Becker's Hospital Review

45 CMO / CARE DELIVERY When hospitals stick nurses with $15K in training costs By Erica Carbajal S ome hospitals are sticking recent nurse graduates with the cost of training programs if they leave or are fired before their contract is up — a practice that has become increasingly common, according to a March 12 report from NBC News. Based on an review of more than a dozen nursing contracts, as well as interviews with people in healthcare, NBC found the practice has become increasingly common, with some hospitals requiring nurses to pay back as much as $15,000 if they try to leave or are fired before their contract expires. Of nurses who said they've participated in a training or residency program, 55 percent said they were required to repay their employer for training as part of a contract if they quit or were fired before it expired, according to a National Nurses United survey. e agreements are standard for entry-level nurses at Nashville, Tenn.- based HCA Healthcare, which operates 184 hospitals. NBC spoke to one nurse, Jacqui Rum, BSN, RN, who said she quit before her two- year contract was up at HCA's Los Robles Regional Medical Center in ousand Oaks, Calif., due to heavy workload and understaffing. Ms. Rum said she has received several letters from the hospital operator since October, asking for the $2,000 she owes for remaining training costs and threatening legal fees. "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," Ms. Rum told NBC. "I didn't even have time to take a lunch break, my hair was falling out, the level of stress just wasn't sustainable." An HCA spokesperson in a statement to the news outlet said the programs were developed by nurse educators as "an important investment in our colleagues and demonstrate our commitment to the nursing profession." e programs enable nurses to receive training across specialties and the option to transfer to other facilities, the spokesperson said. "Given our substantial investment in this professional development program, we ask participants to commit to stay with us for a certain period of time aer 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 hospital operator said. Hospital officials say the practice of embedding training repayment into contracts is a long-standing practice. An official at UCHealth in Aurora, Colo., said their training program can cost a hospital $60,000 to $100,000 per nurse for the first year. e system recently moved to stop requiring repayment. e Consumer Financial Protection Bureau began investigating the practice in September and is reviewing training repayment programs to assess whether it should take additional oversight actions. n Image Credit: Adobe Stock The unexpected benefit Erlanger saw after raising nurse pay By Erica Carbajal C hattanooga, Tenn.-based Erlanger Health System has seen fewer nurses call in sick since the approval of a 10 percent pay raise in January, the Chattanooga Times Free Press reported Feb. 26. The Erlanger Board of Trustees approved the raise for 1,500 hospital-based nurses and more than 300 on-call nurses in January, with the adjustments effective Feb. 5. During a recent board meeting, Rachel Harris, BSN, RN, the system's senior vice president and chief nurse executive, said the reduction in the number of nurses calling off was an unexpected benefit of the pay raises. She cited Erlanger's decreased reliance on internal contracts that mandated nurses work four or five shifts per week throughout the pandemic, and the base pay increase as the main reasons why fewer nurses are calling in. "They would come, and they were tired, and so four or five shifts in, they would call in. They're exhausted," Ms. Harris said, according to the Chattanooga Times Free Press. "I think it's giving them a chance to build back their resilience. And I think we're getting more quality care out of the staff, because you just can't continuously for [two and a half] to three years work this amount of hours." In a statement to the news outlet, Ms. Harris said Erlanger has also seen improvements in nurse retention since it added more focus on well-being. n

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