The absolute worst system I've ever worked for, I've worked for five. 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. Pushing 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 afloat. Entirely metrics-based after hearing conversations with managers and charge nurses. I was recently talking to my wife about changing careers and she reminded me I only ever bring that up when I'm contracting with an HCA facility.