Habits

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How to Combat Decision Fatigue and Improve Patient Care

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The human brain is capable of making thousands of decisions in a day, but each choice we make comes at a cost. As we move through our day, we are constantly presented with decisions to make, both large and small. From what to eat for breakfast to whether to take on a new responsibility at work, the sheer number of choices we make can be overwhelming. This mental exhaustion caused by decision-making is known as decision fatigue.

Decision fatigue is a phenomenon where the quality of decision-making deteriorates as a result of mental exhaustion. It is a real and recognized phenomenon that can have a significant impact on our daily lives. When we experience decision fatigue, our ability to make decisions becomes impaired, leading to poorer choices or even decision paralysis. This is why, by the end of the day, we tend to make poor choices in our nutrition. We ate healthy food all day and suddenly we find ourselves picking up fast food on the way home.

woman eating cookie and saying shhhh

So Many Choices

One of the reasons decision fatigue is so prevalent today is the abundance of choices available to us. In the past, choices were limited, and decisions were simpler. Today, we are presented with an endless array of choices in everything from what to eat, wear, watch, and do. With so many options, it’s no wonder our brains can feel overwhelmed and exhausted. Even just scrolling through social media creates hundreds of decisions – where to focus your attention, what to “like” or “love,” what makes you mad, what you should click on, etc. 

Decision fatigue can also be exacerbated by stress and anxiety. When we are under stress, we tend to become more indecisive and have a harder time making choices. This can lead to a cycle of decision fatigue. The more decisions we have to make, the more stressed we become, and the more difficult it becomes to make good choices.

Unraveling the Impact of Decision Fatigue

Decision fatigue can have a significant impact on nurses, who are required to make a large number of decisions every day. Here are three examples of how decision fatigue might affect nurses:

Medication errors
  1. Medication administration involves a complex set of decisions. Nurses need to choose the right medication, the right dose, and the right time to administer it. They need to be aware of possible contraindications. When nurses experience decision fatigue, they may become more prone to errors,
Patient assessment
  1. Assessing patients is an important part of a nurse’s job, It helps to identify any changes in a patient’s condition that may require intervention. However, assessing patients involves a large number of decisions, Nurses make decisions such as which assessments to perform, what the results mean, and what interventions may be required. When nurses experience decision fatigue, they may become less thorough in their assessments. Or they may miss important details that could affect a patient’s care. They can be led astray by distracting findings.
Prioritization of tasks
  1. Nurses are responsible for managing a wide range of tasks, from administering medication to coordinating with other healthcare providers. When nurses experience decision fatigue, they may struggle to prioritize tasks effectively, leading to delays in care or missed opportunities for intervention. For example, a nurse may become overwhelmed by the number of tasks they need to complete and miss a medication administration or forget to follow up on an important lab result.

The good news is that there are tactics we can use to prevent decision fatigue and make better choices.

nurse giving medication to pediatric patient

Strategies to Boost Mental Stamina and Improve Patient Outcomes

Limit the number of decisions you make
  1. One of the simplest ways to avoid decision fatigue is to limit the number of decisions you make each day. For example, you could plan your meals for the week ahead of time so you don’t have to decide what to eat every day. You could also limit the number of choices you make when shopping by sticking to a list and avoiding distractions. Have you ever considered that meal planning could make you better at your nursing job? Crazy to think about!
Make important decisions earlier in the day
  1. Our ability to make good decisions declines as the day goes on, so it’s a good idea to tackle important decisions early in the day when our minds are fresh. This way, you’ll be more likely to make a good decision and avoid decision fatigue later in the day.
Use routines to simplify your day
  1. Routines can help simplify your day and reduce the number of decisions you have to make. For example, you could create a morning routine that includes exercising, showering, and eating breakfast in the same order every day. This way, you don’t have to decide what to do first each morning, and you’ll save your decision-making energy for more important choices later in the day.
Prioritize your decisions
  1. It’s important to prioritize your decisions and focus on the most important ones first. This way, you can avoid decision fatigue by only making the most important choices and delegating or postponing less critical decisions.
Take breaks
  1. If you’re feeling overwhelmed by the number of decisions you have to make, take a break. Taking a break can help you recharge your mental batteries and come back to your decisions with a fresh perspective. Sometimes taking a break can be as simple as sitting down, closing your eyes, and taking a few deep breaths.
Outsource decisions
  1. Finally, consider outsourcing some decisions to others. For example, you could hire an assistant to help with meal prepping or a personal shopper to help you with wardrobe choices (I use StitchFix for this). By delegating some decisions, you can free up mental energy and reduce decision fatigue.

