registered nurse

patient care technician

registered nurse - pacu

registered nurse - operating room

medical assistant

Northside Hospital

Very unappreciative company that preaches work/life balance but doesn't practice.

The typical day involves handling 100-125 emails per day. Each recruiter is assigned to certain facilities (hospitals, schools, etc) and they are required to maintain a pipeline of applicants for various positions. At HCA, applicants are the top priority and are treated with "kid gloves." The recruiters are literally treated like a disposable asset. Applicants are allowed to miss interviews, mistreat the recruiter, etc. There is no regard for a recruiters time or schedule. HCA cares about making numbers and filling positions at any cost.

In addition, the recruiter is responsible with maintaining communication with between 10-15 department managers, 1-2 Assistant Chief Nursing Officers, and a Chief Nursing Officer. Each department manager has specific requests/requirements for their potential applicants. Scheduling applicants for interviews is extremely tedious due to rotating schedules and the majority of the applicants are students that have school schedules. Most hiring managers will interview between 3-4 applicants per position with a hiring number of 3-5 each cohort. One facility is more than enough work for a recruiter but at HCA, each recruiter covers 2-3 facilities. In our department, we started with 7 recruiters and eventually ended up with 2 covering the same amount of facilities.

The facilities are given specific deadlines for finalization of cohorts including accepted offer letters but they are never held responsible for these deadlines, which creates intense pressure for the recruiters. The facilities wait until the last minute to make their decisions, if at all, creating a bottle neck in the process which requires the recruiters to work additional hours and creates frustration, stress and anxiety.

Recruiters are also tasked with marketing and hiring events. A marketing event is usually just for brand awareness and makes no positive impact on recruiting but it does waste a full day of a recruiters time. Hiring events are usually very productive and are recommended to the facilities but the advice is not always taken.

There is no training program for the New Graduate Recruiting program. None. Zero. I requested training from division on several occasions and they were never able to provide me any training and two of the division managers completely ignored my request but were happy to hold me accountable for mistakes made on tasks they never provided training for.

The division management, especially in the Far West Division, is completely clueless and pay no attention whatsoever to the issues that are brought to their attention. The last two division managers were two of the worst people I have ever worked for. Neither of them put forth even the slightest amount of effort to understand exactly what we do, nor did they care about the unnecessary stress and poor work/life ratio. The interim manager was literally one of the most backhanded, spineless weasels I have ever worked for and I feel sorry for anyone who has to work for this guy. He did not listen to any of our issues. He did not hold the facilities responsible. He really did nothing productive as far as I could tell and our job satisfaction and productivity went down under his "management." Be prepared to work for the most two faced person you will ever work for. The new division manager is no better and despite our issues and voiced concerns. When the entire division voiced our frustration over the amount of work we were being tasked with, they released 3 more recruiters. The division manager is extremely short sighted. That is a great example of the way HCA treats their recruiting departments.

We consistently went to meetings with the Corporate Talent Acquisitions department and they really seemed out of touch with what the recruiters were actually dealing with. They were more busy managing "skits" and unnecessary training instead of really finding out what the recruiters were struggling with. The truth is, they do not care. HCA has a terrible reputation, there is a reason for that, they earned it.

