update: I resist pressure to work long hours — but my coworkers don’t

It’s a special “where are you now?” season at Ask a Manager, where all month I’m running updates from people who had their letters here answered in the past.

Remember the letter-writer who resisted pressure to work long hours — but their coworkers didn’t? Here’s the update.

When I submitted my question to Ask a Manager, it was the beginning of 2020. A lot has happened both in my workplace and the state of the world.

Looking back I was clearly asking for a bandaid solution for a secondary issue to my main problem. The majority of my time at my current position we have been understaffed. All of my coworkers including myself feel this is due to toxic management.

As some guessed during the initial post I work in healthcare, specifically medical admin work. I acknowledge there are systemic issues within the field as your workload does directly impact patients wellbeing, making healthy work/life boundaries difficult.

However in my department, it’s clear now that’s only part of the issue. I have tried writing this part multiple times, but I can’t communicate how awful it’s been to see COVID decimate my work life. All departments in my field are having staffing issues (COVID). Since our management has chased away all the casual staff they hired at the start of the pandemic, we are once again expected to keep ourselves afloat. All of our time sensitive workloads are heavily behind, work days are about managing the most urgent fires. Every piece of work is done late if it at all.

Unfortunately, obviously with this work climate my co-workers continue to not take their breaks. I do, as was encouraged in the comments to support my team verbally, and celebrate any of their small victories. I have picked up some shifts in other areas that take breaks though!

I would argue the straw that broke the camel’s back for me happened closer to the start of the pandemic. We had to scramble to cancel everything for an undetermined time. Then they asked us to restart booking from scratch but only week by week, not allowing us to prep future dates. I am part time and independently manage schedules on top of all my other work. I knew from the start I could not manage this change in workload and begged for help. Instead I was put under the microscope for weeks. It ended with a meeting with my manager where they said they couldn’t understand why I was so upset and crying (after weeks of criticizing my work, saying it was my fault I couldn’t keep up with the newly ‘changed’ workload) and they asked me if I was so upset not because of work but instead because a close family member of mine had passed a month ago. Frankly I was livid that this was said to me, but I didn’t pick a fight, I’ve moved past it determined to leave the job.

Months later, my coworkers’ workloads are worse than mine now. Management has been implementing new changes to our processes since then, causing extra work for us while we struggle daily. Our pleas continue to fall on deaf ears.

I have been more bold, being honest to my team since then and I haven’t regretted it. I was upfront with my Physicians/NPs/RNs this summer that I was applying for work elsewhere. I guess I shouldn’t be surprised as management had already told me they receive an unprecedented amount of positive feedback (previous to COVID), about how well I do my job from both staff + patients… but boy have my doctors/nurses/fellow admins made my management uneasy. They’ve sent management emails with glowing feedback about me, requesting for me to be made full time. My coworkers regularly make my management uncomfortable, asking them why they can’t make me full-time in meetings when the topic of our under-staffed department arises. It’s more attention than I want, but has been so uplifting to hear.

I requested to not be put on my department’s schedule as a casual anymore, which they obviously didn’t take well (they did try to interrogate me about why). They don’t know it but I recently applied for full-time work in one of those other departments I mentioned before (that actually take their lunches!). Most of the admins (all much more senior then me) on my team have independently confessed to me they have or are planning on exit strategies out of our workplace in the next year. COVID has really just put a big spotlight on previous issues.

Long term I’m not as sure about, I am mostly hoping that leaving the toxic environment will help a lot. But as I write this cases are spiking here. COVID for me at least has a huge negative impact on my job in every aspect, and that isn’t going away soon. On top of this where I live they have decided to lay off thousands of healthcare support staff in the middle of the pandemic. Facing likely mass layoffs and private sector rehiring with a wage decrease in the next few years for myself, I am researching career alternatives (payroll/time clerk business admin? Suggestions appreciated from your readers!) as I’ve already seen the stress negatively impact my physical and mental health.

Thanks to all who commented, please stay safe.

{ 62 comments… read them below }

  1. Harvey 6'3.5"*

    Best of luck in your job search. The time management aspect of your job would probably mesh well with a law firm docketing clerk (and perhaps Admin staff) who need to make sure papers are filed on time. So long as you avoid Biglaw, you can make sure the firm has reasonable hours.

