Monday, June 1, 2009

The death of common sense

I filled in as the first shift commander on Saturday. At 1500 hours, Sgt. Michon Morrow relieved me, and I changed into street clothes and headed home. My portable radio was laying on the front seat, and I hadn’t turned it off. I was thinking ahead of a lawn to be mowed and a brew to be consumed when a radio transmission caught my attention.

Officer Mike Schaaf was being detailed to a drug treatment center on a missing person report. The dispatcher gave him the description of the person, then said something to the effect of, “We don’t have a name, the caller said she couldn’t provide that because it is confidential.” Did I hear that right? I called Mike on the radio and took him to a side channel: no, I wasn’t hallucinating. I asked him to shoot me an email later with the details.

Apparently the employee was unwilling to provide the client’s name due to her concern that this would be a violation of the The Health Insurance Portability and Accountability Act—the dreaded HIPAA. It’s not, by the way, but that’s what she was worried about. Officer Schaaf ultimately convinced her that it would be difficult to investigate a missing person without knowing who the person was, and all was well.

I really don’t mean to criticize the employee, it just seems to me to be a good example of a more widespread phenomenon. Rules, regulations, computer programs, and protocols just can’t replace sound judgment by reasonable people who are willing to make a decision and stand by it. This is not to say that discretion shouldn’t be guided by regulations, or that the computer program’s recommendation isn’t a valuable resource. At the end of the day, though, there has be a person who exercises old-fashioned common sense—something that seems to be in short supply these days.

Ever made the tactical error of flipping out three pennies after the cashier had already pressed the “enter” key?

20 comments:

Anonymous said...

When rules become thick enough, some see it as safer to follow them (even if it means doing the wrong thing), because you can't get fired for following the rules - but you can be fired for doing the right thing, if what you do is a violation of the rules. That's not the way I operate, just the better-safe-than-sorry CYA that some live by.

Anonymous said...

25 years ago I had to train people on a cash register. Even then, teens would panic at the thought of the 3 pennies. You want to really watch them get woozey, try handing them a dollar and a dime on an .85 bill.
I'm no math wizard but counting change is a survival skill no one should be without.

Anonymous said...

Happens all the time Chief. Just try and get info from the Friendship Home or St Monica's when they initiate a call for service regarding a client. Common sense isn't written in the policy manuals at those facilities so it isn't applied.

Anonymous said...

Here's an even better, and I suspect, more common situation.

I'm at work. I get a call from the dialysis center that my mother has become ill during treatment and was being transported to the emergency room by ambulance.

Because of the ER rotation policy that the hospitals have, she isn't guaranteed to be transported to the hospital that is 4 blocks away (St. E).

The dialysis nurse didn't know where she was going to be taken. The Fire Department dispatcher wouldn't tell me (HIPPA), the first two nurses at the ER's wouldn't tell me.

Fortunately, I got a compassionate nurse who told me that an ambulance had just arrived, but wouldn't tell me if my mother was inside. I took a chance....

That was 3 years ago. I can only imagine how bad it is now, after continuous reinforcement about the laws.

Hey - but at least her privacy was protected...

Steve said...

The problem with rules is that, far too frequently, the people who make them aren't, shall we say "savvy" enough, to realize all the possible consequences or loop holes they may have. I'll be the first to admit, it's difficult to write a rule that accomplishes what you want it to. First, there are the people who will find a loop hole in it just for the sake of showing how stupid it is (sometimes, that's me). Then, you have the unintended consequences that you failed to forsee. Next, you have the unforseen circumstances that put you in a bind. And, finally, you have the people who break the rules for some personal gain or just plain evilness, and you're faced with how to enforce the rules and "punish" those who break them.

Even the professional rule makers (our legislators and their aides) don't do a very good job of it. Look what happened with the safe haven law, or how local municipalities keep finding ways to get around state laws.

The chief is right, at the end of the day a person needs to exercise good old-fashioned common sense and stand by their decision. Unfortunately, Anonymous 7:25 is right, too. People don't get fired for following the rules, but they might for breaking them, even if it makes good sense to do so.

Anonymous said...

Thank the lawyers and lawsuits for protecting us from ourselves.

Anonymous said...

The more detailed the rules, the more creative the miscreants get in finding "loopholes." For instance, if a school has 10,000 rules (don't run with scissors, for example), then the kid says, "can I skip with scissors?"

Often, a better approach is a broad admonition of "Act safely." That way, in the above example, you can say, "well, even though it doesn't expressly outlaw skipping with scissors, because it's not safe, then it's prohibited."

