I work in the areas busiest ER. While management talks a good game, policies change without announcement. One day we are doing something, then suddenly, we are not allowed to do it. The assistant managers are always chasing their tails and micro managing. Panic seems to be the order of the day. Most of the people I work with are amazing practitioners. The doctors range from "Everybody's great!" to "Everybody's an idiot."
Senior management cannot grasp what we do and spends it's time on community projects while ignoring the needs of workers. If this were any other business, it would close.
Pay scale are just high enough to keep one from quitting. Benefits are generous, but difficult to navigate.
Everything has to go through a committee, and no one can make a decision on their own. People that decide on wages have never met the workers or understand what they do.