The absolute worst system I've ever worked for, I've worked for six. I'm an ED nurse and have traveled a total of 18 months with HCA. I won't elaborate too much on this, I'm just here to validate everything you've already heard. HCA pushes unnecessary treatments on patients, sepsis workups, trauma workups, etc., all just to pad their numbers and pockets. Absolute minimum skeleton staff, just barely enough to keep the department from burning down. Entirely metrics-based operations model, it doesn't matter if the entire ED is full of critical care patients, they'll force the manager to force the charge nurse to send RNs home if the census metrics aren't met, this was witnessed first-hand. The worst part is how HCA duped me into working overtime for free, and why I would rate compensation with negative stars if I could. When I was at Good Sam, management practically begged me to work as much overtime as I possibly could, I agreed. I did 12 out of 14 days straight, including Christmas eve and day, and new years eve and day. About a month later my recruiter tells me HCA submitted a new contract that pays less for the remaining month I was there, which I had to agree to in order to stay on as a traveler. The total for the third month worked out to be what I would have made that month minus the exact amount of overtime I put in during the first month of that contract. Thanks to HCA I've never picked up extra shifts with any contract since. The only way I would ever consider contracting with HCA again is if I was on the verge of homelessness.