once things settle down. But particularly shrewd is the leader who realizes when painful changes are taking a toll and stops to let employees catch their breath. "Humans can only take on so much change," says Campbell.