Healthcare Professionals

Patient Safety Culture & Navigating Unsafe Assignments


September 14, 2022

Patient safety culture in healthcare is a hot-button topic these days. If you talk to almost any healthcare professional, they will undoubtedly tell you their workload has increased while the focus on patient safety has drastically decreased. In short, healthcare professionals are simply being asked to do more, with fewer resources.

As a traveler, it is usually assumed that whatever unit you are taking a contract for is short-staffed, and as a result, you may experience this more regularly. However, there is a fine line between being short-staffed and expected to work hard versus being expected to work in unsafe conditions.

How to Identify an Unsafe Assignment & Poor Patient Safety Culture

If you are not sure whether or not your current assignment is unsafe or simply short-staffed, here are a few questions to ask yourself:

  • Are you able to regularly check orders to make sure you aren’t missing changes?
  • Do orders get completed in a timely manner?
  • Are you constantly having to give medications late, skip important tasks, or forgo basic care like regular baths due to lack of time?
  • If you find yourself stuck in a patient’s room or off the floor, are you confident your other patients’ urgent needs will be addressed?
  • When you bring up concerns with other staff, do they acknowledge that things are difficult or unsafe in their unit?
  • Are you spending an excessive amount of time after each shift charting?

If your answer to more than one or two of those questions is a resounding “YES,” then there is a good chance your assignment is unsafe.

Understanding Your Options in an Unsafe Environment

What happens if you feel an assignment is dangerous enough that breaking your contract feels like the only option? In unsafe scenarios, keep these tips in mind to protect yourself as a healthcare professional while promoting patient safety culture.

First and foremost – keep an honest conversation running with your recruiter.

The best thing you can do when you are feeling like there is a patient safety concern is to bring it up with your recruiter and/or clinical liaison as soon as possible. It is best to do this in email form so you can have a paper trail to keep track of the dates and times your concerns were raised.

Next – ask your recruiter what the company protocol is if you feel unsafe or that your license is at risk.

This is a tricky piece to navigate, and also why it is imperative to maintain a good working relationship with recruiters you can trust. Ideally, your company will support your professional judgment and offer options.

Your company may offer to let you leave effective immediately, or they may offer (or require) a two weeks notice. In the event that they do offer a two-week notice, they can also send a list of acceptable patient safety standards that are to be adhered to for the remainder of your contract. For example, they may specify max patient assignment numbers or floating guidelines.

If they won’t support you – you need to do what you know is safest for you.

Unfortunately, there are too many staffing companies out there to know exactly how each one will react to individual situations. The reality is, a company may be more concerned about supporting its relationship with a hospital or vendor rather than supporting its healthcare staff.

You should know going in that you may not receive unwavering support, and that doesn’t mean you are making the wrong decision. You are making the difficult and brave decision that you know is best for safety in the healthcare industry.

Consider how to navigate the situation financially.

While there is always a risk of contract cancellation and sudden loss of income as a traveler, it is still never fun to find yourself unexpectedly unemployed. Once again, your company may have a policy for when they will begin to re-submit you for jobs if you decide to give notice. Be sure to communicate with your recruiter if you will need to find a new position as soon as possible, so they can find the best fit for you.

If your recruiter and company support your decision, keep in mind that it is respectful to at least consider the jobs they will be offering. The absolute worst thing you could do is leave a job suddenly to take a contract with a new company, especially if you aren’t having an open, professional conversation with your current recruiter.

If you feel unsafe, depart professionally.

Regardless of how your decision to leave is received by the unit or even by your company – it is ultimately your decision. If you don’t feel like you can keep your patients or your license safe, you can make the decision to leave.

Remember that your choice to stand your ground in an unsafe situation is not the reason your coworkers are being overworked. It is the culture of safety within that unit or organization that is allowing patients to be put at risk continuously.

Stay Safe While Keeping Patient Safety Culture Top-of-Mind

While all of this seems very hard and heavy to navigate, know that assignments that are truly unsafe are a lot fewer and far between than you would think. Will you work harder as a traveler in units that are more desperate for staff? Absolutely. But the flip side of that is those units and facilities are aware they need help and are taking proper steps to address that issue.

The beauty of being a travel nurse in these scenarios is that you get to be in charge of your path. You are not stuck in any job, and you have a tangible way to take a stand and speak up when you feel like patient safety culture and standards are not being prioritized.

Thank you to Kamana partner Alex McCoy for contributing to the content of this blog.

Alex McCoy has been a PICU travel nurse and writer for the last six years. She currently travels with her husband and two daughters in a travel trailer. She loves good wine, coffee, and getting outside to explore National Parks. Alex can be reached via Instagram @alexmccoy_rn, or by email at

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