The schedule is brutal at times, because the work is not only stressful and difficult, but the shifts that are expected are very long, at times without breaks. Time off was a difficulty, as some shifts are only covered by one employee. Ultimately, we were responsible for finding someone to cover a shift that we wanted to take as a vacation day, but many times the willing person was not suitable in management's estimation. There were little to no pay raises. After the company left Summa Health System, morale and company culture went downhill fairly quickly.