Trapped

With nurses in short supply, U.S. hospitals are leaning harder than ever on underpaid contract staffers who aren’t allowed to leave when their shift is over

- By Josh Eidelson, Photography by Haruka Sakaguchi

A couple of years ago, Novie Dale Carmen paid $20,000 to quit her nursing job. She was less than halfway to fulfilling the three-year commitment she’d made to Health Carousel LLC, the healthcare staffing agency that had helped get her from the Philippines to a hospital in Muncy, a town about three hours northwest of Philadelphia. From across the Pacific, the deal had seemed like a good one, but once she was in Pennsylvania, she began to feel differently.

Carmen says she was paid much less than the American nurses around her. She was banned from discussing her working conditions or going out of town without notifying the agency. Health Carousel seemed to keep finding ways not to count her work toward the 6,240 hours on her contract—the first three months of shifts didn’t qualify, the company said, because it considered that time part of her orientation period. Mandatory overtime didn’t count toward her quota, either. And because she couldn’t refuse overtime, her shifts could stretch as long as 16 hours in an understaffed emergency room.

“I was basically trapped,” Carmen says. “Duped.” To pay Health Carousel’s $20,000 quitting fee, she borrowed the money from her boyfriend, who’d been saving for years to buy a house. She’d refused his offer before, out of guilt and pride, but was desperate to get away from Health Carousel without being sued for quitting, as had happened to many of her peers.