There is a 14th century French parable about a donkey who was equally hungry and thirsty.  The parable goes, that the donkey finds itself equally distant between a bale of hay and a trough of water.  Gripped with indecision of which need to satisfy first, the animal died.  The question is, what did the donkey die of thirst or hunger?  The obvious answer is C: the donkey died of indecision i.e. analysis paralysis.

What does a 14th century donkey have to do with speech pathology today?  Clinicians can sometimes be crippled by indecision.  We can sometimes be paralyzed by analysis paralysis, when there is more than one thing to work on and we don’t know what to do first.  If our job is to make someone safe, why not just downgrade a diet and ensure safety?  Well, the answer is, making someone safe is only the beginning of our responsibilities.  We also are called to bring our clients back to their prior level of function.  Having a single clinician in a facility can often breed increased questions and anxiety over making these exact types of questions.  So, what does a clinician or administrator do?

Overcoming indecision is not complicated, but it can be difficult.  Clinicians, especially young clinicians, can feel overwhelmed finding the correct answer.  Afterall, they have been graded for the last 19 years or so.  Having a team of clinicians can help alleviate some of the questions surrounding the perfect answer.  Having a strong clinical supervisor who can help a young clinician is a benefit.  Even experienced clinicians need help and other clinicians to help as a sounding board. 

The main key is to start making decisions, careful monitoring of the plan and the ability to course correct if the plan isn’t working the way that it should.  This is one reason I am so fearful of “evaluation only” sessions.  I question the efficacy of the eval only.  This practice means that a clinician can make judgements about diet safety in 30 minutes or less (Pizzas deliveries take longer) that will affect a person’s diet for the rest of their life. 

Indecision and analysis paralysis are real things and clinicians, new as well as experienced, need to be aware of the trap we may fall into while evaluating and treating our patients.  Having a good clinical fellow supervisor, a team of clinicians available for support, and being prudent with evaluation only sessions are three simple ways we can be just a little smarter than a donkey.