Pharmacists are not valued as medication experts at HCA. They are simply viewed as enforcers of the formulary; pawns that will help the company save on drug expenditures and ensure optimal profit margins. The shareholders take precedence over all else, incluing sick and dying patients.
Attempting to grow and expand services at the facility level is not allowed. Decisions in this regard are driven from the corporate office and are generally extremely short sighted. The onus placed on facility-level pharmacy is to do more with less. When the case is made that additional staff is needed, the answer is always "no." Small hospitals especially find themselves woefully under staffed; so much so that patient safety is compromised. The argument that deploying an adequate number of pharmacists to perform clinical work will improve patient outcomes thereby reducing total costs of care (which is well substantiated by evidence) is given no merit. 
The formulary decision making process is driven from the corporate level and is fraught with short-sightedness and generally poor judgment. The basis of nearly all decisions is reduction of direct drug expenditures. No consideration is given to patient outcomes or evaluation of costs from a broader perspective. Certain medications are essentially banned from use due to their cost, regardless of whether their use would result in the best outcome for the patient. Whether a pharmacy department is managing their supply expense well is evaluated based on drug expense per adjusted patient day; a metric that in no way reflects whether drug purchases are appropriate for the patients receiving the drug. The metric is used simply because it gives the best estimate of income for the company. Thus, if expenditures per unit of income are minimized, a favorable profit margin can be ensured. (Remember, shareholders come first.)
A top heavy structure is consistent throughout the company. Frontline staff especially have no voice. While management will attempt to deceive staff into believing that their opinion counts, nothing could be further from the truth. Nearly all decisions are made at a division or corporate level with virtually no input at the individual facility level. The end result is disorganized, severely flawed, poorly executed initiatives led by unqualified individuals that often need to be revamped soon after they have been rolled out. The practice of "putting the cart before the horse" seems to be a long standing HCA tradition.
In my time with the company, I have seen many decisions made that most would consider to be morally reprehensible. If you raise your concerns, you are considered to be a troublemaker. Individuals who simply keep their mouths shut and do what their told are held in high regard. This is especially true if you suck up to the right people.
Administrators and other leaders will preach about ideals such as accountability and integrity; yet fail to exhibit these characteristics themselves. One would dare not share this observation, however; lest you be considered a problem employee. This is a prominent concept within HCA in general: a lot of talk and very little (if any) action.
Finally, physician bullying is overlooked. Despite its detriment to patient safety, the fact that happy physicians make the company money is enough to convince administrators that there is no sense in addressing physician behavioral issues. The prospect of losing a physician's business is simply not worth the risk.
With so many health systems developing increasingly innovative ways to deploy pharmacists to ensure patients are making the best use of the medications they are receiving, I cannot fathom a reason one would want to work for this company. That is, unless you prefer to be a complacent "yes man" in an extremely bureaucratic environment. 

Over the 10+ years I've worked at HCA in various IT&S positions in the southeast divisions, the company went through some significant changes.  Projects became much more 'cookie-cutter', defined by corporate, and left little wiggle room for common sense.  They are entering the late stages of what I would call the "virtual savings" period of Lean, meaning the pressure to meet the corporate demand for more efficiency and savings starts having the opposing effect.  The pendulum has clearly swung the other way now as supervisors and managers alike are struggling to make up new ways of how they "saved" money for the company in a last-ditch effort to promote themselves.  This has lead to a worsening culture (as long-term Lean initiatives always do) which shows little signs of repairing itself until management changes.  Once investors start seeing X amount of savings made this year, it is next to impossible to turn those expectations back to a realistic level.

There are clearly 2 classes of staff at HCA facilities: professional and management.  I rarely saw a member of any level of management leave work late.  They average about 45 hours a week and have a rather cushy position.  Most of the managers and directors I worked with were enrolled in an online college and would spend large parts of their day completing their schooling so they could move up in the company.  In the meantime, most professional positions were being worked a minimum of 60 hours a week with little compensation.  This 2 class system has been aggravated by a recent push to look for outside candidates for filling management positions.  As an IT division manager put it, "We expect that everyone that wants to move up in the company is going to put their time in and prove that they want it."  Which is to say, if you want to move up, you have to be willing to put in ungodly amounts of effort into becoming a 'company man'.  The whole "work/life balance" talk here is strictly that... just talk.  At least in the IT realm, there is no such thing until you make management.  Then you are allowed to see your family again.

This review may seem like the rantings of a bitter employee, but keep in mind that I base my opinions on what I saw in over 30 HCA facilities in the southeast over a 10 year period.  I've seen hard working long term employees discarded like refuse because they weren't an "A worker" and they couldn't work them more than 60 hours a week.  This is not just my situation, but what I see happening to many HCA facilities.  Perhaps other divisions throughout HCA are different.  I can only speak of the southeast and corporate employees that I know and work with.

