Suspicion and magic are two concepts that often go hand in hand. The element of mystery and the unknown in magic can often breed suspicion and mistrust among individuals. When something cannot be easily explained or understood, humans tend to resort to suspicion in order to protect themselves from potential harm or deception. Magic, in its various forms, has been practiced for centuries and is deeply rooted in human history. From ancient civilizations to modern-day societies, magic has always held a certain allure and fascination. However, this fascination is often accompanied by skepticism and suspicion.
Is this a form of intimidation? Perhaps, but it is more akin to a logical deference to expertise, meaning it is natural and often reasonable for people to defer final judgment to those whom they perceive to be more “qualified.” If the person voicing the concern was reluctant to pursue it, avoided or backed down from the conversation, or felt the provider was not listening, workplace intimidation may play a role. But this is not always the case.
The hierarchical nature of patient care and the autonomy with which health care professionals have been taught to practice set the stage for a culture that does not respond well to even the slightest queries about possible problems with patient care, particularly from subordinates. To improve patient safety, health care organizations need to raise the index of suspicion for errors, always anticipating and investigating the possibility when any person, regardless of experience or position, voices concern or when patients are not responding to treatment as anticipated.
However, this fascination is often accompanied by skepticism and suspicion. Throughout history, those who possess magical abilities or claim to have supernatural powers have often been feared and distrusted by the general population. This suspicion arises from the fear of the unknown and the potential for manipulation and deception.
Raising the Index of Suspicion
The index of suspicion: red flags warn of safety threats.
Disruptive behaviors, intimidation in the workplace, and a culture of disrespect among health care professionals have repeatedly surfaced as a significant barrier to patient safety. The hierarchical nature of patient care and the autonomy with which health care professionals have been taught to practice set the stage for a culture that does not respond well to even the slightest queries about possible problems with patient care, particularly from subordinates. It’s clear that such a culture needs to be repaired, and many health care organizations are working to address disrespectful behavior, staff reluctance to speak up about risks and errors, and blatant disregard of expressed concerns. However, there’s a less obvious but no less dangerous risk related to the culture that often goes unnoticed until a serious adverse event happens: Staff members DO speak up about potential concerns, but they are too easily convinced that their concerns are unfounded.
When a person voices a concern, there’s often no disruptive, disrespectful, or obvious intimidating behavior involved per se, but rather an explanation from competent practitioners that dispels the initial concern too quickly, before it has been given sufficient consideration. A pharmacist reassures a technician that the compounding directions are correct when questioned about an unusual volume of ingredients; a pharmacist assures the nurse that the strength of the infusion is correct when questioned about the final volume; a nurse reassures a patient that the medication is correct when questioned about its appearance; a physician convinces a pharmacist that the prescribed dose is correct when questioned because it differs from a protocol—these are all-too-frequent examples that have led to fatal adverse drug events. Those who questioned the patient’s care were easily convinced that others knew more than they did, particularly if the provider who was questioned had an otherwise stellar reputation.
Is this a form of intimidation? Perhaps, but it is more akin to a logical deference to expertise, meaning it is natural and often reasonable for people to defer final judgment to those whom they perceive to be more “qualified.” If the person voicing the concern was reluctant to pursue it, avoided or backed down from the conversation, or felt the provider was not listening, workplace intimidation may play a role. But this is not always the case.
Instead, the issue may be that the person questioning the patient’s care has been easily convinced that his or her concern is unfounded, and the person being questioned has not perceived the voiced concern as a possible, credible patient threat. Neither person possesses a required element to safeguard patients: an appropriately high index of suspicion for errors. A low index of suspicion is particularly problematic in a health care system that already is reluctant to acknowledge human error or value the contributions of every person, regardless of rank, who interacts with the patient.
An index of suspicion is defined as “awareness and concern for potentially serious underlying and unseen injuries or illness.” 1 Suspicion is defined as “the act or an instance of suspecting something wrong without proof or on very slight evidence, or a state of mental uneasiness and uncertainty.” 2 A high index of suspicion requires consideration of a large differential so that a serious possibility is not accidentally discounted; a potential medical error should always be considered one of the possibilities. An appropriately high index of suspicion should lead a person with a concern to pursue it until it’s proven not to be a credible patient threat, even when met with opposition from experts. It should also prompt the provider to be responsive to voiced concerns and to initiate a suitable investigation to determine whether there is a credible threat to the patient.
