“Nurses work in a pitiless system. We in the United States don’t have a unified approach to maximizing people’s health and well-being. We mostly have a for-profit medical industry focused on illness and conditions and, then, on potential billable cures and fixes. Health care workers generally do their very best to provide good care, but our “system” is often at cross-purposes with that effort. Nurses in particular, whose discipline is not medicine, are trying to work in a medical industry that was not built to make the most of their expertise or, really, even to recognize it. The fee-for-service model dictates that physicians—mainly the ones billing patients’ insurance companies—are the revenue generators. Nursing is just as important to people’s outcomes, but the fees for nursing are generally lumped in with hospital room and board—meaning that nursing is seen by hospitals as an expense, like meals or supplies.”