Practice Tip of the Week | Exploring the World of Travel Nursing with NSO

Risk Education from NSO

The long-term outlook for travel nurses appears healthy, as the COVID-19 pandemic has exasperated ongoing challenges with bedside nurse staffing, with some nurses choosing to leave the profession, retire early, or switch jobs. As a result, many organizations
are struggling to fill their job openings, leading to a boom in the use of travel nurses. Here is what you need to know before packing your bags to take a travel nurse job, including how to get started, be successful when on assignment, and help protect
yourself from legal liability.

Getting started You should have at least a year’s experience as a nurse before traveling since you will be expected to have the expertise required to practice independently. You’ll also need to have a license in the state where
you’ll be practicing, and some jobs require specialty certification.

When selecting a travel company, don’t simply look at the salary. Check for benefits such as medical and dental insurance and reimbursement for travel to your assignment. Many companies will help you with finding housing, and continuing education and
tuition reimbursement may be offered. Some companies even have retirement plans. If you work with any travel nurses, ask them about their experiences with the company that employees them. You can also check reviews on Google or Glassdoor. It’s also
a good idea to ask how the company typically handles guaranteed hours with an organization because this varies. In some cases, there are no guaranteed hours. If census unexpectedly drops and you aren’t needed, you will not be paid. In other situations,
you may need to float to another unit to obtain your guaranteed hours.

You’ll be asked to create a job profile with the company and complete some paperwork before you are assigned a recruiter and start your job search. Most travel companies require a background check, drug testing, physical examination, a current negative
TB skin test, and various immunizations such as Hepatitis B. Proof of vaccination against COVID-19 is also likely. You’ll probably be asked to complete a skills checklist that potential employers can review. Ultimately, you will sign a contract
with the company. Review this document carefully before signing, paying particular attention to what your compensation does and does not include (for example, housing). Keep in mind that your contract is with the travel company, not the organization
you are assigned to.

Interview time The interview with the manager of the facility where you will be working will likely be by telephone or video platform. As with any interview, the manager will ask about your expertise and they will be looking to
determine if you are a good fit for the organization. And as with any interview, this also is your time to ask questions, such as nurse to patient ratios, floating policy, how scheduling is done, and specifics about the types of patients you will
be caring for. Other good questions include who provides any required scrubs, and parking availability. Once the organization agrees to your assignment, the travel company will send a confirmation notice that includes items such as start and end date,
assigned unit, and the number of shifts per week.

Starting the assignment The organization you will be working for will usually ask you to complete a test to verify your expertise in areas such as

 arrhythmia detection and drug administration. Even though this is a temporary assignment, you’ll still complete an orientation, although it will be shorter than if you were a permanent employee. Travel nurse Gloria Gillman writes that

 in her experience orientation typically involves shadowing a nurse for 2 days before functioning independently. She advises nurses to walk the unit several independently. She advises nurses to walk the unit several times to become familiar with
the layout. In addition, flexibility and friendliness are keys to establishing productive relationships and promoting a good experience.

Liability considerations You will need to be licensed in the state where you’ll be practicing. This is easier if your “home” state is part of the Nurse Licensure Compact, which allows any nurse who resides in a participating
state to practice nursing in another member state. The National Council of State Boards of Nursing has a map of contract states at https://www.ncsbn.org/nurse-licensure-compact.htm.
If your state isn’t part of the compact, you’ll need to apply for a license; but your travel company can usually help with this.  

While on assignment, you’ll need to adhere to the laws and regulations in the state where you are practicing. Pay particular attention to the state’s Nurse Practice Act since the nursing scope of practice can vary by state or territory. You’ll
also want to visit the State Board of Nursing’s website, which typically contains good information related to expectations related to practice. 

Follow the policies and procedures of the organization. Failure to do so leaves you open to litigation should patient harm occur. In addition, remember that your supervisor and colleagues will not be as familiar with your expertise as would
be the case with a permanent job. If you’re given a task or assignment that you don’t feel qualified for, speak up. Describe what it is about the task or assignment you don’t feel equipped to handle, the reason for your feelings, and the
training or accommodation you would need to be more confident and better prepared. 

A new world Travel nursing can open a new world of opportunity for those who are flexible and confident in their skills. By understanding expectations and taking steps to protect yourself against liability, you can
enjoy multiple rewarding experiences and grow as a nurse. 

References 

Gillam G. Travel nurse essentials. Am Nurse J. 2021. https://www.myamericannurse.com/travel-nursing-essentials/ Morrison D. The adventure of travel nursing. Am Nurse Today. 2018. https://americannursetoday.mydigitalpublication.com/articles/the-adventure-of-travel-nursing  NSO. When to refuse a nursing assignment. 2017. https://www.nso.com/Learning/Artifacts/Articles/when-to-refuse-an-assignment Schmidt K. The ultimate travel nursing contract checklist. BluePipes. n.d. https://blog.bluepipes.com/ultimate-travel-nursing-contract-checklist/ 

Disclaimer: The information offered within this article reflects general principles only and does not constitute legal advice by Nurses Service Organization (NSO) or establish appropriate or acceptable standards of professional conduct.
Readers should consult with an attorney if they have specific concerns. Neither Affinity Insurance Services, Inc. nor NSO assumes any liability for how this information is applied in practice or for the accuracy of this information. This risk management
information was provided by Nurses Service Organization (NSO), the nation’s largest provider of nurses’ professional liability insurance coverage for over 550,000 nurses since 1976. The individual professional liability insurance policy administered
through NSO is underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company. Reproduction without permission of the publisher is prohibited. For questions, send an e-mail to service@nso.com or call 1-800-247- 1500. www.nso.com.