Here's a bit of a crazy story from Florida: Fired Fla. Lifeguard Offered Job Back, Says No.
A lifeguard, Tomas Lopez, was “hastily” (and incorrectly) fired by a supervisor after saving a swimmer in distress… because the swimmer was outside of Lopez's assigned zone. Are you kidding me?
From the article:
Hallandale Beach Mayor Renee Crichton said it has always been the city's policy that a lifeguard must respond to an emergency inside or outside of their protected area.
The lifeguard wasn't fired due to a bad policy… he was fired because a supervisor misinterpreted (or didn't understand) a policy.
That's just common sense that Lopez should have saved the swimmer.
It sounds like the supervisor didn't even know the proper rules and regulations… firing Lopez because they thought he violated some rule.
We can't put rules, procedures, and “standardized work” in the Lean parlance ahead of common sense and judgment. Can you image the uproar of Lopez had just sat there because saving that swimmer “wasn't my job”?
We need to be careful that our standardized work, especially in healthcare settings, aren't overly restrictive or violate common sense. Maybe this lifeguard story is a good illustration of what could go wrong…
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Mark, who defines common sense? From Wikipedia: Common sense is defined by Merriam-Webster as, “sound and prudent judgment based on a simple perception of the situation or facts.” Common sense these days are more paced on perception and a person’s mental model. Although this situation appears to be clear cut, we have no information on the supervisor and you rush to judgement based on one side of the facts. Because of this, I avoid using “common sense” as a basis to pass judgement on a person’s response to a situation.
I think common sense is in the eye of the beholder, somewhat, but I think it’s fair to say a vast majority of people would agree it’s silly to fire a lifeguard for saving a swimmer, especially since the lifeguard didn’t violate a policy about leaving his zone.
We have two sides of the story, two sides agreeing a mistake was made – the lifeguard and the officials who tried to correct the wrongful firing. The supervisor hasn’t commented, so we don’t have the third side of the story. But I think the lesson is clear – don’t have silly overly restrictive rules (which weren’t in place here) and make sure supervisors are trained well on what the actual policies are.
Perhaps the supervisor transferred over from the Alameda Fire Department (or Police Department for that matter)? At least the lifeguard in Florida made the decision to save the swimmer’s life and risk his job. Sounds like Florida might be a nicer place to go swimming, anyway. I bet the water is warmer than 60 degrees.
http://abclocal.go.com/kgo/story?section=news/local/east_bay&id=8161285
ALAMEDA, Calif. (KGO) — Alameda police and firefighters stood by and watched as a man drowned off Crown Beach in Alameda on Monday. Authorities are now trying to explain why they had no choice but to stand on the shoreline.
Alameda police received a call shortly before noon on Monday from a woman saying her son wanted to kill himself. Raymond Zack, 53, then walked out into the water off Crown Beach.
“I thought it was kind of weird that they weren’t going out to bring the guy in, you know, he was out there, his head was above water, he was looking at everybody, there was plenty of time for them to react,” witness Perry Smith said.
For more than an hour, Zack stood up to his neck in the frigid surf off of Crown Beach in Alameda.
“Well, we expected to see at some point that there would be a concern for him and somebody would go out there and pull him in,” witness Gary Barlow said.
About 75 beachgoers could not understand why Alameda police officers and firefighters stood idly by and watched the man slowly succumb to the 60 degree water.
“We’re not trained to go into the water, obviously the type of gear that we have on, we don’t have the type of equipment that you would use to go into the water,” Alameda Police Lt. Joe McNiff said.
The man was a 150 yards out; it was too shallow for a Coast Guard boat and its helicopter was on another call. It arrived too late.
“It’s horrible,” Barlow said. “How can we let that happen? How can our emergency personnel allow that to happen? I don’t get it, I don’t understand it.”
The Alameda Fire Department says budget constraints are preventing it from recertifying its firefighters in land-based water rescues. Without it, the city would be open to liability.
” Well, if I was off duty I would know what I would do, but I think you’re asking me my on-duty response and I would have to stay within our policies and procedures because that’s what’s required by our department to do,” Alameda Fire Div. Chief Ricci Zombeck said when asked by ABC7 if he would enter the water to save a drowning child.
Alameda firefighters could not even go into the water to get the body, so they waited until a woman in her 20s volunteered to bring the body back to the beach.
“The frustration is certainly understandable and I think the sensibility would be probably that we’re going to evaluate our response protocols,” Zombeck said.
Alameda fire officials say they are going to have a serious discussion about why Alameda, as an island city, does not have the ability to save people in danger in the water.
