Decision Fatigue and the Prisoner's Lunchtime Dilemma
Feb 25, 2024 10:30 am
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No time to pee
You’ve no doubt heard the refrain, or even said it yourself, “I don’t have time to take a break”.
I’d like to move the needle toward the contrapositive, “I don’t have time to not take a break!”
Working with clients on shift endurance and efficiency, I’ve consistently seen improvements in performance, patients per hour, and RVU with break-taking.
Does the math add up?
On the surface, it seems like a paradox - taking time away from the critical activity (patient care) could end up saving time.
"That's a straw man argument!" you might say. And yes it is. In the cool light of day, it seems obvious that taking a break is beneficial but, in the frenzy of a shift, it can be a challenging practice to embrace.
If you want a deep dive into the neurobiology of maintaining focus and taking breaks, our most recent pod will not disappoint.
For this article, however, I want to take you to court.
Are you always at the top of your game?
A seminal study on the impact of taking breaks analyzed judges’ rulings on prisoners’ parole requests.
The judges said, “Yes,” to parole requests about 65% of the time when fresh and fed.
Hangry, decision-fatigued, and not at our best
The percentage of “Yes” rulings diminished to near zero as the day progressed.
But then they bounced back.
After each break, consisting of food plus a brief cessation of casework, the yes rate shot back up to 65% and then steadily degraded back to zero.
In the above diagram, the green circles are 'peak yes' - they happened either at the start of the day or after a break, red circles are 'nadir no'. The dotted line represents the break period.
Why would a yes be different than a no?
A yes involved more time and a longer written verdict than a no, suggesting that rejecting a request was easier.
It wasn’t just time, it was thinky time
Cumulative time wasn't the ingredient for the negative trend in rulings, it was the number of decisions.
So what did the snack break provide? Did it salve decision fatigue, restore glucose levels, or recharge focus ability? This study doesn't answer that question, but the effect of taking a break and eating was consistent.
You are making way more decisions than a judge!
Have you ever wondered why you are inefficient at the end of a shift or workday?
Your decision-making engine is depleted, focus is compromised, and brain fuel running on fumes.
Grinding it out for the entire day, even when the sh*t is hitting the fan, is a recipe for declining effectiveness.
The two-break challenge
If you don’t have defined breaks during the day, I encourage you to adopt the habit.
Start with two breaks. Not so long that they freak you out. 5 minutes is just fine.
3 Rules for Breaks
- Eat and drink every time
- Don't talk about work or surf social media
- Get outside if possible (and safe)
The show notes of this episode have more details on break-taking skills.
If you already take a break or two, up the game to a q2-hour pattern.
Don't leave it up to chance
Pre-plan what’s going to happen in the break, where you’ll do it, how long it will be, and how you’ll delay but not defer if you’re in the midst of a critical task when it’s break time.
Your brain, body, and patients will thank you.
Keep on rocking,
Robbie O
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