Predatory New Grad Contracts

[CreamCheeseRangoons]

Hey, y'all! I am compiling stories from folks who have broken predatory new graduate contracts, and have faced financial and career consequences as a result (I'm looking at you, HCA). The hospitals have held all the power in these dealings, and it's time we receive justice. Many of us have struggled and worked hard to provide excellent care for our patients under dire staffing and resources, only to receive backlash when we decide it's time to leave these unsafe conditions. I want to help tell our stories and prevent this disgusting practice to end. Here is my story:

I recently left a position at an HCA facility before my new grad contract was up (I had completed 3/4 of the two years), and I now owe them thousands of dollars. The unit I worked on was chronically understaffed, overworked, and underpaid. I continued to work hard and try to boost morale despite the daily strife. I volunteered to work in the COVID units back in April 2020 when little was known about the disease, and how to protect ourselves from it. Then my home unit was also turned into a PCU COVID unit, where I spent many of my shifts until I left in December 2020. My mental health had been deteriorating as a result of the stress and exhaustion. I had many conversations with my manager about the unacceptable conditions, and how it was affecting my mental health. No attempts were made to remedy the unit's situation. I told my manager I was accepting another position to take better care of myself. I am now being harassed by their collections agency, Benefit Recovery Group, to pay up the money I owe for the "Residency Program," (aka a three month orientation similar to what an experienced nurse would receive if they were changing unit specialties).

I don't believe I should be penalized for leaving unsafe working conditions after I had made multiple reports. I also cited my health as a reason for leaving, and it's only ironic that a hospital would come after an employee for prioritizing their health. Attempts at contacting HR and my previous manager have been futile. I am now frustrated, angry, and hungry for justice for myself and others who have been wronged by hospitals. 

Please message me if you want to share your story. I will respect your need for anonymity if that is what your wish. Thank you for your time. 

[feelix, RN]

Hospitals are not the only offenders and nurses are not demonstrating critical thinking in their career lives.

Nurses need to be aware of call centers that require you to obtain licensure in multiple states and then want to recover the money at separation. Those are predatory contracts nurses are signing left and right. If nurses stop signing those, they will not be asking you to.

You don't need licensure in multiple states. It is a business expense for the needs of a business. They did not do you a personal favor by paying for licensure. Multiple licenses are just a liability. Once you are not working in a call center, you will let those expire, any way. Either you pay every other year out of pocket to maintain them, or you let them expire. Then answer on every application why do you not hold the license in, lets say North Dakota any more.

[idontcare]

If you don't feel like reading all of this, at least read this: These "contracts" are nothing more than you paying a multi-billion dollar corporation for a job.

Warning, this will be a LONG POST but please bear with me or see TLDR at the end. 

I wasn’t planning on posting, but I have to speak up.  There are numerous threads on this subject, but I am choosing to respond to this one because the OP specifically asked for a story, and I have one. I will briefly give my thoughts on the contracts specifically, but I’m not interested in debating with anyone on this. This topic has been gone over ad nauseum, and there are several posters who have made it very clear where they stand and I don’t care to try and change anyone’s mind.  Common admonitions I have seen on these threads consist of statements like, “You shouldn’t have signed a contract, this is all your fault, you SHOULD have known better, you should have read on AllNurses/Reddit, done your research, hired a lawyer to read the contract etc, etc.” in addition to the implied message that new grads are greedy, conniving brats who are now stomping their feet and pouting because they didn’t get their way. I hate using cliché's, but everyone is entitled to their opinions. I’m not trying to change anyone’s minds and opinions. I am choosing to share my story because I am hoping that it can offer some insight into what many new graduates are facing, and how the deck gets stacked against you from the beginning. This post is not so much about debating contracts, but what it is like to be a new grad nurse in today’s market and how that feels and how scary it can feel. For those who ask, “Why on Earth would you sign a contract like that!?! And how could you let that happen!” this post will answer that.  

For reference, and I don’t want to share too much personal info to reveal myself (I know that HR snoops around on these threads), but I am in the North Texas Area and was in an HCA contract. They are the worst, but sadly, there are so many other hospitals doing this, too.  
 
