Decision Fatigue and Neurosurgeons' Clinical Decision Making: An Enemy in the Shadow

Decision fatigue is a recognized phenomenon in healthcare psychology. Prolonged activities can lead to stress and fatigue, a familiar term in neurocognition. This is called decision fatigue; it is related to the ability to make the best decisions that decline with the course of the day. There are three key attributes to be included in this process; behavioral, cognitive, and physiological. 1 The management of the neurosurgical patient is a complex process. Multiple fi elds of medicine have shown that there is this decision fatigue due to multiple complex processes in place to practice medicine. As the US president correctly said, “… I am trying to pare down decisions. I don ’ t want to make decisions about what I am eating or wearing. Because I have too many other decisions to make. You need to focus your decision-making energy …” . 2 The pandemic of COVID-19 has shown that this enemy is real and bedside intensive care nurses were the most impacted. 3 The practice of surgery is also known to have decision fatigue.Apatientwhoisseenattheendoftheworkinghoursof orthopedic