    1. Shad*

      In addition, any experience you have with the medical knowledge will be both useful and valuable in a personal injury or workers compensation firm, though more relevant at a paralegal level. In smaller firms, there can definitely be a lot of overlap, with paralegals handling some of that time management, and there’s a low formal education barrier to that particular career change.

    2. OP*

      Thank you for suggesting that!! OP here, legal was a field I looked at before settling on medical admin… I think it just intimidated me at the time. Sounds like I should do some research on it. I really do love the time sensitive juggling many tasks type of work, or tbh even regular busy positions.

  2. not that kind of Doctor*

    I don’t know if it’s true where you are, but in my area it’s very hard now to find even entry level people in accounting and HR. These are jobs that start with basic data entry but have tons of room for growth. I’m recommending everybody try it. :)

    1. lailaaaaah*

      Seconding this! Entry level HR/internal recruitment was my first office-y role, and your skills sound right up their alley.

    2. OP*

      I’m happy to hear that! I’m wondering if you would know if most accounting departments expect a certain level of education? I had looked into them here in our medical field but my employer requires lengthy education. (3 or 4 year program here)

  3. Purely Allegorical*

    Oh my gosh I’m so sorry to read this. Hugs from afar. As I was reading, I kept thinking over and over that you sound ripe for a career change. Depending on what your healthcare role is, I think a lot of those skills could be transferrable to other industries.

    1. OP*

      Thank you! I had definitely hit my my burnt out point by the time I had written the response. I’m doing better now but feeling pretty confident about the decision to pivot out of the field now. I had thought I could transfer my skills but kinda been putting myself on the backburner to get through Covid work-life day by day. So super thankful to see so many suggestions!

  4. Keymaster of Gozer*

    I know it’s not the same, but part of the reason I changed careers from virologist to IT tech/manager was the workload is generally (there are always outliers) less ‘you must give all your hours to this job’ when people’s health and lives are not on the line.

    I’d spent a long time with keeping various lab software and computers running so it was kinda a sideways move.

    (Other reasons were becoming disabled because you can’t make a viral research lab disabled accessible to all, and a few others).

    1. OP*

      Thank you Keymaster! I agree it’s so weird to see with all the mental health and self care campaigns in media past few years… But getting into the field there’s almost a hostility to self care, that it’s can be seen as selfish to put yourself first. I disagree, if you don’t look after yourself you will not last to look after others.

      I am glad to hear you were able to pivot yours and hope you are feeling better now too.

  5. Not your average Jo(lene)*

    If the writer works in healthcare, just know that there are other options. Amazon is hiring for their disability and leave departments under HR. Just a thought if you want to switch. I think there are more options out there than you realize!!!! Good luck!!!

    1. JillianNicola*

      Would not work for Amazon even if starving and on fire, but yes – there’s lots of lateral type options out there for your skillset! The finance world – specifically financial advisory or health/disability insurance might be a good one to look into as well.

      1. Krabby*

        Yeah, having just interviewed someone who currently works there in HR for an HR position at my company… Not in a million billion years would I apply to Amazon.

    2. ThisIsTheHill*

      One place to look is health insurance companies. They’re always looking for people with familiarity w/ general medical terminology. Entry level claims positions, admin jobs, even customer service to get a foot in the door. In my experience, if you’re motivated & willing to learn you can move up within the company once you find your niche.

      1. Jack Straw*

        Absolutely this. My SIL was an ER Nurse and is now loving life working as a supervisor for a team of phone nurses. She spent a year on the phones and was moved into management at almost exactly her year anniversary. Even in the entry level customer service positions–a healthcare background is a HUGE help and all but guarantees a move to another department in a year.

        1. Charlotte Lucas*

          I second this. Also, government healthcare agencies hire a lot of nurses & medical professionals.

          1. Where the Orchestra?*

            Agreed strongly with this: USA Jobs as a search (can’t remember the actual web address), and the VA/VISN are both really actively hiring for medical support people.

      2. Lyudie*

        My company makes software for healthcare and we have a number of former nurses and doctors at all levels of the company. They are tremendously helpful in guiding development to suit different types of healthcare settings and understanding the regulations and workflows.

      3. OP*

        Hi Hill! Thank you for your suggestion, are there a lot of variety of opportunities with insurance?

        I do think it’s a good idea career wise. My concern having dealt with many a heartless insurance companies though… I know I could never live with myself if I had to be a case manager, the stories I wish I could tell about some of the medical letters I’ve had to transcribe/write that was addressed to them oh boy.