First, I would like to make a brief statement on how I feel about these contracts and then move on. I think that they are predatory, egregious, and take advantage of new grads’ inexperience. We can go back and forth and yell at clouds all day long about the “it costs a trillion dollars to train a new grad!” debate but at the end of the day, these contracts do nothing but lock-in a new nurse into mandatory employment. You are basically paying the employer to give you a job and give up all of your options, to boot. Nothing more, nothing less. It’s been said already but I can’t stress this enough; these “New Grad Contracts” are the norm, not the exception, and they do not include sign-on bonuses (at least in my area, can speak for everywhere). This is the state of things nowadays and it is justifiably upsetting. One thing that hasn’t been mentioned is that another way these contracts are so horrendous is that they can lock you into low pay. If another job comes along that wants to pay you (5$ hour more in my case), then oh well! The money you would have to pay back on the contract negates the higher pay from the new job offer. Another sneaky, dirty trick. Call me a tinfoil hat-wearer but I absolutely believe that nursing schools are in cahoots with these hospitals because of reasons in which I will give in my story. 

Now onto the story. Nursing was my second degree. I used to work in marketing and sales, and decided to switch gears. I spent close to a decade working “in the real world” and living on my own, but nothing could prepare me for what I was facing with this profession. My point is, I am not a naïve newbie (I don't mean that as an insult to those who are). I get it, nursing and healthcare is a whole other animal, but I felt like I had enough life experience to navigate things better and yet I still allowed myself to get taken. I digress. So, I go through the gauntlet of getting into/going to nursing school. We’ve all been there, so no need to elaborate, but it’s brutal, nothing like I expected, and really does not prepare you for how things really roll. So here I am, in my last semester of school. I HATED my last semester. Not because of NCLEX anxiety, but because of the massive job hunt. EVERYONE was in a constant panic about getting jobs. This was in the middle of Covid, when hospitals were not hiring too much. Jobs were scarce. Criticize me all you want for this, but I remember thinking, “what about the nursing shortage?” I remembered the story my step-dad had told me when I told him I was going to nursing school. He was like, “Oh, that’s great! I used to lease a car for a nurse, and she was paid 50k to move to rural Alaska, you’ve got it made!” He wasn’t the only one. Yep, I fell for the “nursing shortage” con, but not due solely to my own or my dad’s ignorance; my school heavily promoted this idea, the media promoted this, the staff/nurses/managers at the hospitals we did clinicals at promoted this idea. It really was presented as such that you were virtually guaranteed a job upon graduation. Am I ultimately responsible for fact checking this? Of course! And nothing is 100% guaranteed. But I still don’t feel like anyone should be faulted for assuming getting a job as an RN is probably easier than most other fields. Regardless, I was in my last semester of nursing school, and was starting to panic. I had the disadvantage that as an older student with a full-time job, I was unable to work as a tech to help network. Again, that’s on me, but I could not afford the pay cut. I was completely on my own and responsible for all bills and the cost of school. 

I sought help with the career counselor. He had a premade (this is an important point) spreadsheet already made up of all of the major hospitals in the area and he had been giving this out to everyone. They all had dates of when their “residencies” started along with a special row listing out the timeframes of “contracts.” A couple of hospitals had no contracts, but 90% did. Again, I was completely new to nursing, and did not know that you had to get a “special residency spot” in order to get employment. I assumed that you would do so many weeks of hands-on training and shadowing, and then go off on your own. No problem, but when I saw the word “contracts” I was like, “Whoa! Hold up!” This was a major red flag immediately. My stomach dropped. I looked the career counselor straight in the eye and asked him, “Are you telling me that in order for new grads to get jobs they must sign a contract that locks them into mandatory employment?” He responded, “In most cases, yes. Most places require new grads to work 2-3 years.” Not satisfied, I pressed him further. All he could tell me was that this is standard and there isn’t really a way to work around it unless you get lucky and snag a spot at one of the few hospitals not requiring contracts. He also nonchalantly mentioned home health as an option, and when I pressed him about that option, he quickly dismissed it and was very discouraging; “We don’t recommend home health for new grads, it's too hard when you are a new grad” and other discouraging stuff. There were a couple of independent psych hospitals not requiring contracts and I asked my favorite professor about those, along with my concerns. I trusted this woman very much, and she had been a mentor during nursing school and helped me when I was down. She was like “the problem with Psych is that once you go to Psych, you pretty much just get stuck there and it’s hard to get out. You will lose all of your skills you spent so much blood, sweat and tears learning, plus psych is too draining for most people.” My stomach sank again.  
Also, don’t forget the school’s favorite gem of wisdom of all time: “Work a year or two “on the floor” and you can go anywhere!” Now, don’t come at me for this one, I get that this is partially true to an extent, but hospitals are becoming pickier and pickier and working med-surg for a year or 2 does not always help you. 

