Does a nurse have to pay back her sign-on bonus?

By | 2019-02-14T14:34:03-05:00 February 13th, 2019|0 Comments

In an email, a nurse recounted how she signed a contract to work the night shift on weekends at a local hospital and received a $10,000 sign-on bonus.

Shortly after beginning orientation, her shift was given to someone else and the nurse was told she would be working the day shift five days a week.

In addition to this major change, the nurse found out that “infection control standards” at the hospitals were not being met. The nurse discovered four other nurses left their jobs at the hospital because of these inadequacies.

After two months, the nurse quit her job and moved out of state. Subsequently, the hospital asked her to repay the $10,000 bonus. She asked me if her employer’s request is “legal.”

This question highlights the significance of contract law in nursing. Most often, nurses are very aware of professional negligence liability in nursing but are not well versed in other areas of law that affect their practice.

What’s contract law about?

Contract law does not involve torts, such as professional negligence, but involves an agreement of the parties — the nurse and employer — in which one person agrees to give, to permit, or not to permit something expressed or implied by the agreement.

In this case, the employer agreed to pay the nurse $10,000 when the employment contract was signed for the specified weekend shift and the nurse agreed to those terms.

Although the nurse did not mention the contract’s other provisions, one thing is clear: the employer changed two of the provisions of the contract — the days worked and on which shift that work was to occur.

Contract law states when either party does not live up to provisions in the contract, a legal remedy is possible — a breach of contract action. A breach of contract is defined as not performing any term of a contract without a legitimate legal excuse.

It is unclear if the employer’s change of shift and days worked was with or without a legitimate legal excuse. Did the contract allow the employer to change the provision that governed days and shift worked and, if so, under what circumstances? Did it allow for the employer to change other provisions?

Additionally, was the weekend night shift a tentative arrangement or did the employer orally state it would be a permanent arrangement to the nurse, even if the contract did not state it was a permanent arrangement?

The email also did not mention the contract’s provisions concerning the nurse’s rights and whether there was an ability to challenge changes by the employer. For example, did the contract allow the nurse to challenge a change of shift and days worked? Did it contain a provision to complain to the employer if established working conditions did not meet nursing standards of practice?

Moreover, was the $10,000 sign-on bonus linked to a specific period of time the nurse had to work for the employer? Or was repayment to be waived by the employer under any circumstances?

Keep it civil

A breach of contract action is civil in nature and allows the injured party — the employer or the nurse — to be placed in a position they would have been in had the breach not occurred. In short, in most instances, this means monetary damages are awarded to the non-breaching party.

How this situation would be resolved if a lawsuit is filed by the nurse, or if the employer files a suit to recover its sign-on bonus, remains to be seen.

The nurse could be required to repay the sign-on bonus she received. Or the employer could be required to rehire the nurse at the same salary on the shift and days agreed to in the contract.

In contract law, this is called specific performance — requiring the employer to fulfill the specific provisions in the contract.

Regardless of how this particular case would be resolved, as a nurse it calls attention to details you should be clear about if an employer offers you an employment contract, especially if it involves a sign-on bonus. Keep these tips in mind:

  1. Think carefully before accepting an oral employment contract or promises made outside the “four corners” of the contract, as they can be difficult to prove.

  2. Determine time parameters that are required in the contract, such as length of time you have to be employed or the length of time the contract will remain in effect.

  3. Carefully review the employer’s ability — as well as your own — to change the terms of the employment agreement.

  4. Identify what options are available to you if working conditions do not meet standards of nursing practice.

  5. Use the employer’s established procedures in the contract to negotiate changes in the employment contract.

  6. Realize that, unless the contract so states, the length of time you worked for the employer may not relieve you of your obligations to repay a sign-on bonus or other monetary benefits, such as tuition reimbursement.

  7. Contracts of employment can contain implied agreements, such as an assumption that if the nurse left the agreed-to job, she would have to repay the sign-on bonus, which a court would have to determine.

  8. If you are offered a contract of employment, have it reviewed by a nurse attorney or attorney before signing it.


Take these courses related to nurses’ rights and responsibilities:

The Nurses’ Bill of Rights
(1 contact hr)
The Nurses’ Bill of Rights is a statement of professional rights rather than a legal document. It establishes an informal covenant between nurses and their employing institutions to help guide organizational policy and to focus discussions between nurses and employers on issues related to patient care and working conditions. Nurses can advocate more effectively for patients’ rights when they have critical information about their own rights. Not every nurse is familiar with the Nurses’ Bill of Rights or related rights described by various state boards of nursing and nursing associations in their position statements. This module provides an overview of them.

Sexual Harassment and Retaliation
(1 contact hr)

Sexual harassment is a form of sex discrimination that constitutes an unlawful employment practice in violation of Title VII of the Civil Rights Act of 1964. This statute prohibits employment-based discrimination on the grounds of race, color, religion, national origin or sex in all aspects of the employment process, from recruiting through termination. As the result of a 2006 Supreme Court ruling, plaintiffs need not prove that they have suffered an ultimate employment action, such as involuntary termination, to file a claim of retaliation after filing a discrimination complaint under Title VII. Employers and employees need to understand the implications of Title VII in the workplace environment.

Protect Yourself
(1 contact hr)

Nurses have an obligation to keep abreast of current issues surrounding the regulation of the practice of nursing, not only in their respective states, but also across the nation, especially when their nursing practice crosses state borders. Because the practice of nursing is a right granted by a state to protect those who need nursing care, nurses have a duty to patients to practice in a safe, competent and responsible manner. This requires a nurse licensee to practice in conformity with their states statute and regulations. This course outlines information about nurse practice acts and how they affect nursing practice.


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About the Author:

Nancy J. Brent, MS, JD, RN
Our legal information columnist Nancy J. Brent, MS, JD, RN, received her Juris Doctor from Loyola University Chicago School of Law and concentrates her solo law practice in health law and legal representation, consultation and education for healthcare professionals, school of nursing faculty and healthcare delivery facilities. Brent has conducted many seminars on legal issues in nursing and healthcare delivery across the country and has published extensively in the area of law and nursing practice. She brings more than 30 years of experience to her role of legal information columnist. Her posts are designed for educational purposes only and are not to be taken as specific legal or other advice. Individuals who need advice on a specific incident or work situation should contact a nurse attorney or attorney in their state. Visit The American Association of Nurse Attorneys website to search its attorney referral database by state.

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