We’re going to discuss the Documentation and the Compliance process. I know what you’re thinking; documentation sucks and this has got to be the most boring topic in the world! However, I think you’ll find our discussion quite interesting and we’ll definitely provide some actionable information that you can put to use to simplify this process.
First, we’re going to discuss the technical aspects of managing your documentation. We’re going to talk about some apps and other details that will help you simplify. Next, we’re going to look at the four main categories of travel nursing documentation, Licenses and Certifications, Clinical Records, Standard Paperwork and Hospital Specific Paperwork.
HOW TO MANAGE YOUR TRAVEL NURSING PAPERWORK
So, let’s jump right in with the technical aspects of travel nursing paperwork. Now, when we talk about the technical aspects, we’re talking about the aspects that you control, things like copies of your licenses and certifications and other important documents that are in your possession. We’re going to provide some tips on how best to manage them from a technical standpoint.
FILE SIZE FOR TRAVEL NURSING ELECTRONIC DOCUMENTS
First, it’s important to remember that email services typically have file size limits on the attachments you send. So, if you attach compliance documents to an email and the size of the attachments are too large, then your email will either not get sent, or not get accepted on the other end.
The standard limitation is 25MB.
You can get around this by using file sharing applications which we’ll discuss in a bit, but these limitations still make it very useful to make sure that you’re keeping your file sizes smaller as opposed to larger.
What happens is that many travelers will scan their important documents as image with the highest resolution setting and their files will end up being 3 to 4 megabytes each. All you need is 7 or 8 of these to get to the 25 MB size limit.
So, here are some tips for keeping file sizes smaller.
First, check the settings on whatever hardware or application you’re using to make sure you’re using a reasonable resolution setting. There’s no need for optimum settings.
Second, scan to PDF whenever possible. This is good for file size as well as many other issues.
Third, if you already have large files, then there are plenty of applications that will allow you to reduce them. TinyPNG and ImageOptimizer are two commonly used applications, but you can also use a program like MicroSoft Paint which comes standard on all Windows Operating Systems. All of these applications are really easy to use, simply load or open the image in the application and select the resize option you want.
APPS TO HELP MANAGE YOUR TRAVEL NURSING DOCUMENTS
With this in mind, let’s move on to some of the simplest ways you can manage your compliance documents electronically. Of course, PCs and Printers have features that allow you to scan and store your documents and you can certainly use them. However, they have limitations. Mainly, these typically aren’t items that you’d take with you everywhere you had to go. And ultimately, you’re going to mess with important documents at some point when you’re not around your PC and Printer.
So, let’s take a look at 3 types of applications that will help. Essentially, we need to be able to do four things, store documents, share documents, sign documents and scan documents.
This first set of apps helps you store and share documents. We’re talking about DropBox, Google Drive, Microsoft’s One Drive and Box. Now, each of these are relatively similar. The general idea is that they let you create an account, store documents on their servers, and access those documents anywhere you have an internet connection. So these applications work across all your devices, you just need to load the apps for them on your devices, or visit the application websites. They also let you share the documents by inviting people to have access to selected file folders, emailing documents, or sending links via email so that people can access the documents.
The next set of apps helps you scan documents by turning your smartphone or tablet into a scanner. The main ones are CamScanner, TinyScan, GeniusScan and TurboScan. I believe that camscanner is the most popular. You can scan documents to multiple file types and you can even store your documents in your document storage system right from the app.
The third set of apps helps you sign documents right on your smartphone or tablet by allowing you to drag your finger like a pen or pencil. These are apps like Docusign, CudaSign, and SignEasy. Now, Docusign is probably best for travelers because it’s free to sign documents which is all travelers really need to do. These apps will also let you save documents right to your document storage applications, but that typically costs extra.
MANAGING THE 4 TYPES OF TRAVEL NURSING DOCUMENTATION
So that covers the technical aspects of documentation, now let’s take a look at the types of documents we’ll be engaged with. There are four basic document types: Licenses and certifications, Clinical Records, Standard Employment Documentation and Hospital Specific Documentation.
TRAVEL NURSING LICENSES AND CERTIFICATIONS
Let’s take a look at licenses and certifications first.
There are a couple of things to know that will save you tons of time, trouble and money down the road.
First, be sure to obtain your certifications from the most widely accepted certifying body covering the certification in question. For example, get your BLS and ACLS from the American Heart Association. This goes for almost any certification that they cover, like PALS and others. If you’re getting a fetal heart monitoring certification, then make sure it’s through AWHONN.
Second, be sure you sign the certifications everywhere it’s indicated to do so.
Finally, always make a front and back copy of your licenses and certifications.
It’s best to copy multiple nursing licenses and certs on one page to save time and space.
It’s also important to note that there are some nursing certifications that are commonly required for travel nurses, that aren’t as commonly required for permanent nurses. Remember, as a travel nurse, you’re going to be moving from hospital to hospital. So it’s always best to have all the bases covered because it opens more potential nursing job opportunities. Rather than bore everyone with a list, we’ll link to blog post about this topic in the show notes.
TRAVEL NURSING CLINICAL RECORDS
Next, let’s discuss your clinical records. Basically, we’re referring to your medical records.
The single most beneficial piece of advice is to obtain and keep copies of EVERYTHING.
When you get any exam (even a yearly physical exam) or test done, ask the provider how you can get a copy of the results. This is obvious if you’re getting the test done on your own. However, it’s not so obvious when you’re getting it done through an agency.
