You name it. You get settled in your department and they sell your department. Management sucks. you have to be a good 'ol boy to get anywhere. Promotions are not based on merit, but how much you brown nose and go drinking with the upper crust management. EVERYONE gets 3% rasies, even if you sit on your duff and do absolutely nothing, or you work 100 hours overtime to keep your department running, it does not matter. Their idea of safety (when it came to the ambulance service) was "If we tell you to drive 300 miles at 3:00am, during a 24 hour shift that started at 7am the previous day, you'll do it or you"ll be fired." They do not care about their employess, just their bonuses. Every manager gets some kind of bonus, employees get a $25 gift card to Kroger's grocery store for Christmas (if you are lucky). Upper management loves to micro manage, so if you do get lucky enough to get a decent department manager, you are still screwed.
If you do have knowledge in your particular field of expertise, so what. Most of their paramedics they did have working for them provided better care than 95% of their nurses that they have. No wonder their patient satisfaction scores are in the tank (of ourse you will only hear about the 1 in 200 that says something nice.