Clinical judgement, arrogance……. or laziness?

How many times have you seen it? How many times have you done it yourself?

At first, you start doing things by the book. Following all the rules. After awhile you get comfortable, and then you make a mistake. A mental switch is reset. You get careful again.

It’s a phenomenon seen in all humans and there’s a bell curve associated with most professions (I tried to draw one on MS paint. Graphic design is not my strong suit).

Just call me Michael Angelo
You start on the left, and inevitably move to the right. Lather. Rinse. Repeat.

Our initial fear makes us do things properly. But as people get more confident we find short cuts, things that are unique to us. Sometimes these are legitimate improvements or ergonomic advantages.

But often when I see cases where clinicians who thought they knew better, hurt a patient, I can nearly guarantee that most of the time the cause wasn’t their honest mistake. It was their pride.

The belief that they are smarter than other people, that they can give drugs outside their guidelines because they’re experienced of have done wider reading. That they don’t need to take vital signs on a patient until halfway through the consultation (if at all) because they can recognise a sick patient.  These all stem from an inflated view of their abilities.

Lots of times they’ll get away with it. If they’re really good, most of the time they’ll get away with it. But eventually they won’t, and when they don’t, it’s a patient’s life in their hands. Someone’s child. Someone’s livelihood. Someone’s future.

The longer a person gets away with it, the bolder they become. Eventually, they’ll respond to challenges with hostility, and often the opinion of colleagues about them will be deeply divided.

Offenders may try and pass it off as ‘clinical judgement’, but often, it’s just laziness. Because in their mind, their time is more important than following the rules. They’re arrogance dictates that the rules which come from above, are for people dumber, and less skilled then them. That they are the exception to the rules.

Sometimes they will learn from their mistakes, the switch will be reset, and they’ll resume safe practice.

But some clinicians will never accept that it was their selfishness which led to a negative patient outcome. They will always believe that it was someone else’s fault.

As healthcare professionals we have a huge amount of responsibility. We are privileged and blessed to be able to do what we do.

Inevitably, we will all ride the roller-coaster bell curve. It’s up to you to make sure that your decisions are ones which put your patients needs in the right place.

Don’t risk your own safety.

But more importantly don’t risk your patient’s so that you can be faster, get a tea break on time, a report filed quicker (or insert insufficient reason here).

Don’t let your pride threaten your reputation, our industry, or someone else’s life.


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