A sign-on bonus is information before it is money. Units offer bonuses when the normal levers — pay scale, reputation, schedule — have not filled the position. Sometimes that is a boring supply problem: a new tower opened, a cohort retired, the region is short. Sometimes it is the other thing. Your job is to figure out which before you sign.
Read the structure, not the headline
The number on the posting is the least informative part. What matters is the payout schedule and the strings. A bonus paid out over two or three years is a retention device: leave early and you owe money back, which is the point. Ask three questions in writing: When is each installment paid? What triggers repayment, and is it prorated? Does taking the bonus lock you out of internal transfers for a period?
That last one catches people. Some agreements quietly bar you from moving units — even upward — until the bonus term ends. If you are taking a med-surg job as a stepping stone to the ICU, a two-year transfer lock changes the math completely.
The honest comparison
A $15,000 bonus over two years is about $3.60/hour for a full-time schedule. Run that arithmetic on any bonus you are offered and compare it against the base rate at the hospital across town. Very often the no-bonus job with a better base wins over the term of the agreement — and keeps winning after the bonus job's headline number expires. Bonuses expire; base rates compound through every raise, differential, and overtime hour that follows.
