Some of my favorite insight on the topic comes from a post by John Allspaw. In the post, he states that in order to learn from a mistake without inhibition, there must be not only complete trust but also no fear of retribution. I take this view to heart and I'm a devoted defender of the concept.
However, I feel like the view comes with a few provisos. There is possibly a greater philosophy at play in the question. What really got me thinking about this was one of the stories I heard at the conference. The story was about a site outage caused by a technician on the customer support team running a tool written by the dev team, which was known to have a very high risk of causing site outages. The technician had been trained in how to use the tool and, according to the story teller, knew full well the consequences of his actions. So, for the company it was a straightforward decision to fire him. ...Or was it?
If you read about human error, you learn that situations within a system and organization can foster human errors. This is often the first explanation of a failure induced by a human. In our investigation here, it's difficult to imagine any resident situation in the system or org which would have fostered a technician to *knowingly* induce an adverse outage of the application he was paid to support. So, that lead me next to consider that perhaps the technician felt running the script would have no connection to an outage. But again, having been fully trained in the consequence of the script, this felt unlikely. Perhaps a final explanation might be that the technician felt the risk of outage justified the outcome of running the tool. Maybe; but from the storyline, it didn't seem like that was a likely decision.
So, were the theories about human error just somehow inapplicable to this situation?
That's when I realized something about each of the questions. I realized that they were posited on the assumption that the technician was qualified for and satisfied with his job. I realized that if the technician didn't care about his job or hated his boss, then all of my thinking was flawed. All the explanations are based on the belief that the technician wants what is best for the company. If he had no thought for the success of the company, then it would make easy sense for him to take the shortest path to accomplishing an immediate goal despite negative side effects. So, rethinking the first question -- could an organizational, non-technical situation foster human errors? Yes, I believe so. A non-technical situation could certainly foster feelings of dissatisfaction or frustration resulting in a technician who didn't care about the outcome of running a tool that would solve his immediate problem, but potentially cause a site outage.
Excellent! So, the key to success is maintaining an inspired work force, right? Partly, yes; but not exactly.
For the Workforce
If the company is fostering a disgruntled workplace, then the solution is straightforward: keep them happy and inspired. But, what if your employees are happy? How could the tech's actions be explained?
The next idea that occurred to me was perhaps it wasn't the organizational situation at all, but actually the employee himself. What if the employee was generally just a disgruntled or careless person? DevOps and other strong cultures are built upon trust, but that trust needs to be built on the prerequisite that you hire the right people. If poor hiring choices are made, the whole ecosystem breaks down.
A Different Type of Outage
As it turns out, although hiring the right people is such an important task to do well, it's often underdone and rushed. And why? For the exact same reasons we end up with technical debt: urgency. If we've learned anything from technical debt, we know that we create it to solve an immediate problem, but that solution leaves us in a much worse long term situation. If we know this is true, then maybe we should treat firing an employee the same way we treat a site outage. Specifically, we should postmortem all the steps that lead up to hiring: the phone screen, the recruiter's notes, the interviews, the round-up, the closing. I think that if firing were treated as a much costlier action, then perhaps hiring would be conducted with a much higher bar. Ultimately, in the case of the fired technician, perhaps the fault lays more with the hiring manager for putting the tech in the situation to use the tool at all.
So, to bring it back to the original question: would you ever fire anyone who caused an outage? My answer is a lot more complicated now. I will continue to apply the concepts of human error and would never fire an employee only because of an outage. Would I fire an employee who consistently underperforms, is habitually unhappy and careless, costs more than he or she produces, continues to fail at personal performance improvement plans, and is uninterested in other roles within the company? Very possibly. Whatever the case, if an engineer is fired for any reason, I want to postmortem how we came to the situation, starting with the initial phone screen in the hiring process.
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