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How to Break a Travel Nurse Contract or Deal with a Cancellation

Jan 5, 2021
Emma Pointer, MSN, RN

While it’s never ideal that a contract is broken, or terminated prior to the expected end date, there are certainly circumstances in which it may become necessary. When a contract is ended before completion, regardless of the reason, it can be a loss to everyone involved — the employee, facility, patients, and agency (employer).

Contract, or contingent, employees—travel nurses—are primarily engaged by facilities to help fill gaps in staffing related to leaves of absence, seasonality, and quickly, and sometimes unpredictably, changing hospital censuses. And just as hospital census can change quickly, so can the circumstances of those nurses who commit to contractual employment. 

As a professional not wanting to burn bridges, cause unnecessary consequences, and optimize for future employment opportunities, it’s helpful to be informed of making the decision to cancel a contract.

Here, we’ll dive into the main reasons for contract cancellation, initiated by both facilities and nurses, as well as things to keep in mind prior to canceling your contract.

Why Do Nursing Contracts Get Canceled? 

Not surprisingly, the top reason for hospital-initiated contract cancellations is census driven. Nearly 72% of facility-initiated cancellations in 2020 thus far have been related to low census. And equally as unsurprising, a majority of nurse-initiated cancellations during the same period of time have been related to personal matters.

In 2020, roughly 71.4% of cancellations and terminations were by facilities compared to 28.4% by nurses.

Most recently in 2020, due to the COVID-19 pandemic, unpredictability and sharp increases and declines of nursing needs and extreme circumstances for nurses resulted in a 13.7% increase in the likelihood of a contract to result in termination or cancellation. 

This trend has a significant impact on all parties involved and doesn’t seem to be one we can expect to go away anytime soon. 

While it is an unprecedented time, contract cancellations and terminations are pervasive and it is important to understand the why and what you can do to protect yourself and the relationships that you have with both current and future employers. 

Protecting Yourself from Facility-Initiated Cancellations

Preparation and Flexibility

As a nurse, and even as a travel nursing agency, we have little to no control over hospital census and budget. Therefore, we need to prepare the things we do have control over. The key to being a travel nurse is preparation and flexibility.

Understanding the temporary nature of their work and employment, this nurse travels light, cheap, and keeps their options open for wherever their next adventure takes them. While that’s realistic for a free-bird nomad with few responsibilities, anchors, bills, and a plethora of licenses and bucket list locations, we know that isn’t realistic for everyone. 

Since census change is the largest variable here, and it’s also something you have no control over, the most important factor in protecting yourself from facility-initiated cancellations is engaging in minimization of loss through preparation.

pie graph reasons facilities cancel travel nurse contracts

The Particular Assignment

The first thing to consider is the risk of the specific assignment. It is key to understand that as a travel nurse, while you are contacted for a certain estimated time, cancellation is possible and is more likely with riskier assignments. 

It should be noted that any crisis assignments, short term assignments, and exceptionally high-paying assignments carry the highest risk of cancellation. This is because those factors are usually driven by unpredictable circumstances. Thus, the labor that hospitals bring in to handle those circumstances are expensive and the first to go as soon as things return to normal.

Your Investment in the Assignment

The second thing to be mindful of is your investment. As a temporary worker, your investment should be as temporary as possible. The biggest consideration here is likely housing. With the potential for cancellation, short-term and flexible housing is highly recommended. 

You can create insurance for yourself by assessing whether it might make sense to pay more for housing arrangements that are shorter term or that have more flexible cancellation policies in case contract cancellation does happen. 

Whatever you decide to invest in for a particular assignment, whether it be housing, a car rental, or return transportation arrangements, realize that the investment does carry risk and do your best to minimize those risks accordingly.

Stay Observant!

The third consideration is to be observant (without being paranoid!). Knowing these risks, be observant throughout the whole process from interview, to orientation, to your time working on the floor. 

Thing to think about:

  • What impression do you get in the interview?
  • What investment does the facility make in you through your orientation?
  • What trends are seeing in census and staffing? 

Most of these observations should be able to help you decide what and how much to invest in the assignment in turn or how far in advance you can start preparing or considering other options. If you are already investing the bare minimum for your circumstances, these observations may just act as reassurance that you are taking the correct steps to protect yourself. 