HCA corporate employees have an entirely different situation.  They have all of the Cisco learning credits, they regularly receive training, bonuses, and are at a completely different level (as a division employee, I was only offered training twice in 10 years!).  If you are lucky enough to land a job at the corporate campus, prepare for a very VERY easy time with lots of benefits.  Corporate employees also enjoy a certain exclusivity that makes them separated from the day to day operations at the facilities.  It was an extreme rarity to see a corporate IT employee online after 5pm and almost impossible to get a hold of them on the weekends.  

At the division side of the house, say goodbye to your friends and family for a while, consider getting your experience (which you will get PLENTY of), and move on if you don't make management in the first 3 years.  If you are lucky enough to land a director position, consider moving to Nashville and take on a corporate job... then enjoy the good life.

There is no typical day at work. The work flow is not constant or reliable. Your hours can be 40 a week, or 50 if they TELL you to work over time, or 30 if they don't have work for you (if you require 30 hours a week of pay, be prepared to use your time off hours to cover the gaps in your paycheck, which means you can't take a scheduled day off when you need it because you'll be out of hours already). On top of this, the office was under staffed for the most part. Open six days a week for 12 hours a day, yet only five people worked there. Management told us we were over staffed and was looking to cut hours and fire someone at the drop of a hat.

If they tell you that you have a set schedule it's a lie, they schedule you whenever they want you there and if you complain you get written up. You are required to work holidays, unless they decide to close for a holiday which they won't tell you until the week of so you can't make plans (this includes Christmas, Thanksgiving, and New Years). They claim it's because the work needs to get done that day, but don't have a problem mailing work to you from out of state, causing that work to have a 4-5 day waiting period before it gets done.

Family emergencies are not acceptable reasons for being late, having to leave, or calling out. If the hospital is open, your office is open, even if the hospital is closed to the minimum of ER only and everyone else sent home, you are expected to be at work. In fact, anything that makes it hard for you to get to work/need to leave work, is seen as a personal issue which counts against you in your review and can be cause for termination.

Management is located in Virginia, so if your office is in another state you might not see your manager for 3-4 months at a time. This means if there's something you need to discuss with them, if you're not capable of doing it in email or on the phone, you have to wait (which by the way, they read and delete emails in YOUR account they don't want you to have, including previous emails from them which they contradict themselves on policies and procedures). However, the main objective of management visits are generally to discipline everyone in the office for some reason or another. They have one-on-ones with you, which involve pulling up reports of incidents that may have happened 2-3 months ago that you can't remember. All the while any advice/concerns/comments on the office fall on deaf ears as they're too busy managing their own office while visiting yours to do anything about problems you may have.

The people that are happy in this position are people who don't ever want to do more, therefore if you want to do more you're looked at negatively by your coworkers as someone who is "rocking the boat." I'm pretty sure the video "what not to talk about in the office" was made after my office went through a period of long racial/political rants by a few coworkers, none of which were discipline for their remarks (racial slurs apparently were acceptable in the office, even after being reported to management, HR, and anyone who would listen).

The most enjoyable part of my day was going home. When I finally informed management that I would be leaving to pursue another job they scoffed at me and told me they hoped I failed. I cannot use any references from this position and find it hard to talk about in job interviews because I do not want to be so negative about previous employment. There is nothing I took away from this position besides informing people I know to go to other hospitals that are not HCA owned because of the terrible way the whole operation is run.

