The Risks to Travel Nurses During the Pandemic

The Risks to Travel Nurses During the Pandemic

Travel nurses are in great demand right now, as they are helping to relieve frontline workers during COVID-19. While health care facilities are doing everything they can to make environments safe, there are still specific risks that travel nurses are dealing with during this pandemic.

Georgia Reiner, Senior Risk Specialist, Nurses Service Organization (NSO), gave us the latest information about what’s happening with travel nurses, what the risks are, and what they can do to protect themselves.

Are hospitals throughout the country calling on travel nurses to relieve frontline workers? Is the main purpose to alleviate burnout of the frontline workers?

Travel nurses are in high-demand across the United States as hospitals work to treat surges of coronavirus (COVID-19) patients. This crisis arrived at a time when nurse staffing was already a concern due to a multitude of factors, including the growing health care demands of an aging population and nurses aging out of the workforce. Therefore, the demand for travel nurses seems to be primarily driven by a need to build up hospital capacity to handle the influx of COVID-19 patients.

Data from different staffing platforms show that throughout the pandemic, travel nurses are in highest demand in areas most impacted by the coronavirus, like New York and Washington State, and certain nursing specialties like ICU/Critical Care, ER/Trauma, and Med/Surg.

Certainly, as the pandemic continues, the sense of burnout among health care workers will intensify, and travel nurses will likely play an important role in helping to alleviate burnout.

This is a different situation for travel nurses. One risk is checking licensing in different states. What can travel nurses do to be sure that their license transfers? If it doesn’t, but frontline workers are still needed, are exceptions being made?

Before deciding to accept a job, nurses need to ensure that their licenses will allow them to practice in that state/jurisdiction. Multi-state licenses are available for nurses who meet the requirements, which include elements like background checks and education criteria. Temporary licenses are also an option—these are generally reserved for travel nurses who have accepted a job in another state and are awaiting their permanent license.

During the nationwide public health emergency due to COVID-19, some statutes and regulations regarding licensure portability may be relaxed or waived, so it is important for nurses to be aware of what the requirements are both during and following the emergency period. The National Council of State Boards of Nursing (NCSBN) has compiled information about the nurse licensure compact and emergency action taken by states, which is a great starting place for information.

When travel nurses are thrust into an unknown situation in a hospital/medical center that isn’t familiar to them, and they are working with systems they’re not familiar with, what’s the best way for them to cope? How can they avoid burnout themselves? Please explain.

Working in a new environment is inherently stressful. Getting used to new processes, technologies, hospitals layouts, and new people can be overwhelming under normal circumstances, and can be amplified during a crisis like COVID-19. Travel nurses should make sure to take time for self-care to preserve their mental health. This is a stressful time for everyone, so don’t be afraid to reach out to colleagues with questions and for support. Failing to make an effort to cope with these rapid changes can have a negative impact on personal wellness and patient care.

What about a nurse’s scope of practice? what can nurses do to make sure that they are acting in the scope of practice? What if the facility allows them to do more than their own state? Does their scope of practice relate to the state they’re in or the one they’re licensed in, or both?

As the COVID-19 crisis rapidly evolves, travel nurses may be given patient assignments outside of their typical practice areas and locations. When faced with situations that exceed the scope of practice for the state in which they are practicing, or the skills or knowledge required to care for patients, travel nurses, like all other nurses, should develop and implement proactive strategies to alleviate unsafe patient assignments. Nurses need to advocate for patient safety and for their nursing license by speaking up if an assignment does not fall under their scope of practice.

When the assignment is within a nurse’s scope of practice, but not within their realm of experience or training, saying “no” to the assignment could lead to dismissal. At the same time, if the nurse does not feel they are equipped to handle the assignment, they could potentially put patient safety at risk. In these scenarios, nurses should tell their supervisor that they have very limited experience in that area and should not be left in charge. The nurse should describe the task or assignment they don’t feel equipped to handle, the reason for their feelings, and the training they would need to be more confident and better prepared.

What changes have occurred during COVID-19 regarding travel nurses and the risks they face that you think should be permanent either for the near future or forever?  

