By Sarah Gaines
As a new travel nurse, my worst fear was being hired on a unit that was unsafe. My definition of “unsafe” — increased nurse-patient ratios that don’t follow the recommended guidelines, outdated policies and/or procedures that put patient safety at risk, and even nurse bullying.
Since there’s a nursing shortage all across the U.S., any nurse can run into issues that affect patient safety when an assignment does not meet appropriate nurse-patient ratios. Unfortunately, travel nurses tend to run into this problem more often. Travel nurses are usually hired when a hospital is in dire need of staff, so finding yourself on a unit that is extremely short staffed is not uncommon.
Pro tip: Ask about nurse-patient ratios in your interview.
Even when I was proactive and asked about nurse-patient ratios in my interview, I still found myself in an unsafe situation. (Unfortunately, the manager I interviewed with as not honest when I asked.)
So, if you end up in an unsafe assignment like I did, here are three steps you can take that will immediately improve the situation.
Once I knew the steps to take when I encountered a problem as a travel nurse, I felt so much more at ease. The key point to remember in each step is to communicate. Appropriate and professional communication can resolve most issues before they need to be escalated.
If you have an unsafe patient assignment, then the first person you should talk to is the charge nurse — they should be able to make an adjustment that is more safe for you and your patients. If the charge nurse isn’t concerned or makes no effort to resolve the situation, then you should escalate to the next person in the chain of command (this is usually the manager and then the director of nursing). If neither of those people are available, you can always contact the house supervisor who is available 24/7.
If you’re dealing with bullying from a nurse, doctor, or other co-worker, you should first approach the person and address the issue as soon as possible. Starting a conversation doesn’t have to be confrontational! But, if you’re afraid the person may be hostile, then you can always include the charge nurse as a mediator and/or witness. You can also report the person to HR and remain anonymous.
Unfortunately, I’ve personally dealt with nurse bullying on assignment. I attempted first to resolve the issue myself (I’m not afraid to stick up for myself!) by approaching the bully in a kind and professional way. Despite my best efforts to resolve the issue, the bullying continued and eventually escalated. I chose to report the person to HR anonymously and they completed an unbiased investigation. It turned out the this individual was bullying over half of the staff and no one had ever reported it.
No matter what unsafe situation you encounter, it’s important to communicate ongoing problems that arise to your agency and recruiter. I always make sure the event is documented the day-of, so it’s fresh in my mind and I don’t forget any details. By emailing the event to my recruiter, there’s also a paper trail of recurring issues. Keeping your recruiter in the loop is important — if your contract gets canceled, the agency will need to have all the details and facts ahead of time, so that they’re able to defend you.
When I was experiencing nurse bullying, even though I reported the issue anonymously, I was still afraid of retaliation. Keeping in touch with my recruiter throughout the process set my mind at ease. Also, emailing my recruiter when every bullying event occurred made the HR investigation smoother. The documentation was validated by other co-workers who witnessed each event.
Many travel nurses (including myself once) don’t know that travel nurse agencies have people dedicated to preventing unsafe situations from happening.
Some agencies have nurse liaisons that are hired to investigate issues that arise and find a resolution. Other agencies provide an emergency hotline in case issues happen on the weekend or at night.
After communicating with the chain of command at work, documenting the events via email and sending to your recruiter, the next person to contact would be the nurse liaison.
Pro Tip: Send a copy of the email describing the issue to the nurse liaison, so that they can immediately start taking the appropriate steps to solve your problem.
When I experienced nurse bullying, my nurse liaison was a great resource. She also was a nurse herself who had personally dealt with a similar situation, making her the perfect person to talk to. I was afraid that my contract would be canceled due to retaliation, but she reassured me that she would take every step to stand up for me if that were to happen.
I’m incredibly grateful for the support I received from my recruiter and nurse liaison who worked as a team to make sure my experience as a travel nurse was nothing short of amazing.
Sarah Gaines, MSN, RNC-OB is a labor and delivery nurse, nurse mentor, and educator that has been a travel nurse for the last three years.
Passionate about travel nursing (14 contracts and counting!), she’s created the 6 Figure Travel Nurse Course to educate and empower nurses to maximize their income so they can work less and travel more.