Yes, there is, and where there is a choice, it is important that a decision or lack of a decision does not lead to a mistake or more serious consequences. This is an effort to understand decisions and decision making. A mistake which is not rectified, will increase stress, and at a particular level may have serious, complicated and costly consequences.
A DECISION
This is a choice, conclusion, or resolution, reached after consideration where there may be more than two options. It may need to be taken immediately or at a later time. Urgent or Important. Due Diligence, Risk Assessment, Do No Harm are seen as procedures that need to be addressed to reach resolution. People who need to be involved or who may be affected must be part of the process. The efficiency and effectiveness as to how the decision is applied will decide how successful the result will be.
Due Diligence
What are you trying to achieve? Take care to analyse all aspects great and small
Risk Assessment
Look at all the possible outcomes, both right and wrong, including the consequences of not making a decision that is needed.
Do No Harm
Ensure that the result does not cause loss, damage, or harm
These headings all overlap, and each discipline needs to be assessed and weighed against the others, to ensure that mistakes are minimized or eliminated, loss or damage does not occur, and at very least, the best compromise Is agreed. Informed consent applied to yourself, to Your Team and particularly to your Patients. Responsibility and Accountability
CHOICES
Could now be a time to make a decision regarding which direction your journey is going. This is your professional life, and remember, that is not an independent entity or discipline. It exists as part of your entire life and as such deserves careful and ongoing assessment. Given the uncertainty of the current situation with COVID-19, now might be the appropriate time to consider the reasons why a decision needs to be made, the process and people involved
NEW JOURNEY
Starting from now, given that I have just retired (changed direction) I would suggest to those of you who are considering that New Journey, expedite your thought processes and look to succession, the state of your pension, and most importantly, what is your new journey going to be. Will this decision be beneficial to you and your team? Who will be affected and how?
For each decision there is a consequence
CONSOLIDATE
Those in a situation where the hope is to maintain or rearrange your current practice, then the decisions will centre around the financial implications of maintaining or altering what you have. Gather Your Team around you and get Brainstorming.
For every action there is a reaction.
EARLY CAREER
If you are in the early stages of your career, then I might suggest that you would step back, and look at options open to you. Stay where you are, change direction by going abroad, or change from practice to an academic post, or even consider a career change. Being at this stage of your career is no reason to pass up advice and make a poorly thought out decision. Go through the process, all stages of it before you make the decision. Your experience is against you, but time, energy and opportunity are with you. in a slightly twisted way, you do have time to make a mistake. So if you do make a wrong decision, recognise it, admit to it, and then rectify it. Now you have just made three good decisions.
Go Through the Process Learn from your Mistakes
THE TEAM YOUR TEAM
In order to carry out the above protocols, it would be appropriate to assess who is involved in this whole process. By the very nature of how we live more people than yourself should be involved This Team concept is something that has taken me 55 years to Realise and Affirm. You can’t exist in a decision-making vacuum of your own because you don’t exist in a vacuum. You exist in your family and with those you trust, working with your immediate colleagues, with your professional advisors, friends and acquaintances.
You need to assess this group. From it Your Team will evolve. This team you need to affirm and adjust on a constant basis so that decision-making and the consequences are orderly, efficient and effective, at the critical time, with minimal delay, to gain maximum positive effect.
The biggest mistake I made was that I didn’t recognise, and consequently didn’t correct till it was too late. It was that of neglecting important and significant people in my life too often, when making decisions. My wife. Twice. We are still together so I must have done some good somewhere.
ADVISORS are individuals like you and me, who make a living from giving advice and providing treatment and care. Consequently, you need to learn, and know how to deal with and listen to them, and then make your decision with Your Team. One Advisor I believe you should always have, is a Professional Councillor, Psychotherapist, or Psychologist.
It is your life, where you are going and why. What the consequences are, of any decision, or lack of a decision when necessary, must be understood, known and shared. We talk of shared learning and education, in relation to our professional working lives. This concept of sharing has to be applied to the effects of decisions on all other parts of your life.