In Conclusion

In conclusion, decision fatigue is a real and recognized phenomenon that can have a significant impact on our daily lives. With the abundance of choices available to us, it’s no wonder our brains can feel overwhelmed and exhausted. However, by implementing tactics such as limiting the number of decisions we make, tackling important decisions earlier in the day, using routines, prioritizing decisions, taking breaks, and outsourcing decisions, we can bring some peace to our lives and decrease the chances of making a mistake.

You can read more about What Doctors Wish Their Patients Knew About Decision Fatigue

tiny habits habit tracker

Tiny Habits Book Summary

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Tiny Habits: The Small Changes That Change Everything by BJ Fogg is abook that challenges readers to embrace small changes in their lives to achieve significant results. In this book, Fogg, a renowned behavior scientist, presents his theory on how tiny habits can create long-lasting change. He intersperses the concepts with stories of people who have put the concepts into practice in their lives.

3 Sections

The book is structured into three main parts. The first section introduces the concept of tiny habits and how they can help individuals create lasting change. Fogg explains that the key to creating lasting change is to start small (tiny, really…even smaller than you think) and work on habits that are easy to implement. The second section explores the intricacies of habit formation and how to effectively create tiny habits that stick. The third and final section provides practical advice on how to integrate tiny habits into one’s daily routine.

The essence of Tiny Habits is this: Take a behavior you want, make it tiny, find where it fits naturally in your life, and nurture its growth. If you want to create long-term growth, it’s best to start small.

B..J. Fogg

Actionable

One of the standout features of this book is the practical nature of the advice. Fogg provides clear and actionable steps for readers to take to implement tiny habits in their lives. He encourages readers to start with small, easy-to-do habits and build from there. He also advises readers to anchor new habits to existing routines, making it easier to remember and incorporate them into daily life.

Keeping changes small and expectations low is how you design around fair-weather friends like motivation and willpower. When something is tiny, it’s easy to do – which means you don’t need to rely on the unreliable nature of motivation.

B..J. Fogg

Celebrate

Another aspect of the book that I found particularly compelling was Fogg’s emphasis on celebrating small wins. He encourages readers to celebrate their successes, no matter how small they may be. This is a way of reinforcing new habits and increasing motivation to continue on the path to change. Celebrating the positive things in our lives, even the tinyest of positive things, let’s your brain know that it’s important to you. The brain learns that celebrating feels good and therefore, it becomes your ally in doing your tiny habit and helping it grow.

Overall, I found Tiny Habits to be a highly engaging and informative book. Fogg’s approach to habit formation is refreshing, and his practical advice is easy to follow and implement. The book is well-researched and draws upon a wealth of scientific evidence to support its claims. I would recommend this book to anyone looking to create lasting change in their lives, no matter how small the change may seem.

Nurse smiling at man in wheelchair with gratitude

A Simple Gratitude Practice Can Reduce Stress

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Nurses are the backbone of the healthcare industry. There are more than three times more nurses in the US than physicians. Nurses work tirelessly to provide care and support to patients, often at the expense of their own well-being. It’s no secret that the nursing profession can be stressful and emotionally challenging, especially in today’s healthcare climate, but one way nurses can mitigate the stress and burnout is by practicing gratitude. It sounds crazy, but research has shown that simply spending a few minutes each day in gratitude can make a powerful difference.

Gratitude is the act of appreciating and being thankful for the good things in life. It’s a simple concept, but it has profound effects on our mental and physical health. Numerous studies have shown that practicing gratitude can lead to increased happiness, better sleep, improved relationships, and reduced stress levels.

