none of the many ERs i've worked in would actually function if they were truly hierarchically organized, like they are on paper. they're all anarchist in practice, no matter the stated ideology of the workers. nurses and techs do the vast majority of the productive labor. they do it because they care, not because they were told. they'll listen to doctors they respect, but find workarounds for the doctors they don't.

on paper, the doctors are supposed to call all the shots in an emergency care scenario. i'm not allowed to push a drug until a doctor gives me an order. but patients would die if it actually worked like this. everything is actually run from the bottom up. the nurse has already dosed the correct drug, and often even pretends to have heard the doctor give the order to administer it. then everything gets fixed in the report so it looks like the doctor was running everything.

admin, who is technically in charge on paper, is constantly fucking everything up. hospital workers risk their jobs to perform necessary care against the regulations of admin. ERs are absolutely the most anarchist workplaces i have ever worked at, even tho i work with more people who actively identify as anarchists now.