Big hospital bureaucracy with small hospital politics. Don't expect to get promoted from within unless you went to high school with your boss and her boss. A LOT of positions are make-work projects for high-ranking peoples relatives, so you will be working with or directly impacted by at least one person who is totally unqualified for their job but who will always be very important and never go away. Constant senseless changes to standards and requirements, made by people who sit in cubes in Radnor all day and don't know anything about patient care. Pay is lower than average. Crazes for weird things like banning soda interfere basic hospital functioning at times.