•	Managed requirements for creating new templates from doctors and nurses through interviews.
•	Involved in all phases of implementation of a central Epic billing system. (Resolute and Prelude).
•	Organized and facilitated meetings with the management and development team and conducted the requirement gathering sessions with the purpose of creating and defining the Business and Functional Requirement Document (BR/FR) using Requisite Pro.
•	Worked on analysis of the Facets claims processing application in order to gather requirements to comply with HIPAA 5010 requirements.
•	Used Meditech 6.0 Electronic Medical Records to create templates and documents for EMR.
•	Monitored and controlled project schedule, scope, quality and cost. 
•	Documented Business Requirement Documents (BRD) and Requirement Specification Document (RSD). 
•	Analyzed business requirements and segregated them into high level and low level Use Cases, Activity and State diagrams using MS Visio, suggested and managed improvements in the process.
•	Responsible for Process modeling (BPMN: as-is, to-be), analysis and optimization
•	Managed design and development of a global cache across multiple WebSphere servers.
•	Managed project budgets, risk analysis and mitigation, issue management, root cause analysis, project schedule development and tracking using MS Project.
•	Utilized Mercator as an EDI mapping tool to map the claims data that passes through the EDI gateway to the Facets claims processing application.
•	Adhered to rigorous schedule to accommodate batch processing.
•	Co-ordinate with off shore development team and resolved all the EMR related queries
•	Updated and modified progress and resources allocation in MS project for the team.
•	Managed cross-functional teams internal and external vendors
•	Review the client's current ICD-9 claims experience and map them to the equivalent ICD-10 codes.
•	Managed Request for Proposal (RFP/RFI) documents and vendor evaluation by interviewing and simultaneous comparison of all vendors. 
•	Partnered with cross-functional teams (web development, engineering, sales, marketing etc.) to develop new advertising technologies and resolve technical issue.
•	Performed cost benefit analysis to implement E-payment initiative globally using third party payment processor.
•	Coordinate with the vendor (s) for solution scope, estimates, and schedule.
•	Manage project plan, issues, risks and action items for each account.
•	Created extensive test cases and assisted in User Acceptance Testing, UAT.
•	Responsible for requirement scoping and analyzing high priority requirement for implementation.
•	Managed functional requirement reviews and walkthroughs with the designers, developers, and stakeholders
•	Incorporated and implemented all the HIPAA standards, Electronic Data Interchange (EDI 835, 837, 270,271) transaction syntax like ANSI X12, ICD-9, ICD-10 coding and HL7.
•	Evaluated high-level Use Cases from Business Requirements and created UML diagrams like use case diagram and activity diagram using MS Visio for various stakeholders.
•	Managed project for development of virtualized architecture for large enterprise WebSphere Portal Server corporate implementation.
•	Managed gap and feasibility analysis for the design and architecture of the new application.
•	Managed Cache System database management, and as well as in HL7 standards, and data flow among various systems.

I work in Intermediate Care at SDMC and I have to say it is the best hospital I've ever had the pleasure of being employed by. 
I work night shift and twelve hour shifts.  At our hospital we do bedside report, so we get report and the patient's whiteboard is updated to show the change of shift. I introduce myself and discuss the plan of care for the evening with the patients, answering any questions they might have and making sure they are good with the four P's (pain, position, potty, personal items) The majority of our patients (with very few exceptions) are on the bedside monitor and we take hourly vital signs, so I take those into account with report and prioritize my care based on the information recieved. Assessments are done along with evening medications and then patients are bathed and their gowns and linens are changed. Focused assessments are constantly being performed throughout the shift so that we are able to recognize any changes in the patients status and optimize patients outcomes. After all assessments are done, medications are given and patients are able to bathe, patients are assisted to get comfortable for the evening so that hopefully they are able to sleep. As long as patient's are stable, I only wake them when I have to for things such as neurological checks, turning and repositioning and scheduled and prn medications to keep the patient's comfortable and stable. At about 0300, if I have patients with a PICC, I draw labs and get their daily weights, then give report to the charge nurse. After this I continue to monitor and assess until shift change, to which the process repeats itsself. 
I have learned a lot about critical care working here, from how to insert a dobhoff tube to cardiac rhythm interpretation. 
Management is great and I feel like they are a great resource to the floor nurses.  They do a great job ensuring that their staff remain up to date with their skills and certifications so that we are better able to serve our patients.  I also feel like they welcome and encourage our feedback on policies that are implemented on our unit.
My co-workers are amazing, we really know how to work as a team. There is no "my patient" on our floor, while we do have specific patient assignments, co-workers have no problem taking time out of their evening to help out a patient, whether it be helping make them more comfortable, helping to stabilize, or helping out with other patients during a crisis. 
The hardest part of my job is seeing critically ill patients that are unlikely to have a good clinical outcome.  Part of the reason I became a nurse is that I wanted to help people "get better".  This is not always possible and it can be a very hard aspect of care to deal with.
The most enjoyable part of my job is the patient interaction.  I get to know my patients, and helping them feel more comfortable/stable is very fulfilling.

