1. The entire management group will use your compassion against you, pressuring you to take on too many tasks with too high of a caseload. You will want to work more than 15-hour days, because you care about your patients, but your manager will not care about you. 2. Senior leadership has a "this is how we have always done things" attitude and is resistant to any innovation and change. When presented with new ideas they will find any and all excuses on why not to try. 3. You will have all managers barking orders at you that need to be completed ASAP, many of them will be contradictory to each other. You will have no clear direction and will be written up for using your clinical judgment. 4. The president loves attention on himself and will take all the credit and pass all the blame to you.