“In positive psychology research, gratitude is strongly and consistently associated with greater happiness. Gratitude helps people feel more positive emotions, relish good experiences, improve their health, deal with adversity, and build strong relationships.” (Giving Thanks Can Make You Happier)

Here’s how nurses can benefit from a gratitude practice:

Reducing stress and burnout

Nursing is rewarding, but it can also be an incredibly stressful and emotionally taxing job. Long hours, demanding patients, and the pressure to provide high-quality care can take a toll on nurses’ mental health. Practicing gratitude can help nurses cope with stress and prevent burnout. When nurses focus on the positive aspects of their job, such as the gratitude and appreciation they receive from patients, coworkers and their families, it can help them stay motivated and resilient during difficult times. On my worst days I can still find something to be grateful for. Sometimes you can only find micro moments of awesome to be thankful for.

Improving job satisfaction

When nurses focus on the positive aspects of their job and their life, they are more likely to feel satisfied and fulfilled in their work. Gratitude helps nurses appreciate the impact they are making in their patients’ lives, even during challenging times. This can lead to a sense of purpose and meaning in their work, which can translate into higher job satisfaction.

Enhancing patient relationships

Nurses who practice gratitude are more likely to build strong, positive relationships with their patients. When nurses express gratitude towards their patients, it can help patients feel more valued and appreciated, which can improve their overall experience. This can lead to better patient outcomes and higher patient satisfaction rates. Both parties benefit.

Boosting mental and physical health

Practicing gratitude has been linked to numerous health benefits, including improved mental health and better sleep quality. Nurses who practice gratitude may experience reduced symptoms of depression and anxiety, which can improve their overall well-being. Additionally, gratitude has been shown to boost the immune system and reduce inflammation, which can lead to improved physical health. A gratitude practice can be as simple as writing down 1 to 3 things you are thankful for at the end of the day. Give it a try. I can testify that it works. Even when I was going through my cancer treatment I could always find things to be grateful for.

“In recent years a very large body of evidence has emerged suggesting that gratitude is strongly related to all aspects of well-being…” (Gratitude and Well-being: a review and theoretical integration)

In conclusion, practicing gratitude can have numerous benefits for you as a nurse. By focusing on the positive aspects of your job and expressing gratitude towards patients and colleagues, you can reduce stress, improve job satisfaction, enhance patient relationships, and boost your mental and physical health. As a result, you can continue to provide high-quality care and support to patients while maintaining your own well-being.

desperate and stressed attractive middle aged Asian woman holding notepad asking for help feeling overworked and exploited working at computer office desk suffering stress and fatigue

Gain Clarity With a Thought Download

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I don’t know if this ever happens to you but there are times that my brain just seems to freeze up. I have so many thoughts swirling through my head that I get overwhelmed. We have 40,000 to 60,000 thoughts per day. Some just pass right on through without notice and others are more intrusive. Some thoughts are helpful. And others are negative and critical.

A thought download is a way to take the thoughts from your head and get them on paper. It can also be called a brain dump. It’s a helpful habit to do once or twice a day. Doing them in the morning can help you get clarity for the day ahead. Doing it at night can help empty out all the thoughts from the day and allows for a better night’s sleep. I am working on a practice where I also do it when I’m feeling overwhelmed.

Three times to do a thought download

  1. First thing in the morning – this is a great way to clean out your mind and gain clarity for you day. You can start with just writing whatever comes to mind – plans for the day, thoughts that you woke up with things you’re working on today, etc. If you get stuck you can start with a journal prompt to get your thoughts rolling. Just write, don’t edit. Let it be messy.
  2. At the end of the day – dump out all the thoughts that have been bombarding your brain all day. Put anything down that’s on your mind. Again, let it be messy. Any successes you had today, anything you learned, anything that’s bothering you.
  3. When feeling overwhelmed – a great way to unravel all the stuff running through your brain to sort out what’s important now and what you can just put down on paper and let go.

Then what?