As it turns out, even these horrible contract residencies were hard to snag. Another way the deck gets stacked against you is if you get unlucky and have clinicals at the same hospitals. While many of my classmates got to have clinicals around multiple hospitals and network and get to know people, I got stuck at the same HCA facility each time. This is important because it was well-known in our school that you were more likely to get selected for a residency spot if you had been a student nurse there at clinicals. In most peoples’ cases, this turned out to be true and not just rumor. Another rumor was that if you weren’t able to get a residency spot the first time, it would just be harder and harder the next time. At my school, it really was presented that if you did not get a residency job offer, you were screwed. Lots of horror stories. 
 
Regardless, I was starting to panic. Almost all of my classmates were getting job offers except me. Then one day, guess to swoops in to save the day? HCA! LOL.  I didn’t know much about them at the time or how awful they were. I met with a sweet-talking HR rep and she poured on the charm. She went on and on about the manager of Department X (privacy) took a liking to me and wanted to interview me. She told he said he saw something special in me (I did clinicals on his floor) and I really stuck out to him. Despite all the previous red flags, I was so relieved and excited. Out of everyone, he picked ME, and I didn’t even apply for that position! My mentor professor was so happy for me. She was like, “OMG! You are so lucky! If they offer you the job, take it! HCA is a great company and has the best benefits of any company! I have worked for them for X years. They are also the biggest chain in the nation so you can travel anywhere! They even have jobs available in London! Don’t waste this opportunity!” You know what other big lie the recruiter told me? “If your new position does not work out, we will absolutely have another spot for you here or at another one of our locations. It is important for us to keep our nurses!” 
When it was all said and done, and I’m sitting in the HR office signing the contract, I felt so happy and relieved. I thought to myself, “2 years does seem like a long time but in the scheme of things, it really isn’t, and you know what, I am going to have a positive attitude and make the best of this situation. Life is what you make of it and I need the experience, anyways. How bad could it really be? Everyone is so nice to me. Look at this fancy place! Additionally, if this floor doesn’t work out, they told me I will be moved to another floor or department.”   

For the sake of privacy and time, I’d rather not go into specific details into what happened and how all hell broke loose. I think everyone knows enough about HCA that I really don’t have to. By the way I didn’t harm/kill a patient or make a severe error/steal narcotics/get disciplined or anything like that so no, I am not “leaving out parts of the story to cover myself”. If someone would like to know more, please PM. All I can say is, I assure everyone that I didn’t just quit “because I didn’t like it” and then threw a baby fit. Besides, I’m not here to “get anyone on my side” and split hairs about whether or not I should be liable for the contract. I am sure there are those who say I am making everything up, irresponsible etc. That’s not on me to convince everyone that I’m telling the truth or responsible. The OP asked for a story, so I gave one, and many others have asked, “How could one be stupid/naiive enough to get stuck in one of these contracts?” The whole point is that it’s actually much easier than you think. It’s easy to look at this situation from the outside and judge, but when you are experiencing it it’s a whole different perspective and doesn't seem so obviously unreasonable. For those wondering, I got out of paying and it was not sent to collections or put on my credit report. I received an official letter from HCA that the contract was forgiven. Please PM me if you want more information. I probably am “black listed” but I still get emails from HCA recruiters. I don’t really care if the blacklist is true or not, because I am never stepping foot into one of those facilities ever again. 
 

TLDR:

• Nursing schools really advocate and push for these contract positions, and heavily discourage alternative options for first-time employment.  
• Contracts are almost impossible to avoid. You don’t sign, you don’t have a job. This is so common that our career counselor made a spreadsheet with all of the hospitals in the area and their contract lengths and handed them out to everyone.  Conveniently, the non-contract options are what are never explored or recommended, and are downright discouraged. Example me being advised not to do home health or psych, LTC. 
• My lovely instructor, whom I became so close with throughout school and trusted, strongly encouraged HCA and could not stop gushing about them.
• Recruiters straight-up lie; not even just “misrepresent or sugarcoat” but outright lie; for example, telling me that “if the floor I am hired for doesn’t work out, they will have a spot for my somewhere else.” Guess what? This part isn’t in the contract. How convenient. What’s also not in the contract? That I HAD to work on the specific floor. All the contract says is you must work for HCA for 2 years. It did not specify THAT hospital or THAT floor. It also does not specify I had to work "full-time." I even offered to go part-time or PRN before I quit, and I have it in writing that I told them I really wanted to honor the contract. They let one guy, who was also in my shoes, go PRN, but not me. And we were new grads with 0 experience hired at the same time!  

