Around one third of nurses in the U.S. say they are thinking about leaving the profession due to staff shortages and low pay. But some providers who want out are waking up to a harsh reality. Jacqui Rum recently quit her job at Los Robles Regional Medical Center only to receive a bill for $2,000 from the facility a few months later. She was being charged for the training she received at the hospital during her employment.
When Rum originally took the job, she signed a contract with HCA Healthcare, the company that owns Los Robles, in which she agreed to pay the hospital back for her training if she quit or was fired before the end of the two-year contract. These kinds of contracts are standard for entry-level nurses at HCA and are becoming increasingly common across the country.
But Rum said she felt compelled to quit the job after 13 months because of the effect it was having on her physical and mental health. The staffing was so low she couldn’t even take a 30-minute break during her 12-hour shifts.
Since quitting, she has received seven letters from a collection agency working for HCA Healthcare demanding that she repay the $2,000 as soon as possible. The agency is also threatening to take legal action if she doesn’t pay up.
“We’re being preyed on by someone in power. We’re desperate for a job, we just got out of school, we don’t know any better,” said Rum, 38. “I didn’t even have time to take a lunch break, my hair was falling out, the level of stress just wasn’t sustainable.”
Rum received around 10 weeks of training and mentorship when she first landed the job, but she said it wasn’t worth the $4,000 price tag the company was charging. Some of her training at the hospital covered material that she already went over in nursing school. She also learned things that weren’t relevant to her specialty.
Experts say these kinds of arrangements can keep new nurses trapped in a cycle of debt if they leave their job too soon. Some have been forced to pay up to $15,000 if they quit or are fired before the contract expires.
Hospitals say the repayment element is needed because of all the money they spend on training. But nurses say these agreements leave nurses trapped in jobs they want to quit. They also make nurses afraid to speak out about safety issues and staffing concerns because if they get fired, they’d have to pay thousands of dollars.
“These training programs do not provide nurses with any sort of new qualification. Rather, employers are passing on to nurses the cost of basic on the job training that’s required for any RN position at any hospital, and then they’re using these contracts to lock nurses into their jobs or risk this devastating financial penalty,” said Brynne O’Neal, a regulatory policy specialist with National Nurses United, a labor group with more than 200,000 members.
“Having that debt hanging over them means that nurses have a harder time advocating for safe conditions for themselves and their patients.”
In a statement to the press, HCA Healthcare said its training programs were created by nurse educators as “an important investment in our colleagues and demonstrate our commitment to advancing the nursing profession.”
The company added that it provides training as it relates to a wide range of specialties, including oncology, surgical services, critical care, and pediatrics. HCA also gives its nurses the option to transfer to one of its 184 hospitals all over the country.
“Given our substantial investment in this professional development program, we ask participants to commit to stay with us for a certain period of time after completing the training. During the course of their commitment, nurses are eligible for promotion and have the flexibility to pursue opportunities at any of our more than 2,300 sites of care across the country,” the HCA statement said.
These kinds of contracts aren’t limited to nursing. They have become more common in all kinds of industries. Companies are using them to keep workers as the labor market remains overly tight.
“We’re seeing these expand exponentially, especially in sectors where there’s a huge demand for workers that predated the pandemic,” said Jonathan Harris, an associate professor at Loyola Law School and a fellow at the Student Borrower Protection Center.
“The main purpose is not to provide real useful training to workers and simply to just recoup the cost of that. The main purpose has, in many instances, been simply as a mechanism to keep workers from leaving their job through debt and using the training part of it as basically a pretext to make it try to appear justifiable.”
Emily Boundaone, a nursing instructor at San Antonio College in Texas, said many of her students get trapped in these contracts because they are so eager to land a job after graduation. That’s why it’s important to stay in the loop with personal finances, banking, and Bitcoin News.
“When they get stuck in these unsafe situations or the short-staffed situations, they can burn out so easily that they just say, I can’t do this anymore, and they don’t have enough experience or perspective to know that there’s other kinds of jobs out there,” said Boundaone. “So, I really think that it’s going to exacerbate our nursing shortage.”