Training and Contracts

  1. Hey folks.

    I will be graduating from a BSN program in May and I have started to talk to recruiters at a wide variety of hospitals. I will be heading directly into intensive care, and I'm shopping around for the best training programs I can find. (I know the concept of new grads heading into critical care is a controversial topic, but it would be good if we could save that debate for another thread if possible)

    In your experience, have you found that most hospitals offering solid training programs expect trainees to sign a contract that requires the new nurse to work for x amount of time to 'work off' the cost of the training?

    One hospital I've come across has a great training program, but expects graduates of the program to work for 2 years after completing the training. If a nurse breaks this contract for some reason, they are expected to pay the prorated difference (of the cost of training) that they have yet to work off. For example: Training costs $12,000. Every 6 months, they deduct 3k from the total you would have to pay back if you broke the contract. (FYI- these numbers were taken from an actual contract.)

    Seems like a pretty crafty retention strategy to me...

    Would you sign a contract like this?

    -Thanks in advance for any thoughts you can offer.
    •  
  2. 16 Comments

  3. by   SURFnNURSE
    I would think twice before signing something like that. Does the hospital have problems retaining newgrads. Here, they asked us verbally to stay 2 years since they were taking the time to train me to intensive care. I planned on staying for at least 2 years, but since nothing was on paper or signed, i can really leave before 2 years is up.
  4. by   nekhismom
    um, sounds shifty to me. I DO have a 2 year commitment in exchange for the sign-on bonus. But, if I quit, I don't have to repay the training money back. Just a prorated amount of the sign-on.

    Realistically, I think that you can expect contracts asking for a certain length of commitment if you are getting a sign-on bonus or loan repayment, but for training??? Absolutely not. It is their responsibility to orient you to your unit, plain and simple.

    What area of the country are you looking into? It varies WIDELY from state to state.
  5. by   USA987
    I made a 3 yr commitment for $15,000 cash up front...they called it Tuition Forgiveness...each 2 week pay period they deducted something like $167...so if I were to quit I would only pay back the prorated amount + 3% interest. I signed the contract, PUT THE MONEY IN THE BANK, and started orienting in the ICU....

    Morale was poor in the unit. Several of my coworkers had 1-2 yrs. left on their commitment...they were unhappy & felt "trapped"...but didn't have the $$$ to pay the prorated balance back to the hospital. Seasoned staff nurses were unhappy because the new grads were getting the $$$ but they got NOTHING to help with retention.

    To make a long story short...90% of the nurses in the unit were unhappy...I thought long and hard about it...after 5 months I gave 3 weeks notice and asked them where I needed to make my payment to get out of my contract.

    Morale of the story...go for it, but if at all possible, PUT THE MONEY IN THE BANK!!!!
  6. by   Lorus
    Thanks for the feedback guys. From what I've seen of what most hospitals are offering thus far, it seems a pretty common practice for them to ask for time commitments in exchange for training. I can see how it would be way cheaper for a hospital (and better for them in the long run) to hire and train a new batch of ICU nurses instead of hiring the same number of travelers to fill those positions for their short term needs.

    Im also begining to think that the small financial risk involved with signing a contract for a position could be very worthwhile. Being a new grad 'jumping' into intensive care, my priority is to find a hospital that offers the best training I can find. Im looking at it like an investment in my education I guess. Worst case scenario, I sign a contract at what turns out to be a malignant program, stay as long as I can tolerate it, and leave there with great clinical experience. If its so bad that I feel compelled to bail out on the contract and take a small finantial hit for a coupla months pay, so be it. Certainly things would be different if i had kids, etc, but thats not an issue right now.

    In other news, I just finished getting my ACLS cert today. Whooo! Great course, lots of fun, learned lots.
  7. by   Headhurt
    I recently interviewed and was offered a job at KU Med Center for the nurse fellowship. This fellowship only applies to specialty areas in the Critical Care areas, and requires a 2 year work commitment. Only 6 other hospitals in the country offer nurse fellowships, and they are at some of the biggest, and best hospitals in the country. The first year is A LOT of orientation, classroom instruction, and clinical training. Such programs are only for new grads, and not nurses who have been out in the field for a while.

    The two year contract doesn't bother me (I've been at my present hospital for the past 7 years). I was enticed by the amount of training they offer new grads, and two years is a small compared to the education you are going to get. KU is our area's ONLY nationally accredited Level 1 Trauma Center...all other hospitals in the area transfer their most horrific cases to them. That being said, KU wants to ensure that their nurses can handle ANYTHING that is wheeled through the doors, and it is in their best interest to spend a lot of money in training and education. In two years I plan on taking three months off a year to do a travel assignment (KU allows this). I want to be confident in the fact that I can be dropped in any ICU in the country and be able not only tread water, but swim with the big fishes...maybe even be a big fish myself.

