This is an anecdote that I nearly
brought up in class on Monday but opted not to as at the time I couldn’t think
of a way to aptly relate my experience with the topic of our discussion. However,
after giving it more thought I found a few valid connections so I figured I
would post them here.
I volunteer at Brigham and Women’s
hospital and last week I chose to volunteer during a morning shift. The major
duty of volunteers in my department is to transport samples, blood,
wheelchairs, and occasionally patients from one part of the hospital to
another. Towards the end of my shift I received a request to deliver some
specimens from a patient floor to the lab for analysis. Per usual, I took the
elevator up to the designated floor and made my way over to the nurses’
station, expecting to pick up two or three bags of specimens. To my surprise
the specimen basket was nearly overflowing, and as I rifled through to find the
bags that matched the name of the patient I was assigned a secretary behind the
counter suggested that I just bring all of the samples in the basket down since
they were going to the same place anyways. I quickly decided that juggling
about a dozen small bags whilst trying to maneuver through a potentially
crowded elevator was not the best of ideas and, after first ensuring that
another basket was present should more specimens be collected while I was away,
picked up the basket of specimens and headed for the service elevators.
The service elevators are
notoriously slow, so I was prepared to wait a while and leaned against the
wall. In a minute or so a hospital worker in light blue scrubs rounded the
corner and joined me in waiting. I smiled politely when we made eye contact.
She did not. Rather, she at first appeared startled at something about my
appearance and then continued to glance at me bemusedly for a couple of
seconds. Just as I was about to brush it off she said, “You know you’re not
supposed to bring the basket down, right?” I replied that I did not and that a
nurse at the station had simply told me to bring the whole thing, so I did. I
also made clear my intent to return it as soon as I had dropped off the
specimens. She looked at me doubtfully at first, then shrugged it off and
genially added: “Just so you know for next time.” I shrugged it off as well,
until another hospital worker wandered over to the elevators and the scene
repeated. I experienced at least three more of these encounters during my trip
from the elevators to lab control. After a while the previous advice-givers
mentioned to would-be advice-givers who entered the elevator that I had already
been informed of my indiscretion. I was feeling pretty uncomfortable by this
point and tried to reduce the awkwardness by assuring them that I wouldn’t
stuff the basket under my volunteer jacket and attempt to sneak it out of the
hospital. Needless to say I was immensely relieved to complete my trip and return
the basket to its apparently permanent home at the nurses’ station.
Perhaps this derives from a
tendency to dwell on the past but since the ordeal happened I’ve given it a
good deal of thought. Firstly, although I may be wrong, I highly doubt that a
section of BWH Employee Handbook is devoted to the hospital policy against
briefly removing a specimen basket from its designated location. However, the
response that my mistake garnered seems to indicate that leaving the basket is
a generally well-known practice, one might say a “norm,” within the hospital.
Especially when I recall the variety of personnel who advised me of my error,
which ranged from nurses to janitors to technicians wheeling around carts with
heart monitors, it is clear that members on various nodes in the hospital
network are not only aware of this norm but so attuned to it that there is no
hesitation to instruct unknowing members of the network of its existence.
Monday’s class triggered the
return of these thoughts and also added unexplored dimensions to them. For example,
the impact of rejecting a social norm (whether intentionally or accidentally) on
the behavior of members of the network responsible for the norm is oddly
specific to who commits the rejection. In the case of the basket, I had made
sure that another one was on the desk and had every intention to return it to
its rightful place within ten minutes of removing it. Despite this explanation
(which as the encounters continued was uttered with increasingly desperate
sincerity), each person who pointed out my indiscretion, though they did so
with the best of intentions, still appeared noticeably perturbed or at least
caught off guard. It would appear that a far more uncomfortable situation is
produced if a member of the network that upholds a social norm breaks that
social norm than if an outsider does so, which would make sense as their
awareness of the norm makes their disregard of it inexcusable. My experience
quite aptly reflects this as my fellow hospital workers, who recognized as one
of them by my navy volunteer jacket, appeared to feel uncomfortable by my
failure to abide by the norm. Also, even though I knew that I was simply
unaware of this norm and only acted in the way that seemed the most sensible, I
definitely felt an almost visceral sense of guilt and awkwardness.
Another consideration brought
about by Monday’s class is the purpose of such seemingly trivial norms. When
one considers the many independently moving parts that exist within a synergic
network (such as a hospital), it becomes easier to look beyond the face value
of these norms and acknowledge the role that they actually assume. Although
this may be a bit of a dramatic supposition, one could speculate that the
removal of the basket could cause a specimen to be misplaced which could result
in a delayed diagnosis which could prevent the administration of treatment
which could have adverse effects on a patient. In this sort of scenario it
becomes evident that, with the variety of individual yet necessarily
interconnected activities that contribute to patient care, one flaw in the sequence
of these activities could produce innumerable consequences with varying degrees
of severity. As in many large closed networks that are striving toward a common
yet complex goal, the productivity of a hospital relies upon the unhindered
functioning of the independently moving yet interconnected gears that drive it.
Social norms help to ensure that these gears turn in tandem by establishing
fundamental but necessary practices that every actor in the network learns to
maintain simply through their membership in the network.
Thus, the reasoning behind even
the simplest of social norms can reveal just how integral they are to the
success of the networks that institute them. By carrying the specimen basket I
unknowingly upset the social norm and as a result could have jammed a few gears
in the hidden machinery of the Brigham and Women’s Hospital network. I think
next time I’ll just make multiple trips.
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