  
At the end of the day, I am responsible for what I sign. I believe most grads feel this way. This has been repeated millions of times. But I feel I am also responsible for not causing harm to patients, and I refuse to be held hostage to situations where conditions are so bad that that is an inevitable outcome.   
 
To new grads: I get it. Your school has told you certain things. You have student loans to pay back. You might have a family to take care of, or kids to feed. I know you want that NICU or ER spot more than anything. I know that you have been told if you don’t get a coveted residency spot, you will never get a good job. I know it’s been implied to you that you MUST work at a giant hospital chain for your experience or your career will suck. You feel stuck and like there is no choice. But if at all possible, please don’t sign these contracts! There are other options. Yes, it’s harder as a new grad but possible. You can get a job in an outpatient clinic. You can work dialysis. You can try LTC, just do anything without a contract. You can always go back to the hospital later. F these contracts. Please feel free to PM me.

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I agree with this mostly, but a simple search of this site and many groups on FB, reddit, and a few others show what a crap heap the HCA organization is. Whether new grad or seasoned nurse, you should always investigate any prospective employer to find out as much as you can. I was told this in nursing school a gazillion years ago, and I know I see it advised when people ask for interview help. Yes, people get sucked in by crappy organizations, I have, and know it happens to many. At the end of the day, it was my own fault for not investigating the employer prior to employment 

I get where you're coming from and for the most part, I agree. No offense to anyone on AllNurses or other forums, but with all due respect, it can be really hard to determine legitimate/unbiased information on the internet, especially forums. It is a fact that negative experiences (I don't just mean in nursing) are going to be talked about more often than positive ones. Like restaurant reviews. It is much more likely that people will take the time to write a negative review, instead of a positive one. Not everything on a forum is always accurate.
Our school also featured many "Life After Nursing School" luncheons where previous alumni would come to the school and talk about how they got started in their first job. Not one of them warned against contracts despite working at facilities that had them. When I told people I knew in the nursing community where I got a job at, they were almost theatrically aghast; "No way, you scored a job THERE??? That's incredible, I'm so happy for you!" And they weren't being sarcastic. I'm not saying it's all a conspiracy, maybe they were just being nice. But still.
Over the past year I have lurked around this community and it seems like there are some wonderful people here. But at the time, it came down to Someone I Don't Know Posting Online's word vs. People in Real Life Who Appear Happy and Trustworthy Who I Could Physically Talk To's word.
See bolded portion below. That said, HCA does have overwhelmingly bad reviews, everywhere, and it would have been beneficial to give those more credence. 

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Well and then there's always that nurse that comes around to remind inquirers that everything is fine and dandy and the only people who post their negative experiences online are angry, miserable people. I mean this crops up just about every time someone asks what nursing is really like/if nurses hate nursing/ etc., etc. It's practically a phenomenon. If someone asks is X really that bad some people are going to say yes and some are going to say no, and someone is going to add on that people are just overexaggerating/complainers/angry/miserable.

My sense is that it isn't quite as easy to really find out about a place these days. For example all of this shadowing advice I read on here--I haven't seen that allowed in the time I've been a nurse, in either the academic/very large/metro acute care setting or the community acute care setting.

I think some of the best advice is that if something isn't on paper it can't be counted on. And how does someone really make a great decision when they can't truly see the day-to-day inner workings, have no experience in the role and can't believe anything that isn't on paper? Their best bet is to try to work as a tech and hope the unit they work on will hire them as an RN...and then still not count on anything that isn't on paper.

There are some wonderful older teens and young adults in my smaller community and extended family and I can imagine exactly how this happens: You have a bright-eyed, positive attitude and therefore downgrade the importance of anyone's warnings or negative stories. You have schools of nursing and other forces on the educational path leading students to imagine that their career is going to suck if they can't get a coveted "residency" spot. They then meet a nice sweet-talker employer representative who says things like, "well, technically we could but that never happens..." and other things like, "it costs five-hundred bajillion to train a single new nurse in our highly superior and selective program and so if you leave we will ask for a small portion of that to be paid back" and then all the over-hyped information about their wonderful super-star RN training program...put it all together and, I don't know. It's just easy to imagine how things happen. Not everyone has a wise parent or life advisor who gives good advice.