Many times, simply doing this will be enough. It clears out your head and tells your brain that you’ve “dealt with” many of the thoughts it was trying to remind you of. Sometimes you may be surprised at the things you wrote down. Things that you didn’t even realize you were thinking. It’s like being able to be on the outside and view your own thinking. And you may decide that some of those thoughts are things you want to keep thinking. But some of them are maybe thoughts you want to question. They may be thoughts you want to do some mindset work on. You can do this by putting it through a process like the self-coaching model. You can learn more about doing that on my post The Ultimate Practice to Boost Your Mental Wellness.

Why we don't sleep. Image is frustrated woman with insomnia

Why We Don’t Sleep: Simple Ways to Improve Sleep

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Sleep is one of the foundational habits for flourishing. It is also one of the things we tend to sacrifice. We often don’t realize the cost of a lack of sleep. More than 17,000 scientific reports show that getting a full night of rest regularly can improve your memory, lower your risk of disease, improve your creativity, decrease risk of depression and anxiety, and increase your sense of happiness. (Why We Sleep by Matthew Walker) If you consistently get less than six to seven hours of slumber, you double your risk of cancer. It is estimated that two thirds of Americans don’t get the recommended 8 hours of sleep. Are you one of them?

Tired = Drunk?

One skipped night of sleep has the same effect of being drunk. Not sleeping dramatically diminishes your performance in all areas and also diminishes your psychological well being. I used to work night shift and I know some days I was so tired driving home from work that I probably could have been pulled over for being drunk. My commute is about 35 minutes. I used to have to stop halfway home and take like a 15 minute nap in a parking lot before I could drive the rest of the way home safely. One morning I didn’t make it all the way to my resting point and had an accident. I know I was not the safest driver on the road those days.

Let’s look at why we don’t sleep:

1. We don’t value it. You might think, “oh, I’ll just stay up late and watch one more episode on Netflix,” and you sacrifice that extra hour (or more) of sleep.

2. We are inconsistent. Having a consistent bedtime and a consistent bedtime routine sets the stage for your brain to initiate the sleep process.

3. Too much light. In general, we go to bed we have light from multiple screens like our phones, iPads, or television. Getting all that blue light exposure reduces our melatonin which in turn delays the onset of sleep and also delays the onset of deep sleep. So even once you get to sleep, it takes you longer to get deep sleep. Blue light also stimulates cortisol, your stress hormone due to stimulation from TV shows internet scrolling, etc.

4. Substances. Caffeine, alcohol and tobacco can all impair sleep.

5. We eat too close to bedtime. Your body performs all sorts of vital functions as you sleep. If you are still digesting at bedtime, it can delay the body’s ability to do those functions.

6. We exercise too close to bedtime. Stimulation from exercise can keep you awake longer than you’d like.

7. No sleep sanctuary. Your bedroom should be cool and as dark as possible. Even small lights from electronic devices can impair your sleep. If you are a night shift worker sleeping in the daytime, have blackout curtains on your windows and soundproof your room as much as possible. A sound machine is a great investment to mask the sound of family members or neighbors while you rest.

Numb to the problem

The funny thing is, when we’re sleep deprived, especially if it’s chronic, the less your body is able to sense it. You feel like you’re okay. And until you start getting really good sleep, you don’t realize how not okay, you are. There’s a Greek philosopher, Seneca, that said “The worse a person is the less he feels it,” and that seems to be true when it comes to sleep deprivation.

So, what can we do for better sleep?

Here are some tips to improve your sleep based on the challenges above. See which habits you might want to include in your routine.

  • Stop caffeine 4 to 6 hours before bedtime. Some people might need to stop even earlier.
  • Exercise at least 3 hours before bedtime. Excercise gives you a 12 hour mood boost so the earlier you can do it, the more benefit you will get from that.
  • Stop eating 4 hours before bedtime. At a minimum, stop 2 hours before.
  • Shut down technology at least 1 hour before bedtime. The stimulation from tech will keep you awake longer.
  • Create a sleep sanctuary in your bedroom.

What will you work on?

Comment below and let me know what you plan to work on first.

