My mom was the nurse empress of a large ICU (at least tactically). The biggest issue is there’s no “product manager” for your care. Each specialist doctor has an incentive to do as little as possible as often as possible to avoid having a death on their record, but to be able to bill. So the nurses usually are the most incentivized people to actually take care of you.

From her point of view, the management ensured that the best care for patients happened when family was present, especially on irregular intervals, and for prisoners, who had a CO always watching and sometimes logging what happened.

Her other big thing was hatred of EMRs. The loss of the clipboard made situational awareness tough.