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15 April 2017

I Can See Your Bourgeois Showing, Healthcare Edition

To the research:

Interesting! I worry, though, that the wrong conclusion is being drawn here. Healthcare workers are human. Of course they perform better when they know they are being observed. (Ahem, Hawthorne Effect!) To say that workers aren't working hard enough and should be doing more--in any field, even one where people could be bleeding out on a table--is asking too much of those workers. My spouse, who is an RN who has worked in both hospital and office settings, pointed out to me that what really changes during these periods of oversight is that administrators intervene uncharacteristically, prepping healthcare workers in important ways. To reduce this to "doctors and nurses should be working harder/better" is a problematic framing. To put it into Spinal Tap-ese (Is there a more appropriately named band for this?), turning things up to 11 for a few days is doable--and, now we know, predictable; turning things up to 11 permanently will cause the amps to overheat. We ask a lot of our healthcare workers, especially nurses and techs. Asking more of them is unjust and, ironically, could make health outcomes even worse.

Let me propose two alternative conclusions from this research. First, don't announce your oversight. If the knowledge of being observed changes behavior, don't make people aware that they're being observed. Second, perhaps it is administrators who should be prodded by these findings. Why aren't the administrators doing the things they do during these observation periods all the time? To focus on employees instead of on systems or managers reeks of capitalistic exploitation.

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