If you’re working on new habits this post might interest you next: Morning Routines

If you are in healthcare and want to join the Nurses Getting Healthy Community, we’d love to see you in the group. https://www.facebook.com/groups/healthynurse

flag on the mountain top to represent the goal gap analysis

Rate Yourself: Energy, Work, and Love

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I want to share something that was helpful for me in working on some goals over this past year - kind of like a little goal gap analysis. It's a way of looking at who you need to be in order to be the person that can reach your goal.  A lot of people already have their goals set up and if you don't, this can help you kind of focus your goals in a direction that would be helpful. Let me explain.  (You can read the post or listen in the video at the bottom of the page).

We all have a gap. We have a gap between who we are currently being or how we currently show up in the world and who we're capable of being. There's always more growth that we can experience. If we're not growing then we're being stagnant. This gap is what we're trying to close up when we set a goal. 

So why do we want to bridge this gap? Because we want to be the best person that we can be. The best version of ourselves needs to show up consistently in work, health, and home life. I know sometimes you've probably had a day where you just say that was a great day - a masterpiece day. You finish the day saying, "I wish every day was like that." You're feeling good, you have energy. Your relationships at home and at work are good. We want to become the person that can show up that way more often. So this quiz is just a way to help us look at where you currently are. 

The Quiz
I want you to evaluate yourself in 3 categories - energy, work, and love. Rate yourself on a 1-10 scale with 10 being perfect. Then we'll add up the 3 scores. 

Energy
Evaluate yourself with respect to energy. Some questions you could ask yourself in the energy category are:
- Do you get good sleep? Are you getting seven to eight hours? 
- Are you eating as well as the best version of you can? Are you getting nutrition that you know is fueling you and not dragging you down or causing disease, etc? 
- Are you exercising?  Are you moving your body? Or are you being too sedentary? 
- Do you have mental clarity? 
- Are you able to focus? 

A score of 10 is the perfection. If you are a 10 in this category, you have nothing more to prove. And a score of 1 would mean you're a total mess in this category.

Before you move on to the next category I want you to do a little bit of journaling on what's going well when it comes to your energy. Give yourself credit for the parts of this category, that you've got under control. 

Then list one thing you could start or stop doing that would bring your rating up a point? 

We're going to grab one thing out of each of these categories and even if you don't set goals or resolutions, you will have three things that you could work on to bridge that gap. The one thing I recommend that you make them a super simple things.

Work
- How do you flow throughout the day in your work? 
- How is your ability to focus without distraction?
- How is your level of productivity?
- How is your ability to prioritize your time management? 
- How do  you feel like you're showing up when you clock in in the morning? And when you clock out? 

Score yourself between 1 and 10 in the work category?

What's going well? 

And then what's one thing you could start or stop doing that would bring your rating up a point?

Love
- How are you showing up in your relationships? 
- How are you showing up as a spouse, as a parent, as a child? 
- How are you with your co workers or with your patients? 
- What kind of relationships do you have? 

Give yourself a score of 1 through 10. 

Again, look at what's going well. 

And what's one thing you could start or stop doing that would bring your rating up one point?

Total
Now you're going to total up those three scores across energy, work and love. 
What is your total score? Let's say you scored yourself as a 15 on a 30. Do you think that the person that is a 15/30 is capable of reaching your goals?You probably have some room for improvement. But if you work on those three categories, you're going to be more likely to hit that big goal.  So build some habits to improve your scores and then come back and rate yourself again on your way to your big goals!

laying a foundation of bricks

Creating Your Foundational Habits

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We all know that establishing good habits is necessary for good health and for living your best life. Sometimes we work on habits that are more fun to build and we neglect the foundational habits that are necessary for our health and growth. Over the last couple of years, I’ve let some of these foundational habits slide and my body and mind have felt the difference. Unfortunately, you don’t always notice a slowly developing shaky foundation until something grabs your attention.

Many of us are struggling to stick to healthy habits that we KNOW would help us look, feel, and perform at our best.

In fact, the United Health Foundation found in a recent study that 70% of adults in the U.S. report having at least one unyhealthy habit they need to break…and another study showed 61% of adults picked up bad habits over the last few years alone.

