National Nurses United

"I was standing between him and where he wanted to go," Gaff- ney said, recalling the incident that left her "pretty banged up" and the doctor who reviewed her x-rays questioning her choice of employment. But Gaffney said she did feel very intimidated by the constraints and threats that came with the contract she signed in order to get her first job as a nurse in Redding, Calif. "Shasta Regional Medical Center was the only acute-care hospi- tal at the time in town that hired new graduates with associate's degrees in nursing," said Gaffney. "Plus, I had spent years there working as a patient care tech, so I knew the caliber of the staff and I knew the hospital." Gaffney also knew from other nurses she would be required to sign a training repayment agreement provision (TRAP) when she took the job, but she didn't know the details beyond that and man- agement never took the time to explain it further. All she knew was the take-it-or-leave-it contract demanded she work three years, or pay $30,000. Gaffney was already deeply in debt from nursing school loans and was caring for her disabled father whose dementia diagnosis required him to have 24-hour care. "I felt like I really didn't have a choice," said Gaffney. "I needed a job." So Gaffney signed the contract. While some form of employer driven debt schemes have existed for decades, they really began to proliferate and become widespread in the nursing field during the Great Recession, when some new grads had difficulty finding jobs and as hospital consolidation grew dramatically, said Carmen Comsti, a lead regulatory policy specialist at National Nurses United (NNU). Before that, hospitals took the opportunity during economic downturns to cut their education departments, discontinue preceptor and mentorship programs, and eliminate new nurse grad programs. New nurses used to receive 12 weeks or more of on-the-job preceptorship from an experienced RN before they took on their own patient assignments, and it was typi- cal to pull a regular salary as a full-fledged staff nurse during that training and orientation period. Then hospitals started to force nurses into "residency" programs where nurses paid, either directly or indirectly through an affiliated nursing school, for that basic training and experience to transition into clinical practice. Now the hospital industry has gone a step further in insisting that nurses must pay exorbitant sums if they do not meet the terms of their hir- ing contracts, leaving them on the hook for thousands of dollars. "These coercive agreements exploit the most vulnerable of our nurses, just as they are starting their professional nursing careers," said NNU President Jean Ross, RN. "Hospital administrators have corrupted the notion of onboarding and on-the-job training by cre- ating a scheme of modern-day indentured servitude." NNU and its affiliates have been working to eliminate these types of contracts, challenging their legality and denouncing them for holding nurses hostage as debtors. In 2020, California Nurses Association successfully passed legis- lation, A.B. 2588, to bar employers from requiring direct care workers, including nurses, to pay for employer-mandated training. The bill also created retaliation protection for any job applicant who refuses to enter into a contract or agreement that binds them to pay- ing for employer-required educational programs or training. Since then, CNA's been working with California lawmakers to ensure this ban is enforced. O C T O B E R | N O V E M B E R | D E C E M B E R 2 0 2 2 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 17 M ichelle gaffney, an intensive care unit nurse, is not someone who is easily intimidated. She trained as an EMT, spent a few years as a live- stock steward, has driven at midnight through Kansas snowstorms to help birth calves, and even tussled with a few bulls, including one who rolled her like a breadstick as he attempted an escape. Hospitals are increasingly forcing new RNs to sign exploitative training repayment contracts to get hired. NNU is fighting back, on behalf of nurses, patients, and the profession. By Rachel Berger

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