Many people think that they will be able to get a copy from the travel nursing agency when they need it. This Is not the case. Some agencies give them out with no problems, but others refuse to. They view them as proprietary. This leads many travel nurses to claim that the agency is obligated on HIPPA laws to provide copies. They are not. HIPPA covers the provider of services, not employers. So get a copy from the provider. They are obligated to provide them for a nominal fee at most.
Now, the reason that it’s so important to save all the copies you can is that things have gotten pretty nitpicky out there over the last few years. For example, some places will only accept titer results in certain formats. Or they require very specific verbiage for chest x-rays. So therefore it’s better to have more than less.
Also, you never know when you’ll find yourself in a bind. Even the best of nurses can have a travel nurse contract canceled. So being ready to go at the drop of hat can help save you from potential financial loss. When you’re in a bind, it’s much better to land a nursing job in a week than it is to land one in 3 weeks just because you didn’t have the necessary documentation.
Finally, it’s always a good idea to try and get documentation taken care of at your hospital when possible. So if you currently have a perm position and are transitioning into travel, then get as much documentation taken care of as you can. Your hospital will often be the most convenient place to get the tests done and may even be free. Travel nurses can also benefit from this on rare occasion.
TRAVEL NURSING STANDARD EMPLOYMENT DOCUMENTATION
Okay, now let’s talk about the standard employment documentation. Here we’re talking about employment documentation like your I9 and W4 as well the standard set of tests that are common like a Unit Test, a HIPPA Exam or an OSHA exam.
When it comes to employment documentation, some agencies are happy to have the travel nurse fill these items out online, or just receive copies of completed documents. However, there are some agencies that will only accept notarized copies of these documents. To me, that’s undue burden on the travel nurse, but if you run into it, you should demand that they cover the costs involved.
Now let’s shift gears to the standard testing documentation for which there are several things to know.
First, it’s fairly common for agencies to require the following to be updated annually: a specialty skills checklist, a unit exam, a core mandatory exam that encompasses Joint Commission required mandatory education on 7 different topics, as well as a National Patient Safety Goal examination. Sometimes travel nurse agencies even require clinical references to be updated every few months.
Now, some of these are required by JCAHO and some are not. Those that aren’t required by JCAHO are typically required by hospitals.
It’s important to point out that JCAHO doesn’t certify exams as being JCAHO compliant. They certify healthcare providers not testing. They actually leave healthcare providers with a lot of leeway as to the testing they utilize.
Therefore different agencies can use different exams. Some exams are more labor intensive than others, but in the end, they’re all acceptable exams.
Now, there are a few major players in the testing market. These services like Prophecy and API, are purchased by agencies so that agencies don’t have to worry about developing their own exams. Sometimes, you can download the results of your own testing. This is very beneficial to have as many agencies will accept these documents so you don’t have to fill them out over and over again.
Remember, the tests are good for 1 year, but if you change agencies, then you’d have to take them all over again, unless you have your results. So download those documents if you’re given a chance as it could potentially save you from hours of paperwork.
TRAVEL NURSING HOSPITAL SPECIFIC PAPERWORK
Okay, now let’s talk about Hospital Specific paperwork. This is paperwork that is specific to a particular hospital that the hospital requires to be completed. This has grown immensely over the last few years.
In some cases, hospitals require mounds of additional forms and paperwork to be completed before you even get there.
Many nurses wonder if it’s even legal for them to require this without paying. In most cases it is legal and we’ll link to an blog post discussing that issue in the show notes.
Sometimes though, hospitals allow the agency to bill for the time it takes to complete the travel nurse paperwork. Other times, they do not. It’ll be very difficult for travelers to know when this is the case. However, in the vast majority of cases, the travel nurse agency will pass the money onto the traveler if they are able to bill for the time it takes to complete the additional forms.
Finally, there is often more travel nurse paperwork that gets filled out during orientation, which is okay, because you should be getting paid to do it. However, sometimes there are tests that must be passed or the traveler’s contract is canceled. The most common ones are the PBDS exam and an EKG exam. You want to find out if these or any other tests are required by the hospital prior to accepting a contract or showing up at the facility in order to get properly prepared.
Managing Documents Physically
Even though we’ve talked about storing your travel nursing documents electronically, it’s also a good idea to have physical copies. Not all, but most facilities require that you provide physical copies of documentation during your orientation. This can include your driver’s license, basic life support (BLS) card, immunization records, and valid nursing license. When storing physical copies, keep everything in a file folder or organizer and make sure to label everything. Also, it’s a good idea to give a physical copy of your records to someone you trust, like a family member, in case of an emergency.
Want an Easy Way to Keep Track of Travel Nurse Requirements?
While there are many smartphone apps out there for tracking documents, HCTN offers On Demand, which is an app specifically designed for travel nurses. After downloading the app, you can search for open job postings, set up alerts, or talk to a travel nurse recruiter. Create a profile with your skills checklist, your travel nurse assignment needs, and any additional forms. The On Demand app even offers a document upload feature, where you can snap pictures of your licenses and certifications. They are readily available for your documentation specialist to review with any new travel assignment. The app tracks license expiration dates as well, which is a great feature if you hold multiple state nursing licenses.
If you’re applying or on assignment for any travel nursing job, it’s crucial to have all the required documents. Keep physical copies and bring them along with you to your first day at your new travel nurse assignment. Keep electronic versions as a backup and for sending required documentation electronically.