It is important to resist the urge to avoid being wrong. This could save lives.
Although the tiny twins appeared healthy, their premature arrival at 27 weeks gestation meant that they were considered high-risk.
Fortunately, the medical team at the busy hospital in the city where the babies were delivered was made up of staff from the Neonatal Intensive Care Unit. These included a young Neonatal Nurse Practitioner named Christina Price* as well as a silver-haired neonatologist named Drake. Christina was worried as she looked at the babies.
As a new best practice, her recent training included the administration of a medicine that promotes lung development as quickly as possible for high-risk babies.
Premature babies often have lungs that are not ready to fully breathe outside the womb. The neonatologist did not order the prophylactic surfactant.
Christina came forward to remind Dr. Drake of the surfactant, and was then caught. She heard him publicly berating a nurse for questioning one his orders last week.
She assured herself that the twins would be fine. After all, the doctor likely had a reason to avoid the surfactant. However, it was still considered a judgment call. She dismissed the idea of raising the issue. He was already on his heel and off for his morning rounds, his white coat blazing.
Unconscious Calculators
Christina was performing a quick, but not fully conscious, risk calculation by hesitating and then refusing to speak up. This is the type of micro-assessment that most people do many times per day.
Most likely, she didn’t realize that she had to weigh the risk of being ridiculed or berated against the possibility that the babies might actually need the medication to thrive.
She believed that the doctor knew better than her, and she wasn’t sure he would appreciate her input.
Inadvertently she had done what psychologists call “discounting the future”. She under-weighted the more important issue of the patient’s health, which would take time, and over-weighted the importance of the doctor’s possible response, that would happen immediately.
Our natural tendency to discount the future is what leads to many unhealthy and unhelpful behaviors. This includes procrastinating on difficult assignments or eating extra chocolate cake. The failure to speak up at work is another example of this problem tendency.
Christina managed her image at work spontaneously, just like most people.
Erving Goffman, a noted sociologist, argued that humans are constantly trying to influence others’ perceptions of them in his 1957 book, The Presentation of the Self In Everyday Life.1 This is both conscious and subconscious.
In other words, no one wakes up excited to go to work every morning and looks incompetent, incompetent, and disruptive. These are known as interpersonal risks and are something almost everyone seeks to avoid.2 However, most people want to appear competent, smart, or helpful to others.
No matter our profession, gender, or status, we all learn how to manage interpersonal risks early in our lives.
Children learn to recognize that others’ opinions of them matter and how to reduce the likelihood of being rejected or ridiculed in elementary school. We’re usually very good at it by the time we reach adulthood. It’s so easy that we don’t even think about it.
Do you not want to appear ignorant? Don’t ask questions. Do you not want to appear incompetent? Do not admit to your mistakes. Do you not want to be disruptive? Don’t make suggestions.
It might be acceptable to place a higher value on looking good than making a difference at a social event, but at work, this can lead to significant proverbial consequences
