Kira Farrington entered the nursing workforce last year as the COVID-19 pandemic took the world in its grasp.
As part of a condition of her hire at an HCA Healthcare facility in Asheville, North Carolina, she had to sign a contract that bound her to the system for two years and carried a penalty of to $10,000 if she left sooner.
"That's just not feasible for me who's a fairly new nurse and single mom," Farrington said. "It's a financial burden."
National Nurses United, a union representing more than 175,000 members nationwide, believes contracts like that are "exploitative" and is asking the Federal Trade Commission to investigate. "The true intent of the contracts is to indenture nurses to the employers," the union said in a news release.
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Hospital industry representatives reject that characterization, and insist penalties for leaving an employer are necessary to protect hospitals from spending money training nurses only to have them depart before they've recouped the investment.
Training programs are a "win-win for patients and nurses" because they improve quality and help nurses advance their careers, said Chip Kahn, CEO of the Federation of American Hospitals, a trade organization representing for-profit hospitals such as Nashville, Tennessee-based HCA and Dallas-based Tenet Healthcare.
"Having the most up-to-date and well-trained nurses is a mission critical ingredient of effective patient care in hospitals. That's why FAH member hospitals and health systems invest in their nurses by contributing to their professional development through continuing clinical education and training programs," Kahn said in a news release.
In comments submitted to the FTC, National Nurses United highlighted contracts at HCA, Tenet and Columbia, Maryland-based MedStar Health. Similar to HCA, newly graduated nurses at Tenet's El Paso sites must commit to two-year stints or face a $10,000 penalty. At MedStar, new nurses must agree to stay for 18 months or pay $5,000.
HCA provides "comprehensive training and education for new nurses when they decide to join our hospitals," the company said in statement.
"Our programs were developed by nurse educators as an important investment in our colleagues and demonstrate our commitment to advancing the nursing profession," HCA said. "During the course of their commitment, nurses are eligible for promotion and have the flexibility to pursue opportunities at any of our more than 2,000 sites of care across the country."
Tenet declined to comment and MedStar did not respond to requests for comment.
Farrington's training consisted of five weeks of PowerPoint presentations that reiterated what she learned in nursing school, she said. She also was floated to different units for which she wasn't trained after being on the job only a month.
"Honestly, I was terrified," Farrington said. "I will not sign another contract that locks me into any kind of servitude where I owe them…. You shouldn't have to force people to stay with threats."
National Nurses United recommends a new California law that doesn't allow hospitals to force hospital employees to cover their training costs as a national model.
"We believe that once these agreements have received due scrutiny, the FTC will conclude, just as the California legislature did, that the contracts are in violation of current law and the appropriate remedies must be taken to ensure a fair playing field for nurses and hospital workers," the union said.
