Stranger in a Strange Land:

Stranger in a Strange Land: A Non-Indian Administrator Working on an Indian Reservation

This particular case study is a difficult one, because there are many issues to consider. The case involves the head of the EDP, Terry Green, and her efforts to get a dump site on the Reservation cleaned up. Because she is not Indian she does not always understand how everything works there, and she is also finding that there are some difficulties because the Indian Reservations of this country are generally seen as sovereign nations. In other words, the states that they are located in have very limited power to regulate them or enforce any laws or rules. That is usually done by the tribal elders, instead. Green is discovering that this is true, but only after she goes several rounds with a gentleman who will not clean up the dumpsite that he has created and finds that she is not getting anywhere or getting much support.

This dumpsite is on private property that belongs to the gentleman, and he also owns other property that he lives on. The dumpsite is not on the land where the man lives, but that does not stop him from dumping chemicals and other items there. The land has been tested along with some of the items and it was found that there were toxic chemicals there, as well. He was given five days to clean it up, but did nothing. Green secured a court order wherein he was also given five days to clean it up. He still did nothing. When Green went to the state, it was then that she was told of the fact that there was little that they could do because the man was on the Reservation. True, he was not Indian, but it had less to do with that and more with where the property was located. Frustrated, Green turned her attention to another case in which an Indian family was dumping oil and gasoline in their back yard. The neighbors complained but Green was advised to do nothing because they are important people in the tribe.

Findings

Green found that the people of the tribe really protected their own, even when those people were clearly doing something wrong. When it came to outsiders living on their land they were more interested in having the law work to have people stop causing a problem. This was easily witnessed by how they wanted the illegal dumping stopped but when one of their own was doing essentially the same thing on a smaller scale they did not want anything done about that. This appeared to be because the tribe felt that they had to protect what they had from outsiders. It could, however, also be because they feared retaliation, since the couple causing the problems had close ties to elders in the community.

Also found by Green was that the people in the tribe did not want to anger those who had ties with people who were high up in the community for some very serious reasons. It seemed that retaliation would be a factor, which is not something that is seen in society that much. Many native Americans stick to older ways and traditions, though, and when they do there can sometimes be a conflict between the way that they do things and the way that the rest of the country does things. Direct evidence of how different they are and how seriously they take their tribal heritage and beliefs came to light for Green when she tried to get the state to do something about the dumping.

The state had very little that it could do when something takes place on tribal land, and Green's hands were essentially tied because of it. The idea of the Reservation being a sovereign nation is not something that likely occurred to Green before she accepted a job there, but now it is hitting home completely and the concern that she had for the tribe and helping them out may wane if they do not allow her to do her job.

Recommended Action

There is very little that can be recommended here. Green naturally wants to protect the tribe and the environment, but if there are no people who will help her -- including her own agency and the people that she is trying to protect -- there is not a lot that she can do. She can go ahead and try to get something done anyway, she can go ahead and report the tribal couple who are dumping on their land, and she can go ahead and keep arguing with the agency to try and enforce the laws. However, none of these things are going to endear her to the people of the tribe and none of them are likely going to accomplish much, either, so it could actually end up being worse for her than it otherwise would have been if she would have just left well enough alone.

To that end, Green will have to consider whether she wants to continue working for the agency she's affiliated with in the capacity that she's in now (i.e. On the Reservation). Not everyone is cut out to 'play politics,' and Green might not be happy in a place where she really cannot do anything to help the people there or the environment around them. Her choices come down to three things: fighting on anyway with the potential of trouble for her actions, giving up and just playing the game so she can keep her job, and leaving that Reservation and finding work elsewhere, either in a different capacity with that agency or somewhere else.

No matter what Green does she is likely going to be conflicted about it because she put her life into what she is doing now. However, if she is really that passionate about the environment and about issues like illegal dumping, it might be best if she decided to work for the agency or a similar one somewhere other than the Reservation where she could really do some good.