        1. ThisIsTheHill*

          Background: I had zero medical experience when I was hired in to help the COO manage meetings & operational reports across the 14 states she was in charge of. She saw that I was detail-oriented & good with data, so when a job in contracting opened up, she moved me to that dept. I’ve since worked for a few large cos. in the provider areas, doing audits & data analysis.

          I will say, my co-workers have almost exclusively been dedicated to doing what is right by our members or providers. That doesn’t always translate to business decisions made by those in the C-suite, so you will need to have a thick skin when people bash your employer daily.

          Off the top of my head, you could easily slide into provider relations (the folks that are assigned to specific docs as intermediaries w/ the co.), claims, provider operations (internal workers that keep networks up & running), any admin job, project consultant (loose term used for “not a PM but someone that can work independently on projects”), or even a lower-level supervisor job since your letter indicates you have a coordination skillset. As for case management, you could be the exception to the rule – though as I said earlier, the people I’ve worked with have hated the policies that they need to enforce.

          Good luck!

    3. CircleBack*

      Even Amazon’s corporate offices have high turnover, from what I’ve heard. I’d avoid them specifically, but there are lots of companies who would use your skills for HR-related positions!

  6. JillianNicola*

    God it hurts my heart to hear how we’ve failed our medical community this past year and a half. I hope you find something that is better, and that you’re able to move on from this whole mess. Best of luck to you and your team!

    1. Momma Bear*

      Agreed. There is a breaking point for everyone and these managers are going to find out sooner rather than later what that is, to the detriment of their patients. But that’s what happens when people (on both sides) are just a number.

      1. OP*

        I think this is the hard part is that all of us on ground floor can see the impact it’s making. But those who can actually change this (increase budgets, hire more staff, implement policy changes etc.) Don’t care that were all humans they just see numbers, and that the staff are ‘making it work’.

    2. Jules the 3rd*

      This. And it’s at all levels – I’m close friends with a nurse on a COVID ward, and ‘understaffed’ is the norm. My deepest sympathy OP.

      1. Ali + Nino*

        Re: understaffing being the norm – this is why you see US healthcare facilities/providers hiring or keeping on low-quality staff out of desperation just to have somebody, anybody, there. We all lose out, especially patients. And the problem is only getting worse, with no solutions in sight. /rant over

        1. OP*

          Preaching to the choir, this will probably make it seem worse too but I’m actually working in Canada too, it’s 100% impacting quality and timelyness of patient care. And I’d love to say we will see it get better but don’t know I can… I hear whispers about long haulers + long wait lists (lots doubled or more during Covid) might continue to stress our system.

    3. OP*

      Thanks Jillian, means a lot to hear. I worry about our medical field too. I see a lot of any who can leave, leaving for almost a year now, it makes me worried about the quality of care, and growing wait times to see specialists I and many others I love will receive in the future.

      I’m confident I can improve my career I know I will be leaving many behind who will still have to deal with this, I worry about them too.

  7. PT*

    These letters from the healthcare sector make me deeply upset. We need our healthcare workers to be properly staffed, properly rested, properly respected, properly paid, and properly supported, so they can provide patients with the care we need.

    What is going to happen when they all (quite understandably, I might add!) leave for better fields? It won’t be good for the rest of us. All of us need healthcare at one point or another.

      1. BubbleTea*

        We are having the same issue in the UK and theoretically no one is making a profit from the NHS.

        1. TardyTardis*

          Well, when one of your parties is heavily invested in cutting the NHS budget in hopes to ram an American style health industry in (per The Economist)…you do have my sympathy.

    1. Dezzi*

      We’re going to find out very, very soon. Nurses, especially ICU/critical care nurses, are fleeing hospitals in droves. Something about how we’ve spent this entire pandemic working them nearly to death in unsafe conditions, and even now hospitals are refusing to pay for enough staff to maintain safe patient loads?

      I really wish all the money places spent on billboards/TV ads/banners calling their employees “heroes” had been put towards supporting those staff instead.

      1. Dezzi*

        We’ve been calling healthcare workers (and all the support staff who actually keep the hospitals running) heroes while treating them as disposable. We’re going to find out very quickly how big a mistake that was.

  8. samecoin*

    as a health care admin, you got this. i feel you on so many levels. don’t let the you know what’s get you down. which it sounds like you don’t!

  9. Esmeralda*

    Thank you for all you and your coworkers do, for caring more about the patients than your management does.

