The Briar Patch:  Thorny Challenges for Directors
“Policy Fatigue” and Common Sense
Vic Pantesco, Ph.D.
 
The Thorn
Even if you are sitting in private, raise your hand if you have been swimming in a rising sea of policies and procedures.  On our campus I referred to  this “policy fatigue” in the faculty senate, on which I have sat for 7 years.  Before the electronic age, a professor of mine quipped that if there were such thing as reincarnation, he wanted to come back as a paper salesman to a large academic institution.  At a team meeting in an addiction hospital in the late 1990’s, a staff member displayed the entire record of a patient discharged in 1970 after the 28 days of treatment.  It was one page.  It had one sentence in the treatment plan line (yes, “line,” not section):  “patient was advised to not drink and go to AA meetings.” 
Things have changed.
The Policy Manual in our clinic has, I am sorry to say, bloated to match – well not quite – APA site visit documents.  HIPAA and numerous other policy and procedure gardens make for challenges to one’s sense of balance if not wellbeing.  They are attached to us as socks just a wee bit too tight: they don’t give you blisters but you look forward to the slippers at night.  And if you happen to have a student clinician cohort more reliant upon, and vigilant about your adherence to, all the policies at the dotted “i” level, it can as Huck Finn said, “make it warm for ‘ya.”

To Ease the Pain
I think it comes down to how we balance the ethical as well as cover-your-back elements here.  There are indeed a few times in the year, especially the beginning, when a student may arrive at one of our doors in high dudgeon about how something wasn’t made clear to them.  I have practiced how to keep my ears from bleeding in such moments when the trusty hefty policy manual clearly states.  If only they had read.  So, one tool here is to indeed make the manual as comprehensive and clear as possible,- labor intensity notwithstanding.
Another tool I am considering:  a sign on my door:  “Do Not Enter – Unless You have Read the Manual.”  I doubt I will do it, but isn’t just the thought its own anodyne?
Of course, our trusty weekly team meetings provide constant cultivating of awareness of both the manual and another jewel: common sense.  It’s one of those things we can borrow from Justice Potter’s utterance in the famous Jacobellis case on pornography:  we know it when we see it.  But it’s not only that.  As a director it helps me much when I am able to couple common sense with an awareness that we expect mistakes.  What we cannot abide is the mistake, however, of insisting that a mistake may reside outside the self when it’s just right there in the manual.  If only they had read. 
So, maybe the Director is best resigned to a love – hate relationship with policies and manuals.  It’s like the therapy frame:  your best buddy if created well and articulately presented; a bit of a nightmare if it’s wobbly.