    I've talked to many nurses who work at KU, as well as friends whose spouses work there as well, and I have been told the only real bad thing is the parking (which is not an issue for night shift people). KU has come around to the idea that in order to keep your nurses, you must take care of them. This not only includes training and education, but other benefits as well.

    I cannot fault any hospital for putting contractual obligations for training new grads to work in clinical settings. That is a lot of money when you really think about it. I do tend to worry about these places that offer huge sign-on bonuses. That is usually a red flag that working conditions might be less then ideal.

    Just research your hospital of choice thoroughly before signing on the dotted line. Talk to staff members (not at job fairs either, because at those things...everyone says that working there is a dream come true ), ask a lot of questions, and don't be willing to settle for the first offer you get. I don't think because you are a new grad, you have to work in the armpit of the hospital to start out with. All hospitals have their quirks (I'm not a HUGE KU fan...I'm more of a Huskers girl), but it comes down to what you can live with, and what you can live without.

    Good luck!!
  8. by   zambezi
    When I was a new grad, I might have thought that it did sound a little questionable...however, after working and seeing a new grad come, get trained, and leave...well that sucked. Preceptors had put in a lot of time (and even if you enjoy precepting, 3 months is a lot of time to have your own routine disrupted), the rest of the staff had put in time, and when she left, our staffing had a hole, the unit was short on those days and we had to find someone to retrain for another three months. So yes, I feel that a new grad should be required to stay for at least one year (major extenuating circumstances of course should be considered if they arise...).
    We have also had a newer med-surg rn apply for the unit, she tried orientation but it just never clicked with her...we were all okay when she went back to her old floor---a great lady but it hurt to watch her struggle like that. JMHO..
  9. by   Lorus
    Quote from Headhurt
    Only 6 other hospitals in the country offer nurse fellowships, and they are at some of the biggest, and best hospitals in the country.


    Would you mind listing these hospitals or posting a link to any info on these fellowships? This sounds really interesting, Id love to check them out.
  10. by   Headhurt
    I thought there were six, but there are more. I don't have links, but I am sure if you ran the names through a search engine, you can find them.

    University of Kansas Medical Center
    New York University Medical Center
    Oregon Health and Sciences University, University Hospital
    Stony Brook University Hospital
    University Medical Center-Tucson
    University of Colorado Hospital
    University of Kentucky
    University of New Mexico Health Sciences Center
    University of North Carolina Hospitals
    University of Pennsylvania Hospital
    University of Texas Medical Branch, Galveston
    University of Utah Hospital

    As you see, all these hospitals are teaching hospitals. They usually have first crack at new technology and new procedures. When I toured KU's new MICU floor, I was amazed at all the neat gadgets they had. The floor looked like something out of a futuristic science fiction movie. I am so excited that is the floor I am going to be working on. They have been really positive about me going for an advanced degree. Some places will even offer you a reduced rate if you attend classes at their school...not to mention reimburse you for it.

    Some of these places offer a residency for new BSN's which only require a 1-year work commitment. Check and see who offers what.

    Good luck!!!
  11. by   Lorus
    Quote from Headhurt
    I thought there were six, but there are more. I don't have links, but I am sure if you ran the names through a search engine, you can find them.

    University of Kansas Medical Center
    New York University Medical Center
    Oregon Health and Sciences University, University Hospital
    Stony Brook University Hospital
    University Medical Center-Tucson
    University of Colorado Hospital
    University of Kentucky
    University of New Mexico Health Sciences Center
    University of North Carolina Hospitals
    University of Pennsylvania Hospital
    University of Texas Medical Branch, Galveston
    University of Utah Hospital

    As you see, all these hospitals are teaching hospitals. They usually have first crack at new technology and new procedures. When I toured KU's new MICU floor, I was amazed at all the neat gadgets they had. The floor looked like something out of a futuristic science fiction movie. I am so excited that is the floor I am going to be working on. They have been really positive about me going for an advanced degree. Some places will even offer you a reduced rate if you attend classes at their school...not to mention reimburse you for it.

    Some of these places offer a residency for new BSN's which only require a 1-year work commitment. Check and see who offers what.

    Good luck!!!

    Thanks for the list Hh!