    Good luck with your job search!

  10. I'm just here for the cats*

    Suggestion: are there any local colleges or universities near you. I work at a state university and we have a counseling center and student health center. With your medical background you would probably be a good fit,.either with similar work that you do now or as office staff.

    Also look for other health adjunct related fields. For example a friend of mine workee as data entry for a company that helps Veterans and active military members get services. She then was promoted to other areas, like scheduling. She had some experience in health so she had and so that really helped her.

    Good luck

  11. Machiamellie*

    Just a note that I work in payroll and my company is hiring remote. I’m happy to share info with the OP if needed.

  12. Thin Mints didn't make me thin*

    What about advertising/marketing/PR? Agencies need people to manage schedules and handle admin tasks, and the folks who are great at graphic design and branding are often not good at administration.

  13. Bookworm*

    Thank you for your work and I’m SO sorry that has been your experience.

    Do hope things improve for you very very soon.

  14. Mattieflap*

    I also work in healthcare (but not with patients). I recently switched jobs and I swear this letter could have been written about my former workplace. The callousness of management described here is very familiar to me.

    LW, I hope you find just the right place to land. It’s amazing that so many of your coworkers see your value. Use those references for everything you can! Good luck!

    1. Anon4This*

      I feel the same about this could have been written about my workplace. I’m in healthcare on the admin/support side and it was a nightmare even before COVID and just keeps getting worse. 6 figure bonuses paid to retain doctors, executives with 8 figure salaries, but IT, HR, Admins, and every other support department is going through round after round of downsizing. Our IT department in particular has been stripped bare, with many teams going from 5-10 people down to 1-2. Those who aren’t laid off end up leaving for other jobs because of the stress. When the entire EMR (electronic record management system) is supported by 1 guy, what happens when he gets hit by a bus on the way to work? Or just quits because of burnout from working 100 hour weeks? How are we supposed to provide excellent patient care if the infrastructure fails? It’s frustrating, demoralizing, and exhausting.

      LW I also hope you find a great new role and wish you the best of luck.

  15. Introverted Type-A Employee*

    OP – I feel you, and I think you’re right to get out and never look back. I worked in healthcare administration for over 25 years before I finally bailed due to burnout and poor management (13 years at my last job as a Practice Manager of an outpatient clinic). I was working at all hours, getting texts and calls from 5a to 11p to fix problems, and more.

    I found that my experience with attention to detail and problem-solving transferred nicely into HR and Finance. I am now the office manager at my very first non-healthcare job and it’s been AMAZING. I run payroll, do our books, manage the staff, and here’s the kicker of working outside of healthcare – OUR OFFICE CLOSES! We work our shift, put the CLOSED sign up at 5p, and GO HOME! There are no real emergencies. Things can wait until tomorrow. I had no idea how much stress I was under with the constant pressure, tons of hours, and the stress of knowing that me being behind in paperwork meant I was impacting a patient’s well-being. If I don’t submit XYZ forms to the insurance by D time tomorrow, this will be denied and they won’t get care. Try sleeping while stressing about how to do that for 25 people when you only have time for five. Ugh. Yeah – RUN! Good luck!

    1. Lana Kane*

      Practice Manager is the next logical step up for me, and I am fighting it with every ounce of my being. It’s a thankless job.

  16. GuineverePettigrew*

    Because of the use of “casual” (as in casual contract) to describe OP’s employment, I think this is UK, so the NHS. Terrifying.
    OP, I’m so sorry for your situation and hope you find something better really soon.

    1. Properlike*

      That *is* frightening. That’s the system that’s supposed to work better than our insurance-controlled health industry here. (Can you tell that I’ve spent the week doing battle with my insurance carrier?)

  17. Lana Kane*

    As a healthcare operations employee, I hear you. What we’ve been put through since COVID started has just highlighted how much profit is valued, over employees and patients. At this point I feel the exhaustion in my bones.

    Best of luck transferring to that better-run department! I try very hard to draw a very hard line regarding quality of life in our department, and it’s helped enormously with recruiting and retention. Sometimes it’s just a matter of finding that little corner of the larger system with competent managers.

  18. Manana*

    Happily quit my healthcare admin job a couple years ago and am so glad I got out before COVID as I know my old employer would have risked the safety of all the workers while managers work from home. Healthcare orgs are a racket: “nonprofit” status while the CEO makes millions and they union-bust their under paid and under supported clinical and ancillary staff.

