In a recent article, Pignatiello, Martin, and Hickman (2020) evaluate "decision fatigue" in an attempt to better understand it, across multiple domains.
It is estimated that an American adult makes 35,000 decisions a day (Sollishc, 2016). While some of these day-to-day decisions are seemingly benign, an emerging body of science indicates that making decisions may possess negative ramifications for controlling ones’ behavior and the quality of subsequent decisions. This phenomenon, known as decision fatigue, describes the impaired ability to make decisions and control behavior as a consequence of repeated acts of decision-making. Evidence suggests that individuals experiencing decision fatigue demonstrate an impaired ability to make trade-offs, prefer a passive role in the decision-making process, and often make choices that seem impulsive or irrational (Tierney, 2011).
This concept analysis also possesses implications for nursing practice. It is well known that nurses face a large number of decisions each day, all of which strongly influence the outcomes of patients and their family members (Thompson et al., 2004; Thompson and Yang, 2009). Furthermore, as the American population continues to age, the demand for nurses is increasing substantially, but unfortunately, this demand is not being met. Thus, nurses face a greater workload and encounter more responsibility than ever before and often work to the point of and through exhaustion (Carayon and Gurses, 2008; Rogers, 2008).
Although not currently explored, decision fatigue may serve as an indicator of workload burden associated with the delivery of nursing care. Moreover, the application of decision fatigue is not solely limited to nurses, as the workload and decision fatigue of resident physicians is well-documented (Baldwin and Daugherty, 2004; Berlin, 2008; Thomas, 2004). If nurses, physicians, and other healthcare clinicians are working to the point where they are in severe states of ego depletion (manifesting as decision fatigue) and are in an unideal cognitive state to make logical and safe decisions for patients, the exploration of decision fatigue may serve as a highly relevant and necessary endeavor. Therefore, decision fatigue may possess significance to inform regulatory policies related to the healthcare employee workload.
This concept analysis indicates decision fatigue is a widespread phenomenon that has yet to be widely applied to healthcare decision-making and behavioral frameworks. The manifestation of decision fatigue is contingent upon several factors related to decision-making, self-regulation, and idiosyncratic scenarios.
Pignatiello GA, Martin RJ, Hickman RL. Decision fatigue: A conceptual analysis. Journal of Health Psychology. 2020;25(1):123-135. doi:10.1177/1359105318763510
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