    Ive looked into several of these programs (Tuscon, Colorado, Oregon..) and all look great. And all would provide clinical experience/education worth any time commitment/funky contract... Aaah, decisions, decisions...
  12. by   orrnlori
    I'm a nurse at the University of Kentucky. The fellowship was instituted after I became staff here so I don't know the particulars of that specific program (I know they are very proud of it) but when I came to the OR from the trauma unit, I had to sign a one year contract to work beyond the 7 month OR training program they had. If the fellowship is anything like the training I got, it is worth every minute and every penny.

    For those of you considering such a scenario I think you need to understand that as a new graduate you really know very very little about being a nurse. You know the standards that your instructors have taught you, you know how to take nursing tests, you know how it SHOULD be. But the real world is nothing like school. If you want to work with the very latest procedures and equipment, if you want to see the most varied groups of patients and maladies, if you want to be as highly skilled as possible, a program with an excellent reputation for training is where you want to be if you live near one of these. If you have doubts about the hospital you are looking at that wants repayment for training, then at least try to talk to some nurses who work there. Maybe it IS a trap for keeping you employed as someone else stated, but I would bet those are few and far between. Most institutions that make the effort to train and spend thousands of dollars to do it, want you to stay as staff and want you to feel comfortable as a nurse so you can take care of their patients and keep their standards high. As a preceptor with UK, I know I try to teach everything I can in a meaningful way to every nurse or nursing student who steps into the OR. Many times I give much more than I receive from the nursing student or nurse in training. Some people aren't cut out for level 1 trauma centers. I understand that.

    I know very few nurses who don't gripe about some aspect of their hospital enviornment. We all do, me too. But ultimately there are great places to work, good places to work and then there's all the rest. No place is perfect and much of it is what you make of it. So if they want a contract and are offering a solid training program, it can do nothing but make you a better nurse and make you more employable down the road. If you are interested in a specialty and you don't want to do floor nursing for a year or two, a good training program is the best bet for you.
  13. by   Lorus
    Quote from orrnlori
    I'm a nurse at the University of Kentucky. The fellowship was instituted after I became staff here so I don't know the particulars of that specific program (I know they are very proud of it) but when I came to the OR from the trauma unit, I had to sign a one year contract to work beyond the 7 month OR training program they had. If the fellowship is anything like the training I got, it is worth every minute and every penny.

    For those of you considering such a scenario I think you need to understand that as a new graduate you really know very very little about being a nurse. You know the standards that your instructors have taught you, you know how to take nursing tests, you know how it SHOULD be. But the real world is nothing like school. If you want to work with the very latest procedures and equipment, if you want to see the most varied groups of patients and maladies, if you want to be as highly skilled as possible, a program with an excellent reputation for training is where you want to be if you live near one of these. If you have doubts about the hospital you are looking at that wants repayment for training, then at least try to talk to some nurses who work there. Maybe it IS a trap for keeping you employed as someone else stated, but I would bet those are few and far between. Most institutions that make the effort to train and spend thousands of dollars to do it, want you to stay as staff and want you to feel comfortable as a nurse so you can take care of their patients and keep their standards high. As a preceptor with UK, I know I try to teach everything I can in a meaningful way to every nurse or nursing student who steps into the OR. Many times I give much more than I receive from the nursing student or nurse in training. Some people aren't cut out for level 1 trauma centers. I understand that.

    I know very few nurses who don't gripe about some aspect of their hospital enviornment. We all do, me too. But ultimately there are great places to work, good places to work and then there's all the rest. No place is perfect and much of it is what you make of it. So if they want a contract and are offering a solid training program, it can do nothing but make you a better nurse and make you more employable down the road. If you are interested in a specialty and you don't want to do floor nursing for a year or two, a good training program is the best bet for you.

    Well said orrnlori. Especially liked the last paragraph. There is no such thing as a perfect program. All new nurses can do is research several programs, pick one they like, and go for it. From there, its what we make of it, and attitude is everything. No matter what happens, itll be a great learning experience.
  14. by   Headhurt
    I agree!!! As a new grad (or soon to be one in a matter of weeks), I have come to the conclusion that as a nurse...I don't know enough to find my butt with two hands! A lot of my classmates and myself are just now starting to realize just how little we know. It's one thing to be flying through clinicals...when you have a crisis, there is always your instructor there. In the real world, we have only ourselves. Sure, our coworkers will help us out, but in the end, it all comes down to us and our license.

    There are some in our class who think they will have no problems, know everything...and some of the more seasoned RN's tell me that those are the most dangerous kind of nurses. I'm humbled to admit that I don't know my butt from a hole in the ground right nowin terms of nursing in the real world, and I am willing to submit myself to a two-year program to learn it.

close