    1. Anastasia Beaverhousen*

      YES! I worked for a non-profit meanwhile administration wanted me as a social worker to harass my patients to pay their bills if they were delinquent. No ethics, no humanity, nothing. We are all just dollars and cents to administration in the medical field. One thing that does make me smile is that I am closely tied with the legal community that works with this facility and the court system is noticing how awful they are operating and “if they want to act like a for profit organization we are going to treat them like a for profit organization” so I think that all the sketchy legal moves they try to make are going to get them into trouble.

  19. Peter Piper Picked a Peck of Pickled Peppers*

    OP, with your background you could consider moving into UX, specifically for healthcare. I’m not sure what the job market is like, but if if you’d be interested in applying your experience and knowledge to designing services for healthcare workers and patients, it might be a good fit for you.

    Search for “UX healthcare” if you want to know more, or I can put you in touch with a former doctor who made this career change and does training and career coaching.

  20. Anastasia Beaverhousen*

    I understand your pain, I worked as a medical SW and was on a COVID unit. Administration was awful. No support, nothing was ever good enough, getting screamed at. The medical system is broken from the inside and administration eat their staff alive (the bottom dollar is all that matters). I am thankfully out of that job and in one that values people and actually tells me I am good at my job. It is scary to leave but take the leap, you will be SO much happier. The thought of having to go back to work at that old job for any reason makes me feel nautious.

  21. Seeking Second Childhood*

    Maybe look into regulatory & compliance. It would use your medical background but take you out of the patient care world.

  22. Petty Editor*

    Look at moving from provider side up to payer (insurance) – I know my employer is always interested in hiring that way, they value the expertise from people with provider side backgrounds. Benefits and pay are usually better too.

  23. Editor*

    One of my family members works in payroll in the U.S. as a salaried employee. Even the most recent job, working for a former co-worker, has turned from reasonable hours to unreasonable as the company expanded, adding more states it did business in and other North American payrolls. All of these employers have had a blind spot about increasing payroll staffing, as though handling payroll on a computer system does not increase the workload as workers are added.

    In all cases, payroll has been situated in HR, and somewhere up the chain has been an absolute wimp. Even when, at one place, the payroll staff showed payroll could not be processed without an extra 80 to 100 hours from the 3 salaried staffers and the half-time hourly data entry worker, the head of HR did no more than hand-wringing. If the company you are interviewing with talks a lot about the rosy, expanded future it is looking at, ask a lot of questions, because it is better to have a job where the workload does not spiral out of control.

  24. Anon for this*

    Interesting to me that OP is part-time, which wasn’t noted in the original letter. I think it’s much, much easier to enforce boundaries on working extended hours when you were literally hired to not even work full-time hours!
    (not that part-timers don’t work hard! It’s just quite literally in the definition of the hours of the job!)
    (and sorry your place of work sounds so hellish OP, I hope you get out soon!)

  25. andrea ogden*

    I would also look at medical associations for jobs. There is a wide range of clinical and non-clinical backgrounds needed and appreciated, and the salary tends to be higher than other non-profits. There are tons of medical specialties and adjacent fields that have associations that do every kind of conceivable project and deliverable their constituents might need.

  26. An Orb*

    The letter and the followup were both so funny to me, I could have easily written them a couple years ago before I left healthcare. Everyone was always playing the busy game and management 100% expected it even when it was completely unnecessary, and I got treated like some kind of underbridge goblin for not being willing to play ball. When I left they had to hire two people to replace me, but they preferred that to just not being a bunch of dicks I guess.

    1. OP*

      OP here! Just saw this email notifications before bed. Wanted to comment it sounds like we are mirrors Orb!! I have joked with coworkers it will take them 2 to replace me, but to be honest I was never joking. Added bonus majority of the training has fallen to me too since Covid sooooo glad I won’t be working there when that all falls apart.

  27. Aquawoman*

    Major kudos for fighting the good fight. We need more people like LW who are willing to stick their necks out.

  28. LukeChester*

    I am genuinely outraged when I hear about overtime work from people in different professional fields. We all face unpredictable situations, but usually, overtime work is the result of a certain “corporate culture”. Employers want to save more money and don’t want to hire more employees to make their work process faster and comfortable. And people somehow accept it and work by day and by night… It’s excellent when someone breaks this system and starts looking for something better.

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