The Nightingale experience
Pandemic decisions under extreme uncertainty, from the London Nightingale.
The authors turn to their own pandemic to show how stress amplifies bias and why diverse thinking matters most under pressure. COVID, they argue, was wrongly called a black swan, since warnings like Bill Gates' 2014 talk were on record and ignored. They look at exponential spread and the case for speed over perfection, the chaos of redeployment and a service already running near full capacity with chronic gaps. The London Nightingale, built in nine days, in the end admitted only 54 patients. Their contrasting roles, education for Chen and front-line intensive care for Nagendran, expose the gap between well-meant plans and ward reality, caught neatly by a row over missing chairs.
Three takeaways
- Lean systems near full capacity cannot absorb a surge
- Crises magnify anchoring, search satisfaction and decision fatigue
- Lessons from drills and inquiries are recorded then forgotten
Reflection
Questions for this chapter
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