Instruction given to extremely lazy hospital employee (7)
I believe the answer is:
orderly
'hospital employee' is the definition.
(I've seen this in another clue)
'instruction given to extremely lazy' is the wordplay.
'instruction' becomes 'order' (an order to do something).
'given to' means one lot of letters go next to another.
'extremely' suggests removing the centre (only the extremes of the word are used).
'lazy' with its centre removed is 'ly'.
'order'+'ly'='ORDERLY'
(Other definitions for orderly that I've seen before include "Soldier with special duties - hospital attendant" , "Well-behaved -- soldier attending to a superior officer" , "Tidy officer's attendant" , "Neat, tidy; soldier" , "Neatly arranged; hospital attendant" .)