Questions

1. Sovereignty issues are delicate ones. They require tact and careful study because it essentially means that a group or area inside of another area has jurisdiction over their land. In the case of the Native Americans, they own the land that they live on and they can do whatever they want with it. The government of the state that they are in does not have much say in what they do or not do, but they have to keep whatever it is that they are doing within their own borders.

2. With the Crestfeather family, Green would be putting herself at risk and would be putting the neighbors who told on the family at risk as well. The situation came to be that way on the reservation because people allowed it to. They did not fight back and stand up for themselves because tribal culture is very clear about who is in charge and who is not. It would be better if Green left well enough alone. As a worker for a state agency she has little pull in the Reservation community and could not really do anything to help the family without potentially causing them more trouble.

3. The main ethical issue that Green is confronting is that she is charged with protecting the environment but she cannot do her job because the rules and regulations where she works will not allow her to. Because she is on the Reservation she is subject to their rules. In the future, sovereignty of these types of issues will have to be addressed before a state worker comes to work on the reservation.

4. I would feel ostracized and alone, and I would probably not take a job like the one that Green has, basically for those reasons.

5. In the Thomas case, there is little that can be done. He has refused to clean things up, and unless the tribe rallies behind Green to force him, he does not have to do anything.

Case Study #2 -- Managing Conflict Among a Hospital Staff

Analysis

This case is an all too common one of nice people who grow apart and who are put under too much pressure to continue to see things the way that they used to. It is not one that happens all the time, but it has been seen in hospitals and other high stress businesses more than one. The problem appears to be that the nurse and the doctor used to be friends, essentially, along with everything else that they were. Now, this is not the case. The demands of each of their jobs and the changing face of medical care at this point in history is making it difficult for them to work together and turning them against one another. It is sad to see for both of them and they are undoubtedly angry about it, but instead of sitting down to discuss it they end up lashing out at one another instead.

The doctor knows that he cannot be as effective as he once was, and the nurse no longer needs him to lead and guide her, so even the changing nature of their relationship on a personal level is important. On a professional level it is also significant because they used to have mutual respect for one another and now they are finding that they do not seem to work together well.

Findings

Managed care and the way that is has changed medical care in this country is one of the biggest culprits when looking for a scapegoat regarding why there are so many problems between these two people at this point in time. The doctor clearly no longer takes the nurse seriously, but that is something that is between them as people, not as doctor and nurse. The managed care issue and how their work has changed because of it is also between them now, and that is something that they could and should address on a professional level. It could help to diffuse an otherwise increasingly volatile situation that other staffers are beginning to witness, as well.

One area that is very significant to the nurse, however, is the way that the doctor does not stop the interns from being disrespectful. It is hard enough for doctors and nurses to really get along with one another without encouraging or ignoring the kind of behavior that actually drives them further apart. In other words, most doctors do appear to think that they are better than nurses because they have more skills and experience and can do more things, but it is really the nurses who care for the patients the most and provide them with much of what they need. That being the case, they deserve the respect of the doctors. If they were not there, the situation would be dire.

Because their relationship, both personal and professional, has changed so much, the doctor and the nurse both must be aware of the challenges that each other are facing. Their hands may be tied in some areas but that does not mean that they cannot keep communication lines open. If they are able to talk openly and honestly to one another there is a higher possibility for conflict resolution.

Recommended Action

For the doctor and the nurse to get along like they did in the past may not be possible, but they clearly need to get back to at least a good working relationship, and there are ways that they can do that. They both have to be willing, however, and it is difficult to tell at this point of either one or both of them are willing to do what it takes to re-strengthen their relationship. In the interest of a good working environment it would be best if they would both agree to sit down and talk, perhaps with a mediator like someone from human resources or another neutral party. It is very important that person not be another doctor or another nurse, because it could appear too much as though that person is taking sides.