Minimizing Impact on Relationships with Nurse-Initiated Cancellations

Life happens; we know. Thirteen weeks can be a long time when your world is crumbling back home or you’re working on a unit that you feel is outside of your comfort zone or poses a risk to patient safety. Canceling a contract and leaving your assignment early is a heavy and difficult  decision that can have a major impact on the future of your career if not considered seriously and holistically.

pie graph reasons nurses cancel travel nurse contracts

Communicate

Number one is always communication. As soon as you have concerns, whatever they are related to, ensure you escalate them appropriately. If there are concerns related to the facility or work environment, ensure you professionally communicate these to your manager. 

Additionally, it’s important to let your Trusted Clinical Success Partner or agency know, as they can ensure you receive the support and advocacy necessary. Where possible, they are going to work together to avoid cancellation. 

If your concerns and needs are personal and unrelated to the facility or contract, it’s possible your manager can give you time off (within reason) to address your personal needs or can be flexible with your schedule, especially if you’re willing to extend the end of your contract to account for that time. 

If you are feeling unsafe or unsupported on your unit or have attempted escalation of your concerns to your manager to no avail, your Clinical Success Partner can help support and advocate. However, in order to do so as best we can, communication early and often is important! 

The only way that you can get help is if you surface the issues. If you fear retaliation at the facility, have a conversation with your agency contact to discuss options. Additionally, if issues come up, you should communicate your needs and ask for your concerns to be addressed first if they are manageable. 

If you are seeing safety concerns at the hospital, report them to both parties in case those concerns continue and result in cancellation down the line. The documentation of those past concerns and attempt to rectify before getting to the point of cancellation will be key. 

Share Notice

If cancellation cannot be avoided, any notice that you can provide is incredibly important and appreciated. Leaving a contract with no notice should be reserved for the most severe of emergencies. When a travel nurse cancels a contract effective immediately, they put a facility who is already likely short staffed in an even bigger staffing crunch. 

This can leave the other nurses on the unit and the patients at the hospital in a poor situation for many weeks as it takes time to interview, onboard, and orient a replacement travel nurse. The more heads up you can provide to the facility the better. This means not letting known safety concerns get so severe that you are needing to cancel immediately. 

In communication with your manager, you may find that you want to leave and they are overstaffed not needing your help anymore. You then may be able to come to a mutual agreement to terminate your contract early.

So, cancellation is happening, ready or not, you can’t help it. Focus should then shift to working with the applicable parties to minimize damage to relationships. There are typically four parties that you will want to consider the impact that cancellation will have on your relationship with.

Parties Involved in a Cancellation

The Vendor (Managed Service Provider)

Managed Service Providers (MSPs) are all of varying size and have varying rules on how they nurse initiated handle cancellations. Since MSPs tend to be regional, ruining your relationship with one should not be taken lightly. At times they will mark nurses “DNR (Do Not Rehire)” at all facilities they staff. 

If you are working through a large MSP or one that staffs most hospitals in your region this can be highly detrimental to your travel nursing career and significantly limit where you are able to get contracts moving forward. 

The Hospital and Health System

Having a bad experience with a traveler who left without explanation or notice may result in a hospital or health system choosing to mark you as a DNR for their facility/facilities in the future. All hospitals and health systems have different rules around this but if this is a place you may want to return in the future, so this is a relationship that you should attempt to protect. 

Your Travel Agency

At Trusted, any cancellation, nurse or facility initiated, is reviewed by an internal clinical review team. That team uses the Termination Policy & Point Scale (see page 64) to review the case and decide how to proceed. The team may assign points towards termination and provide suggestions and coaching for professional and clinical growth moving forward. 

If severe enough, Trusted may decide not to work with a nurse in the future. All agencies handle cancellations differently, so be sure you know what to expect. Also, agencies can be fined by hospitals and MSPs if their nurses cancel contracts. At Trusted, we never pass those fines onto the nurse but some agencies will. 

Your Future Employers

Not to be overlooked is your relationships with future employers. Before canceling a contract, consider how it will look to future employers. Some employers require recent references from your last place of employment or may notice and question a short employment listed on your resume. Consider how you will explain this occurrence and how you can ensure that you will be able to note you handled the situation in a professional and appropriate manner.

At the end of the day, you are more than a resource. Your safety and mental and physical health should be of top priority. No job or contract is worth risking that over. Be sure you are working with employers and people who recognize and respect that so that when things don’t go as planned, your openness and honesty is utilized to create the best outcome for all. 

If you are communicative with your needs and work with all parties to handle the situation in the best way possible, relationships are easier to preserve. Ultimately, in an unsafely staffed unit and a staffing crunch, patients are the ones who suffer so anything you can do to prevent that is for the greater good.

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