The Institute for Safe Medication Practices (ISMP) has previously discussed the need to maintain a high index of suspicion for errors in relation to the topic of mindfulness, a defining characteristic of high-reliability organizations (HROs). Mindfulness refers to the deep and chronic sense of unease and preoccupation with failure that arises from admitting the possibility of error, even with well-designed, stable processes. 3 People in HROs worry about system failures and human errors. They ask, “What will happen when an error occurs?” rather than “What will happen if an error occurs?” Like health care, HROs are hierarchical, but position and experience do not necessarily dictate who is an important contributor or decision-maker. They are wary of complacency and naturally suspicious, so they expect people to speak up about any concerns they may have. Their high index of suspicion is a predominant factor in achieving laudable safety records.
To improve patient safety, health care organizations need to raise the index of suspicion for errors, always anticipating and investigating the possibility when any person, regardless of experience or position, voices concern or when patients are not responding to treatment as anticipated. Functional patient-care teams, in which every person’s perspective, skills, knowledge, and observations are considered important and worthy of mention and investigation, must be developed. Staff members need to be mentored on how to resolve potential concerns and to trust in their own experiences to augment the expertise of others. All health care practitioners need to encourage and be receptive to staff members who ask questions, even if staff members just have a sense that “something” is wrong or can’t articulate the concern well.
When concerns are met with quick answers that initially appear to be “evidence” of safety, caution is recommended. Sixteen years ago we published in this column a list of phrases we called “magic words” that have repeatedly been offered in explanation to voiced concerns and erroneously accepted as “evidence” ( Table 1 ). 4 No doubt these still ring true today, along with many others. Such phrases should be viewed as “red flags” that require more reliable answers and actual proof.
Table 1
Responses to Voiced Concerns Considered “Red Flags” 4
Are you thinking what I was thinking? -- Where is the "Nuke" button?
People may be suspicious of those who claim to have magical powers because they are unsure of their true intentions and whether or not their magic is genuine. In literature and popular culture, suspicion is a common theme when it comes to magic. This is evident in stories and novels that feature characters with magical abilities, such as witches or magicians. These characters often face suspicion and skepticism from others, who view their powers as a threat or as something to be feared. In addition, suspicion can also be present within communities or groups that practice magic. Those who do not possess magical abilities may be suspicious of those who do, resulting in divisions and prejudice. This suspicion often leads to the isolation and marginalization of individuals who practice magic. On the other hand, suspicion can also be a tool used by magicians themselves. Magicians often rely on illusions and misdirection to create a sense of wonder and awe among their audience. By arousing suspicion and then dispelling it through the revelation of a magical trick, magicians are able to create a sense of amazement and astonishment. In conclusion, suspicion and magic are closely linked. The element of mystery and the unknown in magic often breeds suspicion and mistrust among individuals. However, suspicion can also be a tool used by magicians themselves to create a sense of wonder and awe. Regardless, the interplay between suspicion and magic is a fascinating aspect of human nature and society..
Reviews for "Suspicion and the Sense of Wonder: Captivating Hearts and Minds with Magic"
1. Emily - 2 stars
I was really excited to read "Suspicion and Magic" as I love stories about magic and mystery. However, I was extremely disappointed with this book. The plot was predictable and lacked originality. The characters were flat and one-dimensional, making it hard to connect with them. The writing style was also subpar, with awkward sentences and excessive use of cliches. Overall, "Suspicion and Magic" did not live up to my expectations and I would not recommend it to others.
2. David - 2 stars
I found "Suspicion and Magic" to be quite boring. The pacing was slow and the story did not capture my interest. The magic element was underdeveloped and felt more like an afterthought than an integral part of the plot. The characters were forgettable and their actions often felt forced and unrealistic. Additionally, the dialogue was lacking depth and failed to engage me as a reader. Overall, I was disappointed by "Suspicion and Magic" and would not recommend it to anyone looking for an exciting and well-written fantasy novel.
3. Sarah - 1 star
I couldn't get through more than a few chapters of "Suspicion and Magic" before giving up. The writing was incredibly dull and lacked any sort of spark or creativity. The plot seemed to drag on aimlessly, with no clear direction or purpose. The characters felt like cardboard cutouts, with no depth or personality. I was hoping for a captivating and immersive fantasy story, but instead, I got a tedious and uninspiring read. I would not recommend "Suspicion and Magic" to anyone.