Currently, there are certain state and federal regulations, declarations, and orders that extend liability immunity in the fight against COVID-19. What’s not clear at this time is the breadth and scope of these regulations and orders.

For example, it is not clear if these orders and declarations extend to all providers in all areas of service or if such immunity will be limited and specific to certain types of health care providers. Since there is lack of clarity in terms of immunity, it is prudent for nurses to not presume they have any immunity.

Further, plaintiff’s counsel can file a lawsuit, immunity or no immunity, if the plaintiff’s counsel believes the client was injured and that injury was the direct result of the nurse or other health care professional providing or failing to provide professional services. In the best-case scenario, the suit brought against the nurse will be deemed baseless and their malpractice insurer will work to get the suit dropped/dismissed.

Is there any other information that is important for our readers to know?

The COVID-19 pandemic is still evolving, and there is much we still do not know about the virus. All nurses should continue to follow the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) for updates and guidance to help prevent the spread of the virus and protect themselves and their patients.

How to Keep Your Patients Calm During the Pandemic

How to Keep Your Patients Calm During the Pandemic

With visitors being banned at most hospitals and health care facilities because of the spread of the coronavirus, nurses are often now one of the only contacts that patients have. So how can you help keep your patients calm during this scary time?

Dr. Judi Kuric, academic coordinator for Walden University’s MSN Gerontology Acute Care NP program, and a nurse practitioner board-certified in adult-gerontology, family, and emergency care. She took the time to answer our questions about keeping your patients as calm as possible.

What are the easiest things that nurses can do to help keep patients calm?

Nurses should keep patients informed about their status and treatment plan. There are a lot of scary stories circulating that can increase a patient’s fears about their own condition. Clear, simple, and individualized information will help allay a patient’s fears.

Set expectations and next steps for the patient each day. Identify one or two daily goals to help the patient understand their priorities for the day. Goals could include exercising their lungs by expanding them hourly or walking around the room three times daily.

Provide meaningful distractions such as favorite television shows, movies, or music to entertain and engage the patient and decrease anxiety.

What are some tips that nurses can use to keep patients calm on a daily basis?

Hospital routines and activities like repeatedly checking a patient’s vital signs can increase their stress. Counteract this by providing reassurance on their physical status. Give feedback when their status is stable or better. If a patient’s physical status is worse, help them understand the plan for improvement. Provide ways patients can help themselves and involve them in developing goals. These can be as simple as taking 10 full, slow, and deep breaths every 30 minutes.

Many facilities are playing uplifting songs or classical music throughout the hospital or unit several times a day.

Encourage contact with family and friends using social media.

What can nurses say to patients?

Open, honest, and calm communication is always best. A patient’s imagination can add to their fears about complications or outcomes that may not apply to them. Engage patients in discussions about their fears and try to address each one. Build continuing and meaningful dialogue with the patient by asking them about a family member, a favorite vacation, or their hobbies. This helps you learn more about the patient and also engages them in positive memories.

How should nurses act around them to keep them calm? Confident? Use calming voices?

The stress nurses are feeling has increased in the pandemic. The pandemic means nurses are providing higher levels of care that require additional equipment, procedures, and safety measures. Restrictions on visitors mean nurses must strive to fill the void for conversation, compassion, and smaller tasks that comfort patients.

Avoid passing on your own stress and anxiety. Try to refocus as you enter each patient’s room; use a calm voice, and make sure your activities seem unhurried. Don’t talk with patients about your stresses.

Nurses need to take care of themselves. If your stress level is lower, you’ll be less likely to pass on your worries to patients.

What can nurses encourage family and friends to do to help the patients stay calm and more relaxed? Write letters? Use social media? Facetime?

Now is the perfect time to use social media. Have set times for family members to video chat with the patient, and ask loved ones to send emails or post on social media. If hospital policy allows it, provide the patient with pictures and letters.

It’s important to encourage families to be calm and use their interaction time with the patient to be positive and supportive. This isn’t the time to detail all the anxiety they are feeling or the stressful things happening at home.

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