And the above also allows people to use common sense, which I guess we are breeding out of people or which is exercised so infrequently, that most people are flabby and winded if asked to employ it.

Anonymous said...

Who needs common sense? The gov't can take care of us and make those decisions for us!

Phillyun said...

Do you suppose this is evidence that its time to start repealing some laws? Do we need to keep passing more every year without throwing some out? Really?
I'm NOT looking for a rant - just agreeing that we all need to use the brain.

Anonymous said...

10:52
I work for an attorney's office and I actually run into this all of the time. It does get extremely annoying, especially if I need to request an itemized statement, they still sometimes require a HIPPA release. Which is just ridiculous. But they are the rules and I just do as they request. It does protect people in certain situations though because you do not want joe blow to be able to obtain your personal medical history. It would be nice if the legislature could make exceptions for certain situations such as this one.

the QI guy said...

What a great opportunity to email out a good website to health care providers that really sums up misperceptions.

http://www.hhs.gov/ocr/privacy/hipaa/faq/permitted/law/505.html

Tom Casady said...

10:52

They already have. The previous link by the QI guy is a thorough recap of the permitted disclosures, and contains this:

"To respond to a request for PHI for purposes of identifying or locating a suspect, fugitive, material witness or MISSING PERSON; but the covered entity must limit disclosures of PHI to name and address, date and place of birth, social security number, ABO blood type and rh factor, type of injury, date and time of treatment, date and time of death, and a description of distinguishing physical characteristics. Other information related to the individual’s DNA, dental records, body fluid or tissue typing, samples, or analysis cannot be disclosed under this provision, but may be disclosed in response to a court order, warrant, or written administrative request (45 CFR 164.512(f)(2))."Lots of people, including health care providers working for covered entities, are confused by HIPAA.

Anonymous said...

Was the missing person Mr. Fnu Lnu?

JIM J said...

The JDC sends the names of clients who are going to the doctor out on the public radio (scanner)
These are not only doctors appointments, but KIDS and all that are under 19. Maybe this is the blog that will have positive change in that arena too.

Patty said...

As a nurse we have had this pounded and pounded into our heads that you can't tell anybody anything. I work in long term care and we have gotten residents admitted from hospitals who when we called to ask something refused to tell us even though they sent the person to us to take care of. It is enough to make you want to beat your head against the wall at times.

Anonymous said...

It's kind of funny you would blog about something of this nature when the police department is full of rules that don't allow officers to use common sense. Child abuse calls for example. If we get sent to a child neglect because a boy is thought to be to young to be climbing a tree but figure out that the boy is old enough and strong enough, well we still have to do a neglect report because that is the rule. I think it is a lack of trust in officers to be honest.
A couple sloppy officers that can't keep their cruiser's clean means we all get inspected instead of just dealing the offenders.
I could go on. It's what our country is coming to. Throw out common sense, put rules in place no matter if they make sense or don't apply, enforce them, and if you don't follow them....poof you're gone. No one wants to lose their job so they follow the rules that are put down. We are all just robots.

Tom Casady said...

5:55-

Oh, we're not immune, no doubt. Check with your colleagues in other cities, though. Have a look at their policy manual(s). I think you'll find that our General Orders manaul is the skinniest one around. It's shrunk by over half in the past 15 years, and not a page goes in without some other page coming out.

By the way, it sounds like you did exactly what I'm talking about--used your common sense on that child neglect call. The fact that you were expected to write a short report about it is hardly an example of the phenomenon I'm blogging about.

JIM J said...

To June 1, 2009 5:55 PM:
The question you post highlights a fact in the Chief's response.
Good supervisors defend a point (blog topic).
Great supervisors say, good point!
Most all of us end up with good, or less than average supervisors. How do supervisors with poor skills get a role like that. I know of two that worked for LPS , one was a meth addict, the other has a robbery conviction. The numbers employed in supervisor positions must be far greater as these are just two we know about.

that's what she said...

What this blog is a perfect example of is a new rule gets passed and they go overboard because they don't understand or know the new rules completely. With HIPPA, the medical people are told they will be in big trouble if they break the rules. They don't fully understand the rules, especially at first, so they go to the extreme and won't release any information.

The same thing could easily happen with the new ruling about searching vehicles incident to arrest. It doesn't mean the end of it all, we just have to understand what we can and can't do.

Tom Casady said...

That's what she said-

I agree, there's a lot of over-reaction to such things initially, and it generally improves over time.