I didn't learn much working there. Management & workplace culture are both terrible. Most of the managers there like to throw their power around and are bullies. Most people that work there are miserable and hate working there. My manager treated her staff like children, and was condescending when she talked to staff. Staff turnover is high. There are NO paid holidays, no matter what they tell you. All holiday pay comes out of your personal PTO. They will tell you that they give you more PTO than the typical company to make up for that, but that isn't true. And they don't tell you this when they hire you. Pay is not competitive, and raises are few and far between. If you ask for something to make you more productive at work, you get told that there is no budget for it. But then you walk into your manager's office and they have the best of everything. I needed a new chair because mine was literally dangerous to sit in. I was told it wasn't in the budget, so we had to go searching in storage areas for a better chair. that chair was still a terrible chair. It just wasn't about to fall apart. They force staff to wear badges that say, "PATIENTS COME FIRST." Those badges are embarrassing, because everyone knows that the almighty dollar comes first, and patient care is low on the priority list. The hardest part of the job was getting out of bed to go there day after day. The most enjoyable part of the job was interacting with patients and trying your best to actually help them with their needs. Their health insurance stinks. When they are recruiting staff they make it seem like you get virtually free healthcare as long as you use an HCA provider. That is also a lie. You still pay copays to see one of their providers, and they pay very little compared to other insurance companies. They also don't tell you that they will not pay for their insured to see Nurse Practitioners, despite the fact that they employ Nurse Practitioners. The first time someone on my plan saw an NP, they didn't pay a dime. When I inquired to the manger of the office, she was the one that told me that they won't pay. You can get around it, IF the manager of the office will agree to bill it through a doctor.  I worked with some people who had serious health issues, and their manager was constantly on their case about taking time off to go to doctor appointments to take care of their health. Despite the fact that most healthcare workers work the hours that most doctors offices are open, their manager told them to go to the doctor outside of their office's work hours. One of the best days of my life was the day I walked out of there for the last time.

I've been with this company for 8 years in a remote insurance verification role. During those 8 years my pay has  gone from $13 per hour to $15 per hour with zero promotions, despite zero call ins, 100% productivity met and 100% on every single QA. Plus consistent praise by management. I have seen 5 managers, helped train them, played a part in ensuring they shine in their roles,  and watched each get promoted at least once, whilst continuing to see an influx of new college grads getting hired directly into management. So, if you're looking for a place to advance, have a degree in business managment. I have a B.A., but not in business management so, non promotable.
I worked as a registrar in the emergency room at first, it was chaotic, but as long as you're OK with a fast paced environment with crazy hours, the work is fine, even satisfying. The worst part of that position is that the nurses were extremely rude to us. We were low on the totem pole and made to feel it.
After transitioning into my current position I loved it. It was Monday -Friday, 7AM-3PM. Low stress, work that allowed you to challenge yourself with reasonable expectations and plenty of room to excel. It was a company that not only had an objective of patient care I could get behind, but one that I believe truly cared for its employees. Fast forward to now, the dollar is the new bottom line. They are in the process of transferring our work to a cheaper, overseas vendor and the transition has gone so poorly that people are jumping ship left and right and those of use left are overloaded. Our schedules now include rotating weekends and it's not uncommon for people to work well into the night. We've lost 11 people in my department within the last year and those of us left are extremely overworked. You are not expected to work OT, but if you don't,  the work will continue to pile up and the further you get behind, the more miserable life becomes. It's a terrible domino effect and it's been made clear that the people who made the decisions that put us here, simply do not care. We're lucky to have jobs at all, right?
My direct management, from the regional director down, are amazing. They are now and have always been supportive, respectful, understanding and even apologetic at the direction the company has gone. THEY are the biggest reason I have remained with this company and all of their promotions have been very well deserved. I couldn't be prouder watching them grow and succeed, but it IS difficult remaining on the bottom ranks in an increasingly stressful environment. 

