A lot of outrage has been expressed at the behavior of the school administrators and the school nurse who did not allow a student suffering an asthma attack the use of his inhaler. The question naturally arises as to how anyone could be so callous as to not respond to an immediate visible need. This was especially so with respect to the nurse whom one would think would put medical needs first and bureaucratic niceties second.
This article reports on a study that may suggest a partial answer as to why people behave in ways that are puzzling.
In the study, to be published in a future issue of The Academy of Management Journal, lead author Keith Leavitt of Oregon State University found that workers who tend to have dual roles in their jobs would change their moral judgments based on what they thought was expected of them at the moment.
“When people switch hats, they often switch moral compasses,” Leavitt said. “People like to think they are inherently moral creatures – you either have character or you don’t. But our studies show that the same person may make a completely different decision based on what hat they may be wearing at the time, often without even realizing it.”
School administrators typically tend to be rule enforcers first and educators second, so their behavior is easier to understand even if we do not condone it. But what of the nurse whose training is to focus on the patient? It could be that if the administrators in the school are continually emphasizing the need to follow ‘correct’ procedures and go by the book, the nurse might well have adopted that mindset, though that same nurse might have acted differently if she were working in a school that had a more student-centered approach.
“What we consider to be moral sometimes depends on what constituency we are answering to at that moment,” Leavitt said. “For a physician, a human life is priceless. But if that same physician is a managed-care administrator, some degree of moral flexibility becomes necessary to meet their obligations to stockholders.”
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“Organizations and businesses need to recognize that even very subtle images and icons can give employees non-conscious clues as to what the firm values,” he said. “Whether they know it or not, people are often taking in messages about what their role is and what is expected of them, and this may conflict with what they know to be the moral or correct decision.”
This goes back to the culture of the institution and not so much the policies. All institutions have policies that cover most contingencies. They all tend to say the right things. But it is the culture that determines what kinds of subtle messages people get on a routine everyday basis that tells them what values are important and how to react to situations. And this culture is largely created by the senior people at the top.
“…But if that same physician is a managed-care administrator, some degree of moral flexibility becomes necessary to meet their obligations to stockholders…”
I love how much that sentence is watered down. *Some* degree of moral flexibility?
Crystal Lee Sutton (woman who inspired Norma Rae) was delayed treatment for 2 months for her cancer by her health insurance company as they tried to figure out if they could save some money. *Some* degree of moral flexibility?
I know nothing about the specifics of this case.
In the past, I have held jobs that placed me in contact with a number of schools in various school districts. One thing that surprised me was that many of the people called “school nurses” were not nurses (RN’s). Because of budget cuts, many schools simply cannot afford the cost to hire a registered nurse. Some simply have parent volunteers who are called (out of long time habit, I suppose) the “school nurse.”
Again, I know nothing about the specifics of this case. It would not surprise me, however, to learn that this person was not a trained medical professional, but rather, some level of pseudo-administrator.
In my experience, students are allowed to carry essential medications. At least, I was. And my little sister ALWAYS had her inhaler close at hand.
It seems, beyond just plain unprofessional conduct, the “nurse” in question has displayed a disgusting lack of ethical judgement. You just don’t put a piece of paper above someone’s LIFE. Ever. I believe she should be fired and charged with attempted murder.
If schools in the US resemble anything, they resemble prisons where the big deal is following ‘the rules’ and where the basic lesson being taught students is that, within the school, they have no rights and that their opinions don’t count. It’s probably to prepare them to be good obedient workers who will agree to work overtime but not be paid for it or who, when told to do work that violates OSHA safety standards can be counted on to listen to orders. Even when ‘the rules’ are clearly pointless, or when they interfere with any actual process of education or when they even endanger student safety, the important lesson being taught is that ‘the rules’ -- no matter how stupid, destructive or pointless, should be followed at all times. When the school makes an asthmatic -- who really should have an inhaler on her at all times -- check her inhaler with the ‘nurse’ (which only means that the attack cannot be treated immediately) the student is being given a lesson in who has power and who does not, and what sort of society she lives in.
I got lucky in that I got out of high school early, but I had this period of time when I was both in high school and attending a community college. What I noticed was the total lack of bullshit in the community college -- no detentions for being late, no ‘don’t wear hats in my classroom’, no pointless busywork, nobody being told they couldn’t eat or drink in class. And yet the community college, without ‘rules’ that I was told in high school or before were necessary to prevent absolute chaos -- was pretty well-ordered. Part of the difference could have been less ego related problems. It’s amazing how clearly schools enjoy showing the kids whose boss and how sadistic people who work with students can be. Working with young people should not be about a power trip.
Parents need to step up and fight this kind of vaguely Fascist tendency in schools. Schools should be made accountable for this sort of thing and parents need to make things get as mean, contentious and ugly as possible. The type of people who run schools enjoy power and won’t cede it without a fight.