You Want to Go to Sleep Tonight Work to Get the Decisions Right
INSTANT DECISIONS
You are treating a patient and a problem has developed. A mistake? An Event? A Decision is needed. What do you do? Are you the one and only person involved in this Decision? Are you? No! What about your Patient, your Nurse and those near at hand? Effectively you will make the decision based on your accumulated knowledge, experience, and the wisdom you have right now. You have to think outside the box. Look in. Ask Questions
Who in YOUR TEAM can help with your Immediate and urgent DECISION and REACTION?
STOP, take a Deep Breath, Watch, Listen, Acknowledge, and then Act. This may prevent the episode from escalating, and diminishes, or takes the urgency out of the situation. Time. This event might be the realization that you have no water spray on the fast-rotating bur. Or worse, the sudden loss of the bur. You can rectify the first on your own. Can you? Or should you? The possible sources of that problem are myriad. Not so the other. The possible consequences of that are staggering. Different problems. Different reactions You must stop in either case. That is the first part of the decision. If that can rectify the situation you can continue. However, there are still consequences of that lack of water, that must be communicated to your patient. Otherwise, you discuss all the options, regarding the lost bur necessary to correct the outcome of this event.
Communication – Experience – Team Meeting – Shared Responsibility – Stress Drains Away
THE EMERGENCY
It has just happened. Something you swore and prayed was never going to happen, but there it is in front of you. You have broken an instrument in your patient’s mouth. Part of it is embedded in the patient’s cheek, part of it is still in your hand, and you are not sure if there is another piece. But you do not know where. A full-blown emergency.
How quickly and how do you react
I have found to my horror that my reaction in an emergency situation is an immediate freeze. Everything stops, the body and thought process and the response. If you have never been in an emergency situation, simulating this may help to educate you about what happens. But until the real thing happens, you don’t know what your true response will be. I have had to advise family, and when working, advise my team about this probable response, which is going to seriously affect the process of decision-making and reaction. Ongoing communication will increase the value of Your Team, as it might not be you in charge.
Take Charge Respond Efficiently and Effectively Depending on Urgency or Importance
EDUCATION
We have a professional, personal and moral responsibility to be able to respond in the best possible way to an emergency that happens anywhere. Do you know where the Fire Blanket is? Where is the Medical Emergency Kit? Do you know the UNIVERSIAL EMERGENCY PHONE number? Do you know that this is essential, as the emergency help needed might not be available where you are?
WHERE IS YOUR TEAM?
Simulated creation of emergency situations can be arranged through the various Organisations, Colleges, Study Groups, and Companies which specialise in giving us the obligatory crash course for CPD requirements. This emergency response needs to be continually to the forefront of the Health and Safety, and Emergency Protocols in your practice. What are the procedures? When were they last reviewed, let alone practised?
Do you know your own reaction to Shock, Emergency, The Unexpected
FIGHT FLIGHT FEAR FREEZE
I can still recall the memory of sitting in the car following the crash, which I was totally responsible for, and just sitting doing nothing. I FROZE I was told subsequently, that I was just in the way by the people who took over. Do you know what your response is going to be and how you are going to make the correct decisions to save someone’s life, which maybe, should be to turn off the mains electricity, or to check if both parts of the broken bur are saved and that there isn’t a third part missing.
CONCLUSIONS
We are making decisions all the time throughout every day, many of which we will regard as instant, intuitive, natural, ”it’s in my DNA”. Some of these decisions and reactions may be inconsequential in the overall journey of your day. Others are not. They may have long-term effects if the response is not appropriate You have to realise that all these decisions and reactions and responses are processed in your brain to allow you respond in a way that will have the correct outcome for all involved.
These protocols of understanding decision-making and response, are learned processes, effected through ongoing educational programs, by continually sharing with our team, discussing, practicing, imagining the responsibilities and consequences of failing to carry out due diligence, risk assessment, to condition ourselves to Make Decisions
TO DO NO HARM BY POSITIVE PRACTICE
Angus P Roche PositivePractice.ie
INSPIRED BY LIFE IN DENTISTRY DECEMBER 2020
HIGHLY CONFIDENTIAL PRIVATE AND WITHOUT PREJUDICE