📱 Spending too much time on screens and not going outside

💪Having trouble sticking to a workout routine

🍟Eating takeout more often than you’d like to admit

🍪🍷 Reaching for sugar or alcohol to cope with stress

🥛 Buying cute water bottles and forgetting to fill them

…the list goes on

Or maybe you just feel like you could stand to eat a little healthier, get a few more workouts in each week, carve more time out to take care of yourself, and start putting your health first.

The 21-day Habit Challenge might just be right for you. Make bite-sized shifts in your habits to create lasting results.

When you join the challenge you’ll get:

📄A 21-day Habit Challenge Success Guide to help you implement healthy foundational habits and give you the tools & strategies you need to hit your goals faster.

💻 21 daily “deep dive” coaching emails to keep you inspired each morning

✅ A daily online habit tracker to track and celebrate your consistency

🕣 An evening reminder to check off your completed habits

🖐 And a private Facebook group with more encouragement and a like-minded community

Join the challenge here for instant access: https://tammyfuller.omcheckout.com/21-day-habit-challenge

morning routine

What a New Morning Routine Can Do For You

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The Benefits of a Morning Routine

Have you noticed that it gets harder to make decisions toward the end of the day? You’re too tired to figure out what to have for dinner or even what to watch on TV. You started your day with good intentions for what you would get done after work. But then you just zone out on the couch when you get home. This can be a result of decision fatigue. Any time we are not operating out of our autopilot habit brain we are using up precious energy. Multiple decisions throughout the day exhausts us. 

Knowing this can help you prioritize. You can cut out a lot of decision making by implementing habits and routines. A morning routine can make a big difference. That way you are able to put more things on autopilot and decrease the amount of decisions you have to make. Your brain loves to be efficient this way. It also frees brain space for morecreative and productive thinking. Routines are great tools that simplify our lives and cut out a lot of our daily stress.

Chances are you already have a morning routine. It just may not be one you have really thought about. Maybe you get up after hitting the snooze button a couple times. You make coffee, check email, scroll through social media, and fix some breakfast before heading into the shower. Let’s expand on that. What habits could you establish in the morning that might make your whole day easier? 

How I Designed My Morning Routine

For me, having a great morning routine starts the night before. On an ideal day my lunch is already packed and my clothes for the next day are already chosen and ironed. The coffee maker is already set up to start automatically. If I am planning to work out in the morning I will set my workout clothes out ahead of time. 

I have learned to get up right away when my alarm goes off in the morning. I used to be a night owl but now I get up early, even on the weekends. A helpful book for getting up the first time (and lots of other good stuff) is The 5 Second Rule by Mel Robbins. On workday mornings I do a stretching routine, get showered and dressed, and pour some coffee to take into my home office. I spend some time reading my Bible and praying and then I write in my journal and make my food plan for the day. I record a quick Marco Polo video for my accountability group and usually by then it is time to head to work. 

Implement some routines into your workday wherever possible. Meal planning helps you figure out what meals to fix and eat. A cleaning schedule makes sure you stay on track with your household chores without you having to spend any valuable decision making skills in the process.

The Morning Routine Starts the Night Before

A bedtime routine not only helps when you’re too tired to make smart choices, it also helps you fall asleep more easily. What works for your toddler works for you as well.

Start by doing a few chores that make the next morning easier. Making sure the kitchen is clean and the kids’ school things are in order are great examples. Come up with a few calming things that help you slow down and get ready for sleep. Read a book, listen to some music or wind down with a cup of herbal tea. I already mentioned some of the things I do in the evening to set my morning up for success. I also brush my teeth and wash my face after dinner. This is part of how I signal to myself that “the kitchen is closed,” to reduce the chance of evening snacking. 

Your Turn to Take Action

Sit down with a pen and piece of paper and think about what parts of your day and week you can turn into routines. Write the down and create daily to-do lists for yourself until you’ve established these new habits and routines. Spending a little bit of time creating a morning routine and habits will make your day run a lot smoother. You might just find yourself less stressed and get more done during your productive hours. And that’s a beautiful thing. It allows you to save plenty of decision making for the fun stuff like figuring out what park to go to, what family movie to watch or what board game to play.

Comment below and let me know what habit you’re putting in your morning or evening routine.