If you happen to pick up a copy of the Kansas legal code for the construction and administration of nursing homes -- which, admittedly, you probably won't -- here are some of the rules:
*The facility shall store each prepared food, dry or staple food, single service ware, sanitized equipment or utensil at least 6 inches or 15 centimeters above the floor on clean surfaces.
*The facility shall providing living, dining, activity and recreational areas in the special care section at the rate of 27 square feet per resident, except when residents are able to access living, dining, activity and recreational areas in another section of the facility.
*Windowsill height shall not exceed three feet above the floor for at least 1/2 the total window area.
*Wastebaskets shall be located at all lavatories.
*All eggs shall be cooked.
Okay, okay -- I'll stop (though, of course, the list goes on). I include these few samples for the same reason Philip K. Howard includes them in his deliberately infuriating new book, The Rule of Nobody: Saving American from Dead Laws and Broken Government. His point is that our country is drowning in laws so vast and yet so persnickety, no one is allowed to use common sense.
Not only are professionals such as nurses and administrators treated like morons -- "Don't serve eggs raw!" -- they are also required to ignore the big picture of making sure the residents are happy and well cared for, in favor of obsessively ensuring the home does not get cited for windowsills that are three feet and two inches above the floor.
This kind of ridiculous regulating pops up in pretty much every public sector. In fact, in my neighborhood, RIGHT NOW, workers outside the apartment building next door are tearing down the beautiful, wrought iron fence that has been there for 60+ years, because the city finally noticed (and cared) that it is 7 inches higher than allowed by local law.
What happens when we pile on laws like this that are excruciatingly precise, but don't make life any better for anyone?
Those who must comply are not only frustrated, they're actually distracted from doing their jobs competently. How can they focus on providing a nice meal or satisfying day if they are busy worrying about the height of their utensil stations and all the other bogus benchmarks? Howard, a lawyer, founder of the non-profit Common Good, and favorite Jon Stewart guest, cites one nursing home that wheeled its sleeping residents into "activities" so it would have the required number of people attending.
Fortunately -- even amazingly -- there is an alternative to this kind of bureaucratic lobotomizing. As an example, Howard highlights what happened in Australia. There, in 1988, the government agreed to scrap hundreds of nursing home "input" regulations (regulations that detail exactly what an institution should do) in favor of 31 "output" regulations -- the kind that describe what the institutions' goals should be. These include providing a "homelike environment" and honoring residents' "privacy and dignity."
While some naysayers warned this would result in across-the-board laziness, or even patient maltreatment, the opposite occurred. Quality improved. Disagreements were less frequent. Once the workers were free to use their hearts and heads, their compassion and ingenuity flourished.
This approach is called "regulating by principles" rather than rules, and it doesn't just work in nursing homes. Anyplace where bureaucracy has choked off common sense, the switch to principles can be made without inviting chaos and corruption. "Instead of a legal instruction manual," Howard writes, decisions are made "by people on the spot." These humans solve problems and stand responsible.
Imagine if we gave that kind of freedom to teachers, city workers, and the folks at the DMV. They'd be less frustrated and so would we. And I'm pretty sure that anyone charged with serving eggs would still cook them first.
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