When people take sides they just end up hurting both parties to the discussion. The person who is 'on their side' does not seem as serious and will not be listened to because there is too much distrust. The other person feels as though he or she is being ganged up on, and that makes honestly listening to what is said very difficult. Someone from human resources is neutral and can mediate between the two sides without taking one over the others. It is very important to have a good working environment, especially in an area where patients can become very agitated and problematic, so working this problem out would be in the best interest of all of the people involved and affected by it in some way.

One or both parties will not always be so agreeable to try to talk things out, however, and if that is the case there might be little that can actually be done to diffuse the situation and makes things alright between the two again. At that point all that could really be done would be to try to schedule them where they did not work directly with one another to avoid conflict in front of other staffers and in front of patients.

Questions

1. When issues like managed care show up they change the dynamics of both professional and personal relationships, and human resources has a duty to make the transition as easy as possible. Managed care at this hospital made things more difficult because there was a lot more paperwork and patients could only be stabilized, not actually treated. Patients should always be able to be treated, so this created an ethical dilemma, as well. Since nurses are so focused on helping patients, this caused a big problem between nurses and doctors at the hospital. Human resources departments need to be more focused on how the people actually feel about these changes so that problems can be lessened.

2. The changes in the relationship between doctor and nurse also came about because the nurse no longer needed a mentor. Because they were so close in the past, it was much more difficult for them to be more distant, and that made them conflicted internally. This spilled out into fights and other problems.

3. The nurse should be been more respectful and not demanded help. The doctor should have been willing to come to her aid and realized that she was not over-exaggerating the situation. In the future, written policy for chain of command and emergency patient aggression diffusal situations should be created.

4. Professional relationship are just that -- professional. Fraternization and joking and those things should be left for outside the hospital or avoided all together. This should be written policy, and respect for ALL people on the staff should be mandatory. How the situations will be handled should also be in writing, read and signed by every employee. The hospital should be a team, with no one being treated as 'less than' to anyone else.

5. In general, human resources should leave people to work out their own problems. Most places do this. When those problems start to spill over into patient care, however, administration must step in and do something about the issue before it becomes more of a problem for patients and for other members of the staff.

Case Study #3 -- Sexual Harassment: Innocent Initiation or Hostile Work Environment

Analysis

In this particular case, what is happening to Keenan is very important, but she has not been documenting it, and that could be a problem. If she cannot prove that she has been a victim she will find that she has a hard time establishing any case. While the harassment is very unwelcome, it is not all that surprising given the nature of her job and the way that she obtained it. In other words, she is the first female in an all-male department and she is breaking through barriers and stereotypes. People who do those things are quite often the subject of harassment and/or persecution because they are not staying within the roles that society thinks that they should have.

With a part of the country that is mostly not interested in changing, there is a 'place' for women, and it is subservient to men. This may not be right or fair, but it is the way it is. With that being the case, Keenan will have trouble trying to keep her job or advance in that department because there will be men who will try to hold her back. They may know about the policies that say this is illegal, but they assume that they can get away with it and that no one is really taking any of it too seriously.

Findings

For this case, the main finding is that sexual harassment does appear to be taking place under the guise of a hostile work environment. Not everyone sees this kind of thing as hostile, but for a woman working in a man's world it is not surprising that she would be offended by it. If she is uncomfortable she should speak up, but it is very difficult to do that when you are the new person and in a serious minority. It puts extra pressure on that person to just go along with whatever is taking place. Unfortunately, this kind of behavior will escalate if a person does nothing about it and the harassment will only get worse.

Women do not want this, and there have been cases of men being harassed, too, although it is not as common and can be harder to prove. The assumption (incorrectly in many cases) is that men like this kind of attention and women do not, so it must be harassment when it happens to women and not to men. With Keenan, however, this harassment has been going on for some time and she has been putting up with it. This could make it more difficult to prove that she was actually offended by it. Speaking up clearly about it the first time and every time is really what a person needs to do if he or she wants to make sure that harassment is documented. The date, time, and what took place should also be recorded in a journal.