Many of us would answer that in a 65 MPH zone we choose to deliberately violate the legal limit and usually drive somewhere around 72 MPH. This routine rule violation is termed by researchers as "legal illegal" since so many people make this violation that while still illegal it becomes "legal" to the many folks driving at this speed. Our decision is made of balancing the pros and cons of doing this. Pros – get there faster, more time for something else, it’s fun to go fast vs. Cons – getting a ticket, increased danger (there is good data from the NHTSA that there is increased risk!!). There is also an "illegal illegal" area where most would say the cons clearly outweigh the pros e.g. driving > 85 MPH.

So what does this have to do with healthcare?

Where do you operate in the course of your day caring for patients? When you walk into a room to give a medicine to a patient, do you still check the armband if the patient answers to their surname? Do you wash your hands before and after each patient interaction? The pros and cons here (if you are taking shortcuts) might be – pros – save time – can take care of your next task sooner vs. cons – give the wrong med to a patient 1 in 100 or 1,000 times, cause a hospital acquired infection (probably the same odds).

As you think about this, consider that your decision to drive 72 mph has implications for you – and to some extent to the drivers around you. Your decision to live in the "legal illegal" realm of healthcare has implications for your patients – they did not consent for you to follow your own interpretation of our Policy and Procedures. While the ‘rules’ can seem cumbersome and not following them to the letter might not even result in a bad outcome the majority of the time, our policies and procedures are there for a reason. They are there to protect our patients, as much as possible, 100% of the time.