This occurred during my early "Registrar" days in Chatham, Kent.
I managed a preterm baby's ventilation using certain strategy overnight. Next morning, while on rounds, consultant asked why I used such strategy. I answered, I thought he would manage it that way. He did not say anything further. But after rounds, he took me into this office and said the following: "When you manage a patient in the middle of the night or any other time, manage according to what you think is right. So, the decisions made will be right according at least one person. Last night, you used that strategy thinking I would like it that way. But, I think, you should have used the other strategy. Now, the decision is not right by either of us! In such situations if you make decision and carry it out according to what you think is right, it would be right at least by one of us - you. It is better to have a decision/treatment strategy that is right by at least one of us rather than neither of us."
I paraphrased it. Tony Ducker was the consultant rounding that morning.
WOW, I think the fear of hierarchy puts pressure on certain decisions. Even if its you who is on the spot and best position to take decisions, might tend to look at what the superior would want to do.
ReplyDeleteIn this, I like Ducker's perspective on freedom of decision making at critical hours.