MODULE 4: Decision Support for Care Delivery

How did the readings influence my perception of my own clinical decision making?

It is amazing to me that more information has been discovered in the past five years than has ever existed in the history of humankind. How do we as simple carbon based units process this information when we are developing computers with the ability to store yottabytes of information? (Just how big is a yottabyte anyway?) Can we, or should we, as healthcare providers be expected to know it all and to keep up with one of the fastest changing professional fields? In our profession, when we don’t have all the pertinent facts and ability to synthesize information outcomes can be poor and people can die. Unfortunately, we are being held to the standards as if we were a precise, methodical, reliant computer. But we are human beings, capable of making decisions that are sometimes deemed as miracles and at other times less than humane.

This weighted responsibility impresses upon me just how dependent healthcare providers must become on today’s technology in order to provide the best possible care. However, I think Pat Benner’s five levels of nursing experience cannot be underestimated. No matter how much technology I have to support my decisions, it still will ultimately be up to me to make some decisions. Much like a compass directing us on a path, it is only a tool to be used by the wise traveler. If we are oblivious to the compass pointing us in a direction that leads to a cliff, then the technology is useless and can even become dangerous unless we apply our own wisdom in the decision making process. We must not lose ability to think on our own, for if all these wonderful tools come crashing down around us someday, we will need to be able to think on our feet. Realizing just how much I do not know about the uniqueness of each patient, the 8000+ medications, tens of thousands of disease processes, thousands of labs, radiographs, CTs MRI, et al. can be intimidating, but not knowing where to go for information, data, protocols, CPGs et al. can be outright neglectful of sound, competent patient care.