Comment by snowwrestler | Hacker News Reader

Comment by snowwrestler | Hacker News Reader

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Hospitals and contractors are great examples of professional fields where job roles are well-defined and the hours worked are carefully tracked. When contractors get too busy, they tell clients their project is delayed. When ER or ICU resources are maxed out, they stop accepting patients and send them to other nearby hospitals. When clinics are fully booked, they stop making appointments.

I understand what you’re saying about a problem solving mindset, but that is not the issue in burnout. The issue is unrealistic volumes and deadlines that encroach too far into the rest of your life.

Personal boundaries exist in medicine, in fact they are essential to surviving a career in medicine. There will always be more sick, injured, and dying people. The hospital has the mission to save them all if it can. An individual doctor or nurse has to understand that they personally cannot. Or they will burn out very fast.

Overworked tech companies could benefit from some perspective from the medical field. Is someone going to die if your feature misses its ship date? Probably not. People die in ERs every day, but guess what: ER staff still work a fixed set of hours, take vacations, etc.

Contractors is overly broad but plenty of contractors work overtime and very long, stressful hours including weekends and holidays.

Hospitals on the other hand, you're just downright wrong about that. Not only in general do hospital staff work 12 hour shifts including being on-call and having to work abrupt hours, especially over the past year their hours have been absolutely ridiculous. This includes nurses and MDs.

Feel free to review some studies on this issue, it's not hard to find nor is it some kind of secret. Basic Google search pops this up within the first few results:

https://www.researchgate.net/publication/200130302_The_Worki...

That study shows that in fact, nurses work their regularly scheduled shift less than 50% of the time, and 81% of their shifts involve overtime even though only 7% of it is scheduled in advance.

Here is a study looking at work hours among surgeons and physicians:

https://forums.ucdavis.edu/local_resources/docs/Freischlag-S...

It paints a very different picture from the idea that medical staff work very strict and well regulated hours. Their working hours are very chaotic and extreme.

I don’t need studies, I have a number of friends and family who are doctors and nurses.

You completely missed my point, which is that it is ridiculous for tech companies to compare themselves to a profession that faces literally life and death situations. Comparing to “the past year” (i.e. a historic global pandemic) just highlights the absurdity.

Your OKRs are not COVID patients!

My ancedote, and general data, agrees with the other person that your ancedote is wrong and healthcare is one of the most abusive environments in terms of nursing staff levels, hours, and quality of care. It's like you live in a different world.

Healthcare was easily the most toxic environment I ever worked in as well. The CTO literally was happy to quote that he treated it like a sweatshop because thats how you got the most value out of your human resources.

We literally had contractors fall asleep at the wheel and die driving between sites during marathon crunches where people got written up for leaving to eat / sleep.

My wife is a nurse at a huge national hospital. You're very wrong. 12 hours shifts turn into 13-14 hour shifts. They're so short staffed right now they're offering double pay + cash lump sums that equate it to triple/quadruple pay. But they pay lower than clinics and other hospitals in the area. They don't turn away patients.

You’re not reading what I’m writing. The fact that you know how long your wife’s shift is supposed to be is my point. The fact that nurses are being paid extra money for extra time is my point.

Engineers in Silicon Valley don’t clock in for a 12 hour shift. They are put on salary and any discussion of schedule is discouraged in favor of talking about “hustle” and “team players.”[1]

My point is not “health care workers don’t work hard.” My point is that they are set up with schedules and structure, which tech companies avoid… and then try to point at health care workers or “contractors” to justify the chaos.

Also I bet your wife is not working so hard just so the hospital can meet its financial goals. If she is like most nurses she is motivated by patient care and probably hates the administration, who are usually seen as bean counters who (if anything) impede care. Again, compare to tech companies who build myths around founders and corporate missions to obscure the purely financial stakes of their work.

[1] I know that not all companies operate this way, not all managers do this, not all engineers experience this. But there is obviously some sort of shared experience among a lot of people that the blog post at the top of the main thread is tapping into.

My wife's schedule is 12 hours: 7 to 7. Except nine out of ten times she's there until 8 or 9. It's "scheduled" but much closer to BAT times then sun revolution times. Any talk of schedule is discouraged and nurses are fired very quickly if they don't become "team players". Engineers in the valley have a lot more leeway because hiring is a lot harder. I can actively push back against my managers. My wife would be fired on the spot.

You're making numerous points and your later ones are good ones. But the working conditions for front line workers, including but not limited to their scheduling, hours, pay, etc, are all terrible.

>tech companies to compare themselves to a profession that faces literally life and death situations

I think you have a narrowly defined scope of “tech”. What about the software that controls the Da Vinci robot in the operating room? Do you want someone to say “eh, code quality checks aren’t my job?” Or the person writing flight software for aircraft? Or the safety critical software for a power plant?

The point being, yes, perspective is important but it’s a difference of degree not of kind.

The point being you aren't changing the code of a robot while it's being used.

There’s a time delay that separates these things. That completely changes your approach.

Fair enough on the Da Vinci robot because it's a turn-key product. But I can tell you that people change production code on the fly in safety-critical applications (particularly in the industrial controls space) much more often than many people would be comfortable with.

A better healthcare example may have been, would you be comfortable with people changing the building automation software that controls operating room air exchange rates or oxygen delivery systems?

But again, this isn’t really about software devs so it should extend beyond just SWE roles. It’s about positional duties, regardless if you write code or deliver meds to patients.

All of these systems run into schedule and cost pressures that often causes people to feel overburdened. I don't actually think they are fundamentally different.

There might be difference between healthcare systems in different parts of world.

> Not only in general do hospital staff work 12 hour shifts including being on-call and having to work abrupt hours

Not in EU countries that do not allow the medical profession to opt out of the Working Time Directive.

See"Are the opt-outs related to long hours?" in https://www.europarl.europa.eu/meetdocs/2014_2019/documents/...

Having personally worked in both healthcare and construction (sometimes even healthcare construction), I disagree.

Roles are not nearly as defined as you suggest. Take construction: there will always be conflicts between sub-domains. If there’s a clash between disciplines there’s nothing more frustrating than two sub-contractors who point to each other as the one who must “own” the problem to fix it. Same thing in healthcare. A surgeon who won’t do a task because they believe it’s beneath them is not benefiting the patient.

I don’t think most missions are capable of having clearly defined roles like you suggest. There will always be jobs that fall in the gray area and that’s why almost every job I’ve had included a “and other duties as assigned.”

I agree that perspective is important, but that’s talking about prioritization not shirking duties. I also understand burn out is a real risk, but I don’t think the right mitigation is taking a "that's not my job" perspective; I'd much rather see someone work with their supervisor to say, "here's where that falls in my current priorities". "It's not my job" tends to results in un-productive finger pointing or venting as opposed to actually aligning one's work with what's important to the shared mission.

I want to work with problem solvers not people who identify with strictly defined roles.

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