Italian healthcare is increasingly a battleground between those trying to make up for structural shortcomings and those making decisions without a real understanding of the system's needs. The political and bureaucratic management of healthcare in recent decades has shown a worrying distance from the reality of professionals in the field, with increasingly evident consequences, from the Covid emergency to the current crises of the National Health Service (SSN). The recent episode in San Fermo, where a man died in a pharmacy during an electrocardiogram, reignites the debate on patient safety and on health policies that risk confusing professional competencies. One of the most critical issues is the exodus of nurses, often replaced by unqualified personnel. International evidence is clear: nurses should not be replaced, not even by doctors. In countries like Australia, Canada, the United Kingdom, and even the United States, nurses play an irreplaceable role in reducing mortality, hospital infections, and antibiotic resistance. Yet, in Italy, attempts continue to fill the gaps with makeshift solutions, nurse assistants, personnel from the poorest countries in the world, etc. The problem is not only the quality of the service, but the management of emergencies. A discharged defibrillator in the square, the lack of a structured emergency response system, the absence of a nurse (properly trained personnel): elements that, put together, led to a death that perhaps could have been avoided, with the presence of a nurse. The question now is: who takes responsibility? The answer seems to be lost in the fog of decisions made from above, without real discussion with those who live healthcare every day. How long will this situation be passively accepted? Vincenzo Parisi - Nursing Up Executive



