Beware

The nursing staff is highly overworked and burnout due to high patient to nurse ratios.  Nearly every unit in the hospital at the Lawnwood location in St Lucie County Florida is short staffed of nurses everyday.  Many of the patients are complete total cares and nurses, as well as PCT's, are often forced to take on harsh patient assignments with little help.  The PCT's are usually assigned nearly 20 patient's and it's expected for the RN to work along side the PCT and provide total care to high acuity patients.  

Most of the nurses I spoke with stated that they wanted to quite the first day I arrived, but the reason they don't leave is because they're stuck in a work contract (they don't want to owe the hospital money for breaking their contracts early).  Some nurses just take the chance and break the contracts early and jump ship to go work with a hospital that actually supports their nurses.  I've seen RN's get assigned upwards to 8 patients on a unit, and it's common ground to see nurses staffed 6-7 patients on a regular.  Absolutely INSANE!  So it's not surprising that the new nurses quit as soon as the come.  The more experienced nurses with years invested in the hospital mostly stay because of close ties with co-workers, or feeling charitable and wanting to give back to the community.  They tend to say, "It's not about the money."   But I say they're right, it's not about the money.  It's about safety for the patient and the nurse and those nurses smart enough to jump ship or give ultimatums are absolutely within their right and make much sense.

Many of the nurses at the Lawnwood hospital are new to the field altogether and are not properly trained to take on harsh patient assignments with little support from leadership.  Which is why they don't stay long.  People often quite their jobs when they feel unsupported, unproperly trained, and ignored by management.  Unfortunately, that's what goes on here.  Now I see the hospital is trying to hire LPNs to work on the units, but many of the managers don't understand the scope of practice of the LPNs.  They try to work the LPNs at the same capacity as the RNs which puts the LPNs at risk of violation for working outside their scope of practice.  But it doesn't seem like management even cares.  Poor staffing, poorly trained staffing, and inadequate support is a recipe for disaster and puts patients at risk of  harm and nurses at risk for violation of their license.  

I learnt that the practice I worked for was complete chaos since long before I started there. Huge turnover rate (10+ employees left in about a 2 year timeframe), poor communication, poor management; training was virtual but mostly learn-as-you-go as hardly anyone had time to train due to the work flow. Strongly recommends the company hires a regional trainer to formally train all employees so that there is consistency and nobody is left wondering what to do from one work station to the next. For this particular practice, the pay did not match the expected workload.  Poor work/life balance; employees not leaving until 7pm/8pm as they are gotten onto for not being a week ahead on charts or appointment confirmations although struggling to complete daily tasks due to the lack of proper staffing...then gotten onto about overtime. Daily, last minute rescheduling because of change in Provider’s schedule; many patients upset/left practice as that’s what the practice has become known for and consider it to be poor patient care. Physicians arguing with employees and belittling them in front of patients/staff and management shrugging it off because it’s a Provider, all the while telling the staff that “Here, we’re family!” More like Favoritism to me; some employees got by with things that others were gotten onto about. I genuinely enjoyed the front desk role but sought growth several times, informed my manager, and nothing ever came of it. The stress became too much for me and when I truly needed the support of my manager so that I could rejuvenate myself to continue performing my job well, manager denied my request for assistance (that was made at Manager’s suggestion) and I was not offered a way to retain employment.  This experience changed my whole outlook on a company that is supposedly “committed to the care and improvement of human life.” It showed me that although I was a dedicated, efficient employee which the company could depend on, I could not depend on my company; I was of no value.

Of course, everyone’s experiences, perceptions, and management styles are different, but this was mine and I hope it has been helpful.

Top Job Titles	Average Salary
Registered nurse 136 salaries reported	$42.39 per hour
Patient care technician 26 salaries reported	$22.95 per hour
Registered nurse - pacu 70 salaries reported	$49.90 per hour
Registered nurse - operating room 85 salaries reported	$50.28 per hour
Medical assistant 28 salaries reported	$23.76 per hour

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