Unfortunately, things aren’t always sunshine and daydreams while working a travel nursing job. Like any other time in life, there are a slew of potential pitfalls. In fact, there are too many issues for us to enumerate and address here. However, we can take a look at some of the overarching themes and offer some recommendations for handling them professionally and successfully.
Family issues while on a travel nursing job
First, you may encounter personal or family issues that necessitate immediate attention. For example, you may become ill, have a family member become ill, or have a death in the family. Such issues may require that you miss a little time at best, or cancel the remainder of the contract at worst.
When such issues arise, it’s always best to personally inform both your company and the hospital. This is the professional approach. You don’t want to leave either party without direct personal communication.
Which party you notify first is your choice. I tend to side with letting your company know first. This is a courtesy to let your company get ahead of the issue and formulate a plan. They may have a candidate that can take your place, or they may wish to contact the hospital in advance of you speaking with the hospital to see if they can work something out that benefits all parties. Also, companies have a tendency to believe it makes them look bad to be the last to find these things out.
In any case, you should document the issue as best you can. If it’s a personal health issue, try to obtain an official notice from your healthcare provider. If there’s a death in the family, try to obtain a copy of the certificate. I understand that this may seem callous, but your goal is to mitigate any potential problems that result from a contract cancellation. Hospitals certainly appreciate the effort. Moreover, companies may be more understanding and overlook any contract cancellation penalties if they receive documented proof.
Problems with your travel nursing agency
Second, you may encounter problems with your company and/or the services they provide. For example, you may encounter payroll errors or problems with inadequate or unsafe housing. My experience is that all companies desire to provide a high level of service. Retaining business is the easiest way to grow their business. As a result, you’ll be able to resolve these issues with your company in vast majority of cases.
However, you may come to an impasse with your recruiter in the process. If this happens, push your issue up the chain of command. You’ll most likely find that supervisors or other managers will resolve your issue promptly.
If you are still unable to resolve the issue, then you may consider taking it to social media outlets as a last resort. Agencies definitely don’t want the negative press and we routinely see resolutions come as a result of social media mentions. However, be very careful with this approach as certain agencies have been known to threaten legal action.
In the off-chance that you cannot resolve issues with your agency, you must document these issues as if you’re building a case, so be sure to start the process at the outset. Maintain copies of official documents such as pay stubs and keep a record of the discussions you have with your agency and other applicable parties. If you have a problem with housing or some other physical item, then take pictures to verify the issues. By adequately documenting the issue, you will ensure that you have proof of the problem and your efforts to deal with it in the off-chance that you cancel the contract.
Problems with the hospital while on a travel nursing assignment
Third, you may encounter problems with the hospital. There are problems that may arise with the hospital that while problematic can none the less be resolved through normal channels. For example, the hospital may not provide the access codes you need to perform your job adequately and efficiently. They may continually schedule you for the wrong shifts or float you despite the fact that you have an agreement not to float.
In all such scenarios, some combination of working directly with the company, hospital, or both, will generally result in resolution. You’ll have to make a judgment call as to how you approach these issues as they’re all quite unique. Many people would advise that these issues be addressed with the hospital first. By doing so, you’ll be dealing with the problem at the source and ensuring a quicker resolution. However, remember that if it’s an issue related to the travel nursing contract, then there is a possibility that your connections at the hospital are unaware of your contractual agreements. Therefore, alerting your company first may be the best route.
It’s also possible to run into personality conflicts that result in a hostile work environment. Again, you’ll need to determine the best approach given the circumstances. One of the best nurses I’ve ever worked with ran into a hostile co-worker while working an assignment in Los Angeles, CA. The permanent employee was upset that the travel nurse was getting scheduled for extra shifts. She felt the shifts should be going to a permanent staff member. However, the travel nurse was simply abiding by the hospital’s policies when securing the extra shifts.
The traveler attempted to deal with it directly with her unit manager who addressed the issue with the permanent employee. The problem subsided for a while but then flared up even worse a few weeks later. The traveler contacted me and we addressed the issue with my agency’s Chief Nursing Officer who wrote a report and sent it to the hospital. The permanent employee was actually released from duty. Things may not always turn out this way, but it gives you an idea of how to resolve these issues professionally and productively.
You may also have difficulty adapting to the hospital’s policies and procedures which can negatively impact your ability to provide the patient care you’re accustomed to. Remember, hospitals typically have very good reasons for doing things the way they do them. Their processes and procedures have typically been in place for years without incident. Part of travel nursing is being able to adapt to these circumstances.
That said, there are hospitals in need of travel nurse because they’re poorly managed and can’t retain staff. If you strongly believe that you’re at one of them, then you should immediately take the issue up with your travel nursing recruiter. It’s always good to ask your recruiter if they’ve had complaints about the unit in the past. This will give you an idea of whether or not there is a history of problems with this particular hospital, but it won’t solve the problem. You should be specific with your recruiter regarding the problems you’re encountering and provide potential solutions. That way, your recruiter can report to the hospital in an effort to resolve the issues.
If you’re unable to resolve the issue through your recruiter, then you can ask to speak with your company’s Chief Nursing Officer or clinical liaison. Sharing your concerns with an experienced clinician can result in several positive outcomes. First, you will ensure that your concerns are documented appropriately should there be any legal action. Second, the clinician may be able to provide valuable insight to help you overcome the issue. Third, the clinician may validate your concerns and seek to address them with the hospital. Finally, if a resolution still can not be reached, then the agency may be willing to help you find another assignment and/or let you out of the contract.
Travel nursing contract canceled by the hospital
Finally, you may run into to the unfortunate circumstance of having your contract cancelled by the hospital for performance related issues. Just like any other job, there are many reasons that this can happen, from attendance issues to vital mistakes that jeopardize patient safety. Unfortunately, there is typically nothing that you or your agency can do in these situations. Typically, the hospital is in the position of power to take this action as they see fit. There may be legal remedies, but they’re typically not going to be worth the trouble involved.
When this happens, it’s standard procedure for the agency’s Chief Nursing Officer or clinical liaison to file a report. They should, but don’t always, receive something in writing from the hospital detailing the reasons for termination. This information will be reviewed with the travel nurse and the travel nurse’s side of the story will be taken in to account. The Chief Nursing Officer will then make a recommendation to the agency as to whether or not the agency should continue to work with the nurse. This is all typically based on a system that assigns points for activities that violate the agency’s policies. Obviously, more severe circumstances will garner more points and increase the likelihood that the agency will be unable to work with the nurse moving forward. A similar decision will also be made at the hospital.
When an agency or hospital determines that they will no longer work with a nurse, then the nurse is labeled “DNU”, “DNS”, or “DNR” in the database. These are acronyms for Do Not Use, Do Not Send, and Do Not Return respectively. They all mean the same thing.
These significations can have a major impact when they are levied by entire hospital organizations or by the largest companies. For example, if you receive this label with the Hospital Corporation of America (HCA), or Kaiser, then this constitutes a significant number of hospitals at which you will no longer be able to work. If you receive this label at one of the large agencies, then it could be even worse. As mentioned previously, the largest agencies are often involved in the Managed Service Provider (MSP) business. They will apply this designation to all of their clients. If another company attempts to submit your profile for an opening through the MSP, then the MSP agency will reject it.
Unfortunately, this can happen to anybody. I’ve had it happen to some of the best nurses I’ve ever worked with. Fortunately, it’s not the end of the world. There are many hospitals in America that use travel nurses. However, you want to learn from it and take steps to ensure it doesn’t happen again.
As always, please share your experiences with this topic and any questions you may have in the comments section below.