Some of the images in the video were obtained from: oaklandlocal.com.
(Copyright ©2012 KGO-TV/DT. All Rights Reserved.)
For one, that’s really unfortunate when a government mismanages its funds so badly that it can’t perform public safety functions (or least do the proper training).
Secondly, they were worried about liability for trying to save him… as opposed to the liability of NOT trying? At some point, a human desire to help others should kick in, rules, policy, training, and funding be damned.
Too many people — not you, Mark — might think that standard work is perfect work, or a rigid set of behaviors with no exceptions. Standard work can always be improved, and an abnormal condition shows where improvement is needed. Ideally, the standard will be tested and compared to a better idea in a controlled way, but that might not always be possible. It’s when exceptions become the unwritten rules that supersede the (unused or lost) written rules and accumulate over time. How should the team meeting and supervisor coaching conversation have been conducted in a lean organization after this near-catastrophic event?
I think that after an event like that (or at the end of any normal shift), the lifeguards and supervisor would have at least a quick meeting to debrief – what went well, what challenges or problems did anybody face… what can we do to improve?
After a near miss like this, the discussion would probably have to be longer and more involved – including lessons learned and any need for follow up. It’s too bad the supervisor apparently jumped the gun in thinking the lifeguard had violated procedures… definitely something that can be avoided in the future (I assume the supervisor now knows the rule).
The downside of NOT knowing the rule was losing a few lifeguards who quit in solidarity with Lopez. Expensive mistake… and it’s more systemic than blaming the supervisor. I’m not trying to demonize the supervisor… why didn’t they know the rule? Who is responsible for that?
Glad you mentioned the phrase “near miss.” Aren’t aviation “near miss” events recorded and subject to some sort of after action review? I seem to recall that some healthcare organizations based reviews of near misses of hospital mistakes that could have resulted in great harm to a patient on the aviation procedures.
There is still a ton of underreporting of near misses in healthcare, according to journal articles (and reports from people I work with). That’s why the aviation folks are still crusading in healthcare as much as the manufacturing people are!
Mark
All of these are prime examples of a society that has become paralyzed by legal and bureaucratic procedures that have no rational reason for being. It is the unfortunate state of our society that we have come to value following the rules more than taking action. Much of this has been created for us by our courts and governments allowing idiotic lawsuits to be pursued against for any reason.
In the case of the lifeguard being fired, there are two key failings in the system, first that the supervisor lacked both the proper training to know the rules, and two that a supervisor could fire an employee without the approval of people above them. Both of these issues show the failure is actually at the higher levels of the organization, in that they failed to properly train a supervisor, and they failed to properly protect employees from wrongful behaviour of the supervisors.
In the second case we see a system that has become totally helpless, because of management incompetence, and fear of repercussions. The honest answer is that both the local fire department and the local police could have taken action, as could have many of the 75 on lookers. Instead everyone stood around and watched, because of stupid rules or fear of being sued. Surprise anyone that tried to save the man would have had to use force to do so, which means the person rescued could have sued them for violating their rights. Add into the equation that the professionals because they weren’t trained or equipped to do it, they would have been in an even worse position, because it could be pointed out that they violated their own protocols. It may be unfortunate, but that is what our society has come to where saving someone’s life can destroy your life via the legal system.
A friend who works for the local government once told me in government you raise to your highest level of incompetence. I do not know if that is totally right, but from what I see there is a real fear to take any action that could be perceived as outside of your field of operation, hence every time a grey area shows up nothing happens, then after the fact we get twelve new needless rules, to protect the senior bureaucrats, politicians and their system in the future, all of which handcuff the frontline staff even more. Most government frontline staff are so regimented and so afraid of stepping outside the rules they have become slaves of a system, none of us wanted nor is it a system we need, and because they have lost any form of control, we the people the government systems are supposed to support, have instead become its slaves as well. We need to wake up as a society and say enough already common sense has to prevail, but that would imply and require we are personally willing to practise common sense.
Lean often fails because no one is capable or willing to practise common sense, instead we insulate ourselves in ever rules. There is a limit to how much you can standardize any job, at some point if you want to be able to create improvement and growth you have to allow for the exercise of common sense by the frontline staff. And when you allow them to use common sense you cannot punish them afterwards for doing so.
[…] Yes, the safety of humanity is of greatest importance. However, by placing such a rule in effect, the Belfast City Council has created a “gray area” of judgment. In such times of ambiguity, it is almost always best to step back and apply the top priorities of common sense and humanity. […]