Wage inequity: You and the other nurses on your case will all be paid differenty. Its depressing to browse the adds online and see new nurses being hired for more than old experienced nurses and seeing big bonuses for a case you're on, but only offered for new hires. Family dynamics with some families can be intense (ex. Drug abuse, Patient Neglect by families, Parents that Hover and Micro Manage, Families that Fight With Each Other, Parents that put down nurses) Most nursing jobs have this issue but since you are with the same familes constantly abusive enviornments can get exhausting. Pro is building tolerance and thick skin if you can deal with it.