Doctor having decision fatigue

Decision Fatigue and Burnout: Physicians and Nurses Need Support!

The average adult in this world makes a large number of decisions each day- estimated to be around 35,000 from small to large decisions in a 24hr period![1] It’s no wonder decision fatigue is so common. The strategy we end up using to have the decision depends on a number of factors such as the time we have to make the decision, the complexity of the decision, and the ambiguity that is involved.

 

When any person is placed under a stressful condition, the decision-making process inherently changes. For physicians & nurses, that change, commonly known as decision fatigue, can be deadly. “Death by medical error or accident is the nation’s leading cause of accidental death, exceeding all other causes of accidental death combined. Medical error and accidents kill approximately as many people each month in the U.S. as COVID-19 did before vaccines became available.[2]

 

The Cause of Decision Fatigue

 

The underlying cause of decision fatigue for physicians has been commonly related to the physician’s stress level and the number of total decisions they have to make in their day.

It is estimated that a typical adult makes 226.7 decisions on food alone, and 35,000 total in a day[3]. Now let’s add in the complexities of a physician’s day- the ongoing clinical-related decision-making factors such as workload & time constraints, lack of teamwork, human and case complexity[4]. Depending on the specialty too, this could add on double or triple the total times they have to make a clinical related decision.

 

Possible Solutions

 

There is no one-fits-all solution to decision fatigue. Healthcare leaders, physicians, and nurses alike must be able to see a solution as a multi-pronged one.

 

For the physicians & nurses, becoming more self-aware of burnout, decision fatigue, and COVID fatigue is vital in staying aware that you must stay vigilant in each and every case. Also, taking a step back during each case to counter-argument yourself about taking another path can help you to conclude on the best course of action.

 

For Healthcare Leaders, there is a number of aspects to keep in mind. First, recognizing that time-of-day/ the longer work hours can affect a physician or nurse[5].  Secondly, listening to what your physicians express being the number one challenge of 2021- the administrative burdens and paperwork[6]– needs to be taken into account and found a solution for. Just like all AVP’s and CEOs have for themselves, personal assistants can be invaluable in providing the support needed for a physician to do their job efficiently and proactively. Medical Scribes are the personal assistant of a physician. They are there present before a physician starts their clinical day and with the physician at the end of the day to ensure all the mundane “paperwork” is complete and all pertinent administrative tasks are reviewed.

 

A Health Leader is given a personal assistant to help them keep track of their calendar, help to make/ complete the much-needed paperwork for the hospital so they can focus on steering the healthcare organization in the right direction. A medical scribe is exactly that for a physician or nurse. The medical scribe keeps the physician or nurse on track, ensures all diagnostics are pulled, charts are almost to the point of completion by the end of the day, and allows the physician or nurse to steer their patients in the right direction. Healthcare leaders and physicians/ nurses should be equal in the support they are given to efficiently and properly do their job right!

 

[1] https://science.unctv.org/content/reportersblog/choices

[2] https://www.statnews.com/2021/08/04/medical-errors-accidents-ongoing-preventable-health-threat/#:~:text=Death%20by%20medical%20error%20or,did%20before%20vaccines%20became%20available.

[3] https://science.unctv.org/content/reportersblog/choices

[4] https://www.researchgate.net/publication/317347245_Decision-making_under_pressure_Medical_errors_in_uncertain_and_dynamic_environments

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8448311/ https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/lo63-decision-fatigue-in-the-emergency-department-how-does-emergency-physician-decision-making-change-over-an-eighthour-shift/52511F5AD28843FCD15E406A5217E236

[6] https://cdn.sanity.io/files/0vv8moc6/medec/0c57e2ac96cdbb5db2d064265b08634c2cf82ba6.pdf/me0121_ezineNew.pdf

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