that step occurs that appears to have caused the error. It probably isn’t only that I failed
to read the book that caused the mistake, but maybe that I was in a rush because the boss had innocently asked how much longer it would be taking me and I had planned to leave a half hour early today. Often we have our scheduled maintenance timeline laid out to perfection when something unscheduled pops up, requiring a reshuffl e of our priorities. The pressure to fi nd some wiggle room can result in one or the other being slighted. This can be especially diffi cult when the unscheduled issue requires large amounts of resources (which might or might not be immediately available) to investigate and correct.
Here is a George Carlin quotation
I like: “When someone is impatient and says, ‘I haven’t got all day,’ I always wonder, how can that be? How can you not have all day?” We spend a lot of time in human
factors training discussing what causes maintenance errors. Examples are things like being in a rush, complacency, fatigue, failure to use written documentation, lack of communication, normalization of bad procedures, distractions, etc. Thanks to Gordon DuPont and Transport Canada, we have the “Dirty Dozen.” If you train people to recognize these and teach how to avoid becoming prey to them, it should reduce errors made. The diffi culty is in seeing the opportunities for error coming and knowing that for every Dirty Dozen
factor, there are deeper causes that we do not often address. This is because root causes are usually buried in human nature. You can’t just put up a “Dirty Dozen” poster and think, “OK, all we have to do is NOT fall prey to any of these things” and expect that to happen. Knowing that you feel like you are being rushed doesn’t in any way off er relief from feeling that way. It’s one thing to talk about not working through fatigue but quite another for a supervisor to say, “We’re all tired — let’s go home early and come in late tomorrow because we’ve worked 10 hours a day for the last three days,” or for you to say, “Sorry boss, I’ve been here for eight hours and am too tired to get in the truck and fi x a broken machine in the fi eld.” Even if we did do these
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