Travelers Are Liable, Too

Accidents happen. But what if one happens while you’re a traveler on assignment?

Liability is often the last thing a traveler thinks about as he packs his bags for the next exciting destination. Life, however, isn’t quite so simple. Travelers should know key points about their liability on assignment and how to protect themselves financially from lawsuits.

You’re no different than anybody else when it comes to liability.

Travelers are as liable in the case of medical malpractice and other incidents as any hospital staff person, says Bonnie V. Custen, RN, MLC, LHRM, CPHA, CLC, corporate risk manager, Cross Country, Inc., a provider of healthcare staffing services.

Take it upon yourself to learn about each hospital’s policies and procedures.

While hospitals are responsible for familiarizing travelers with their individual policies and procedures, travelers also have to take some responsibility for knowing a hospital’s rules. Travelers cannot claim ignorance, says Richard Ives, treasurer, Cross Country, Inc.

Custen recommends that travelers embarking on new assignments at least flip through the policies and procedures manuals of each hospital they travel to. “Even if it’s in their spare time, travelers should familiarize themselves not only in the orientation of the policies and procedures of the facility, but also the policies and procedures of their specific floors,” says Custen.

Travelers shouldn’t assume that policies and procedures are the same among hospitals — they generally are not, Ives notes.

Go to your travel company first in the case of a medical error or other litigious incident.

Everyone, including travelers, is liable in the situation of a medical error.

A traveler involved in any way with a serious incident, sentinel event — even a remote possibility of a lawsuit — should first fill out a hospital incident report. These reports never involve having the traveler offer opinions, says Custen.

The traveler then should cooperate with making notations in the nurse’s notes in the chart.

After that point, the traveler is not responsible and should not make any written or verbal statements about the incident, says Custen.

“They should immediately call their travel company to report these incidents so the travel company can report the incident to the insurance company and take care of the traveler,” she says. “They should not agree to do an interview with the facility, an interview with an attorney — even a risk management root-cause analysis. These things are to be directed to the travel companies. The most important thing that travelers need to remember is that as long as the travel company is paying that traveler, the traveler is the travel company’s employee — not the hospital’s.”

Being covered under the travel company’s insurance doesn’t protect you completely.

Many travelers don’t realize that they should have automatic liability insurance when they sign on with travel companies. In addition to knowing that the coverage exists, they should know what it does and does not cover.

“We have two types of nurses: those who are working as our employees, on our payroll, and those we call ‘mobile nurses,’ who become part of our client hospitals’ payrolls,” says Ives. “If they are working as a mobile employee, then we look for the hospital to be their primary coverage provider, but our policy would cover them as a secondary policy if the primary coverage wasn’t sufficient. If they are on our payroll, we provide the primary coverage.”

Despite having coverage from their employers, travelers should also carry their own personal medical malpractice policies, says Ives. “It’s very inexpensive, and it will cover them for those periods when our coverage will not,” he says. Many can get policies for less than $100, he says.

Travelers are covered by employer coverage as long as incidents happen while they are on the job, performing duties for which they have been contracted to perform. The trouble starts when things happen on the traveler’s off-duty hours.

Say a traveler comes to the aid of a person who is sick on the street during her day off, she will not be covered by her employer’s coverage should a lawsuit result. “What most nurses believe is that the when nurses come to the aid of someone on the street they will be covered under the Good Samaritan law,” says Custen. “Well, Good Samaritan laws in all states are different. Also, in order to be covered under the Good Samaritan law you can do only what is within your own scope of practice under your license. If someone is dying in front of you and that person needs a tracheotomy and the nurse is not supposed to do a tracheotomy, the nurse is liable if something goes wrong — even if she knows how to do a procedure.”

Nurses and other travelers should not believe the myth that by not carrying personal malpractice insurance they are less likely to be named in a suit or pursued for large settlements. That’s not true, says Custen. “What is true is that you need to make sure that you’re covered wherever you go and whatever you do — not just at work,” she says.

A note to hospitals.

Hospitals, like the travelers that work with them, should also report incidents to travel companies.

According to Custen, it’s also important that hospitals first check to make sure a traveler is with a particular company before turning the information over to an attorney. “You cannot imagine the number of phone calls and letters we get, and the nurse is not our nurse — either the nurse was not working for us at all or at that time, or she wasn’t working on that floor that night,” says Custen. “Hospitals should first go to the human resources department, find the traveler’s file and contract, and confirm that he or she is in fact a traveler with a company. That saves the lawyer, hospital, and us a lot of hours of research.”

The travel company is your friend and protector.

Travelers should know that their travel companies are their employers and the companies travelers need to depend on through any kind of liability incident. Proper reporting of incidents to travel companies help to ensure a fairer process for the traveler, says Ives.

This applies, he says, whether a traveler considers an incident to be serious or not. Seemingly small incidents can turn into big lawsuits as much as two years after an incident occurs. And travelers should know that if they were no longer with the travel company or hospital years after an incident has occurred and a lawsuit has been filed, the traveler would still be covered under the employer’s malpractice policy. It’s best for travelers to keep in touch with travel companies with their whereabouts if there is an incident that might evolve into a lawsuit.

What we tell our nurses is that if you get involved in any situation and let us know about it, we are your friend until its conclusion,” says Ives.