Plus then the bigger problem is what do new nurses do when this is more and more the risk of getting an acute care job? There are more stories than ever about people straight up being lied to (off the record, of course). That was NOT what I was up against when I got my new grad job at a huge acute care employer, had my regular old non-fancy (but stellar) "orientation" period, went to specialty-related classes, had a dedicated expert-level preceptor on days and then another one on nights, and was treated very well as a new nurse. Part of the problem here isn't that they shouldn't have signed the contract, it's that there's a huge discrepancy between what they are told (or what they can reasonably be expected to imagine) and what happens when they get out on the floors. That latter part is what sinks things and is conveniently the part that isn't on paper.

This is exactly what happens! This quote is what finally convinced me to make an account and respond.

[JKL33]

5 hours ago, idontcare said:

This is exactly what happens! This quote is what finally convinced me to make an account and respond.

Hello -

That is my response that you quoted and I just wanted to add that I have never experienced a new-grad contract before--I just personally don't think it's that hard to either observe or imagine everything that I wrote (and that you wrote). As far as I'm concerned it's crystal clear what is going on with these contracts. I am really not sure how any experienced nurse cannot imagine that large hospital corporations [who are entirely too big for their own britches and we KNOW this, we know what they are and how they roll] will stoop this low, or that their goal really would be to get the most naïve, cheap help that they can. Or that they would lie about what they are offering. Or that they wouldn't continually look for new ways to treat people poorly if it served their purposes.

Well, anyway, I've already said more than my share. Just wanted to say I wish you well and hope that you will thrive and find peace/joy. There's a quote "Living well is the best revenge." I like it cause it feels good, but it's a little problematic. I say just forget the revenge and live well for yourself and your loved ones. Don't waste any more emotional energy on people who feel proud when they conjure up more ways to suck.

??

 

[brandy1017, ASN, RN]

15 hours ago, idontcare said:

If you don't feel like reading all of this, at least read this: These "contracts" are nothing more than you paying a multi-billion dollar corporation for a job.
 

Thank you for sharing your experience.  I hope it will help others out there avoid the same misfortune.  I'm glad you were able to leave and not have to pay back the contract.  It certainly does sound like a conspiracy between the nursing school and hospitals.  It is sickening that your mentor instructor would push you into it, surely she knew what HCA was all about!  Did she work for them?  I wonder if they get a commission?  Seriously!  

My mom was just in the hospital and her travel nurse was from Florida and we were talking about Ascension and she said they are not as bad as HCA in her experience.  I took early retirement after Ascension destroyed my hospital and cut all our support staff and raised our patient ratios even before covid, but that's another story.  She said she loved Floria, but wouldn't want to work there as a nurse under the present conditions, but was surprised to find there were actually decent hospitals out there during her travels.

Also I wonder if part of the problem is Texas.  It is a very red state to the point where it allows companies to opt out of workers compensation and create their own insurance lead alternative which is anti-worker.  Texas doesn't even belong to the national electric grid which has led to several deadly blackouts most recently in February 2021 because of the refusal to spend the money to winterize the power grid.

Some states are better especially California due to state staffing ratios.  I've heard Washington is also good.  I know not everyone can relocate.  I advise checking out nurses reviews on glass door or indeed, but read the reviews because many nurses will give 3-5 stars even when the actual conditions aren't good.  Also job shadow if you are able.  Also check out what the state law is toward contracts as some states these contracts are illegal, unenforceable, yet corporations will still have nurses sign them as most won't be aware of this fact and can use that to keep a captive audience.

"For nearly two dozen nurses, leaving Parkland early comes at a cost (dallasnews.com)" is a story about nurses breaking their contract and without a lawyer to fight a judge finds for the hospital against them.  I assume therefore that Texas as a red state allows these one way contracts to be enforced.  I was not able to copy the news story as you need to have a membership.  But on a hopeful note the NNU is fighting to stop these contracts, see below:

Nurses call on FTC to investigate hospital contracts that place onerous burden on new RN graduates

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National Nurses United (NNU) is calling on the Federal Trade Commission (FTC) to investigate exploitative employment contracts common in the hospital industry that impose harsh burdens on new registered nurse graduates.