Blink and What Happens in Rapid Cognition

¶ … Blink and What Happens in Rapid Cognition

Gladwell's Blink (2006) is about rapid cognition. The book describes the thinking that happens in a blink of an eye, or what is called the thinking before the thinking. A person's mind is able to make rapid, important, and hopefully good decisions about people and situations. Many people call this "going with your gut," because it feels like using instinct instead of actual thought. In reality, though, it is still part of the thought process that every person must consider. It can be especially helpful when working with others in a situation where one has to make quick decisions with limited information. The first two seconds, when a person comes up with their original insight, is the basis for Blink. Gladwell (2006) goes into detail about what he believes is both perfectly rational and deeply mysterious when it comes to how people think and what they associate with thinking vs. intuition. One of the terms used in the book, thin-slicing, addresses the ability of people to gauge what is really important based on a very narrow period of experience.

This is applied to gambling, tennis, speed dating, military war games, malpractice suits, music, movies, and predicting divorce. There are so many topics that Gladwell (2006) applies to thin-slicing. The most surprising thing I found in this book was that Gladwell also applied thin-slicing to malpractice suits. As I was reading through the portion of the book on malpractice, I was expecting to find that insurance companies would assume that physicians were most likely to be sued based on their past medical records and how many errors they had made during their career. However, I found that Gladwell (2006) actually indicated that insurance companies are more likely to draw conclusions based on listening to short conversations that doctors have with their patients. How well the doctor was liked translated into a lower risk of malpractice suits, which was just unbelievable to me. It would make more sense to think that lawsuits would be based on whether the doctor does a good job, not whether people liked him or her.

Another thing that Gladwell (2006) indicates in Blink is that the results of analyses show malpractice suits are more common among physicians that are extremely skilled. Physicians who make a lot of mistakes, on the other hand, rarely get sued. That seems odd, but it is true. Patients generally do not file malpractice suits because they have received poor medical care from their physician. Instead, they file malpractice suits because they were harmed by poor medical care in addition to something else taking place. They were not treated well, for example, and that stopped them from just letting the other problems go. They might have overlooked a simple issue otherwise, but the poor care plus the poor treatment were just too much for them to ignore. When that happens, it completely boils down to how well the people have been treated by their doctors, no matter their medical care.

Since this kind of issue has happened to me, I am able to relate to it in some way. One day, I had a shift that started out very hectic. There was a code blue happening at the same time as a rapid response team was called, and those situations were unfolding while I was dealing with a patient who wanted the results of a family member's stress test. They wanted those results at that very moment, but I was not able to provide them because the test results were simply not ready yet. The patient who had the stress test was relatively young, did not exhibit symptoms of a cardiac problem, and did not have any health issues that I was aware of. It appeared as though the patient was only suffering from indigestion. I was so busy, and the patient and family kept pressuring me about the results, almost to the point of harassment. It was the equivalent of a drug user constantly looking for a fix. I was not able to provide the patient with the personal attention that the patient's family felt was warranted.

The patient's family later wrote a letter to my manager saying that I was not accessible to them in the way that I should have been during that time. The family member was some type of VIP, which I was unaware of at the time. Apparently, that individual was unhappy that I did not drop everything for the results of the stress test, even though there was actually nothing wrong with my performance and the way that the issue was handled. Human interaction is a tricky thing, and it has such an influence on the perceived right or wrong that is being done in any situation. Hospitality is part of that interaction, and it is the act of being hospitable (or personable) to others. In other words, it is very important that nurses are personable when they work with patients and their families. There is a high degree of social value in that hospitality, and it can affect whether a nurse, doctor, or entire hospital is sued, no matter the outcome of the actual medical situation.

In the literature and research that pertains to nursing, hospitality is becoming a term that is more closely related to the implications that are seen in nursing practice (Gilje, 2004). It is being viewed as moral imperative, with foundations for a moral economy that resonate in the way nurses perform their duties (with smiles, for example). How a patient or family member of a patient perceives the experience at the hospital is implied in everything that the nurse does (Gilje, 2004). Research into nursing and hospitality indicates that the way management puts the service industry spin on nursing care affects the level of comfort that is felt by patients and their families. Often at morning meetings, we will hear information about how good the nursing care was from a particular nurse, usually from a letter that was sent by a patient or the family of the patient.

At Missouri Baptist Medical Center, part of our nursing practice now includes Thank You cards that all of the nurses sign in the patients' charts. These are sent to the patient once they are discharged from the hospital, to thank them for choosing that particular hospital. Of course, there are deeper meanings of hospitality, as well. These are where the research is most applicable for nursing, such as in hospice care. However, with insurance, competition, and malpractice concerns, hospitality in the nursing profession is becoming more like the hospitality that is seen in the restaurant industry. Hospitality was generally not something that was associated with nursing or medical care, because the hospitality industry was more related to food, lodging, and tourism. Malpractice issues have changed all of that, and made it necessary to treat hospital patients and their families differently than in the past. Now, medical care is about the overall experience, as opposed to just the care that a person receives. That has changed nursing and medicine forever.