It doesn't come naturally to me (obviously, since I spend hours deciding on things like phone colors). But every time a decision is placed in front of me as a doctor, I consciously remind myself, "Make a decision, Linda, and stick to it."
Yesterday I sent two kids to the PICU. The first one was a 12 month old girl who had pneumonia and was working hard to breathe. I did my assessment and decided I wasn't quite comfortable with her staying on the floor. She's doing fine and her labs were reassuring... but she ended up on continuous nebs which is a reason to go to the PICU. So maybe I made the right decision by chance. Then in the middle of the night I got called for a 2 year old boy who was having difficulty breathing after being extubated (he was under general anesthesia for a small procedure). When I got there he looked bad. He was sucking his chest down to his spine and had a barking cough. I told the Anesthesia guys, "Yes, he needs to go to the PICU" and together we came up with interventions for this little guy's upper airway problems. He started looking a lot better and by the time he got to the PICU he looked 100% better. I felt a little silly bringing a comfortable, crying baby to the PICU, but considering what he looked like when I first saw him, I felt very justified in my decision. And I committed to it. It was a good feeling.
I'm in a transition period now where I'm getting towards the end of my second year. In July I will begin my third and final year of residency. I will be expected to make decisions all the time. I will be the senior resident on call and I'll have first and second year residents looking to me for answers. It's a little scary, but I think I'm ready. Or at least, I hope so. We'll see!