> 3. IT systems that they have to use were designed by people who have not talked with the workers who use them. They may have been designed with laws and compliance in mind. Nurses aren't the people who choose or pay for these systems. But, they use them a lot (maybe the most) and it's obvious they weren't taken into account when designing the UX. It's maddening for them.

Working in Healthcare IT I can only concur on this point.

For me there's multiple reasons behind this issue :

1. Regulations. First and foremost, IT is here to help/force users in complying to those regulations. So it's the first thing that dictates how you'll develop the piece of software.
Those regulations are mostly written by people that aren't Healthcare professionals nor IT professionals. They are regulations people. So they can't produce something that makes sense for Healthcare people and is even harder to _solve_ for IT people.
And those regulations are updated quite frequently, most often creating breaking changes. So if you want to keep up (and you have to if you don't want people ending in jail) you must work fast, meaning skipping important steps to produce something user oriented.

2. There isn't much money. At least on my side of the Atlantic. This is not necessarily a huge problem because contrary to people at FAANG-like companies, here most people are focused on helping people to help other people, not on their paycheck. But there's so much middle-men taking their cut that in the end, you only worked understaffed with unrealistic schedules. Meaning the only way to deliver something is to take big shortcuts. And again, leaving UX/UI on the side of the road to reach the main goal : being compliant with regulations.
And when I say there isn't much money, it's partially true. When it's about buying a nice startup, there is heaps of cash. Because you need to keep the market as closed as possible. But when it's time to actually invest in making better software, the wallet is empty.

3. There's a weird mindset where in most cases, end-users are simply not considered. At my previous jobs, I always asked to sit with actual users of the software to see how they work and what their actual requirements are. Since I joined Healthcare IT, on the ~20 projects I worked on, there's only one case where I was authorized to do so. On all the other cases, the "IT Project Manager" (whatever this is) just said that they knew exactly what the users needed, even though they never actually worked with them.
And on the project I was allowed to work correctly, instead of the original proposal that was agreed on, based on my observations, I came up with a solution that was much simpler for the users, easier to build for the IT team, so delivered faster and at a lower cost. So the customer was happy and decided to sign a contract for another piece of software at the company. Everyone happy in the end. But it's an exception.
In the other domains I worked on, it seems obvious to everyone that gathering intel from the actual users was mandatory to produce something valuable. Here, management think they know better. They don't.

And honestly I don't see how it can improve since those three points keep getting worse and worse every half-year.